On October 23, workers from various healthcare sectors—especially primary care providers, who are responsible for community-based prevention and health promotion initiatives—gathered in front of Rio de Janeiro’s City Hall at the “Not One Worker Less” demonstration. The event was organized by the Union of Nursing Assistants and Technicians of Rio de Janeiro (SATEMRJ) to call for solutions to budget cuts by Mayor Marcelo Crivella. The workers occupied a lane of Avenida Presidente Vargas in downtown Rio and walked to the Central do Brasil train station, chanting ‘’Hey Crivella, don’t take healthcare away from favelas or from the ‘asphalt’ [formal city]!’’ Demonstrators also cited the mayor’s statements, upon taking office, that he would “take care of the people.” Everyone was very engaged, and also concerned, seeking strength in numbers in order to be heard and valued. Some professionals were inclined to strike, such as nurses, who announced a cease-work strike starting on October 29. Crivella did not comment on the demonstration. On the same day, via social media, he announced the resumption of construction work on a Family Health Clinic in City of God, which is scheduled to be launched in three months.
One of the public servants’ demands is the full payment of delayed salaries since many of them are contracted through Social Health Organizations (OSS)—privately-run public health companies—that depend on the disbursement of funds from City Hall to pay employees. On October 9, some Family Clinic workers received the news that they would receive payment for only 5% of the value of their salaries. Additionally, employees from other healthcare sectors, such as hospitals, complain of delays and nonpayment.
Threats to Reduce the Number of Family Health Teams
Another reason for concern is the threat to reduce teams of healthcare workers, thus resulting in layoffs—as confirmed by Paulo Messina, secretary of the Chief of Staff’s Office. If approved, the de-accreditation of these teams would further overburden healthcare workers and decrease the quality and availability of primary care services. Messina stated that the cuts will be based on the Social Development Index (IDS)—which takes into account factors such as income, basic sanitation, waste collection, and illiteracy rates—therefore prioritizing more vulnerable areas and cutting resources in locations with higher indices.
Ronaldo da Silva Moreira, president of the Union of Community Health Agents of Rio de Janeiro (SINDACSRJ), questioned: “How much longer will we stand this? How much longer will you, the population, endure this? We have to say ‘enough.’ We have to demand our rights: dignified healthcare for all with workers who are respected and valued.” The event organizers emphasized the importance of the participation of both workers and beneficiaries of the Unified Healthcare System in future acts.