### Doctors’ strike in Kinshasa: Towards a polarization of emergency rooms revealing a health system in crisis
On January 4, 2025, tensions are rising in the health sector in Kinshasa. Doctors from the National Union of Doctors (SYNAMED) have chosen to continue their strike through a new strategy: the polarization of emergency rooms. In an interview with Radio Okapi, Dr. Patrick Boloko, provincial executive secretary of SYNAMED, explained the modalities of this symbolic action which will have significant repercussions not only on the management of care, but also on the future of the Congolese health system.
#### A crisis that is intensifying
The decision to polarize emergency rooms is based on specific demands. In particular, the doctors are demanding that 1,000 of them be brought into line with the professional bonus as well as the payment of a second level concerning housing and transport. These grievances highlight how crucial the issue of working conditions and remuneration is in a country where the medical profession remains one of the fundamental pillars of public health.
The financial difficulties faced by Congolese hospitals are not new, but they have only worsened in recent years, exacerbated by factors such as the COVID-19 pandemic and chronically inadequate infrastructure. The polarization of emergency departments, which will result in alternating care between a few public hospitals, shows a cornered health system, where medical staff must increasingly improvise to meet the needs of the population.
#### Polarization of emergency departments: a symbol of social emergency
The polarization of emergency services means that only two hospitals will operate every 48 hours. This situation inevitably has disastrous consequences for patients, who are forced to navigate from one hospital to another to receive care. It is a strategy that, although pragmatic, highlights the absurdity of a system that, instead of guaranteeing equal access to health services, forces doctors to set priorities that the population should not have to endure.
Indeed, this crisis is indicative of a great malaise in the management of public health. Did I mention that the Democratic Republic of Congo has one of the lowest rates of doctors per 1,000 inhabitants in the world? According to the World Health Organization, only 0.09 doctors per 1,000 inhabitants are available, which underlines the need for deep and urgent reform.
#### Impact on public health: a broader analysis
Through this strike, we are also witnessing a more complex dynamic that affects not only doctors, but also society as a whole. Social inequalities are widening, particularly in regions where access to quality care is already limited. Women, children, and vulnerable populations are often the most affected by service disruptions.
It is worth recalling the findings of a study by the Global Alliance for Women’s and Children’s Health: each year, millions of people, mainly women and children, die from preventable causes. This crisis highlights the need to reaffirm the government’s commitment to public health, and to take concrete measures to improve the working conditions of doctors.
#### Towards a sustainable solution?
For things to really change, a constructive dialogue between the government and doctors’ unions is imperative. The concerns of health professionals must be heard and integrated into health policies. Ignoring this strike will only make the situation worse, both medically and socially. The government must also consider increasing its investments in the health sector, as an act of responsibility towards the population.
We are at a critical crossroads: how the government and civil society respond to this crisis will largely determine the future of the health system in the Democratic Republic of Congo. In Kinshasa, the polarization of emergencies could be seen as a wake-up call, prompting us to reassess our collective values and redefine our public health priorities.
In conclusion, the current situation in Kinshasa deserves urgent attention. The doctors’ strike is not just a medical conflict; it is a reflection of a broader crisis that requires societal mobilization to restore access to health care for all, in a country struggling to guarantee the fundamental right to life and health of its population.