Wu Rulian, HIV-OSH, ILO Country Office for China and Mongolia
In 2014, during a routine surgery on a patient with liver cancer at a provincial Chinese hospital, Dr. Xu Jun, 35, accidently cut himself with a scalpel.
He got worried. What if he got infected by HIV or hepatitis? He waited for months for a diagnosis, fearing the potential impact of illness on his job and ability to care for his three-year old son. One of his colleagues had previously lost her job after getting infected with HIV.
“I couldn’t sleep a wink for six months,” Xu told fellow healthcare workers at a recent ILO training on workplace safety and health. “I worried about getting an infection, but I also can’t afford to lose my job. I need it to support my little boy.”
Xu is not alone. ILO research suggests that only one in four healthcare workers across China has the masks and gloves necessary to protect themselves during surgery.
“To some extent, the work-related illness and injuries faced by healthcare workers are even greater than those belonging to the manufacturing and construction industries in China.”
When you consider that the country’s nine million healthcare workers make up an estimated 10 per cent of the global healthcare workforce, the scale of the problem becomes clear.
That’s one reason that Occupational Safety and Health (OSH) is a top priority for the ILO as China implements its 13th Five-Year Plan, which was launched in March 2016.
ILO/Wang Wenning
The plan prioritizes “improving the nation’s education and health level”, which includes optimising the healthcare working environment, perfecting the dispute mediation mechanism and building harmonised doctor-patient relationships.
All of these steps are aligned with the United Nations Sustainable Development Goals, particularly Goal 3 for “Good Health and Well-Being” and Goal 8 for “Decent Work and Economic Growth”.
“Decent” work must also be safe work
The Chinese Government recognized HIV as an occupational disease in 2013 and is currently working with the ILO to integrate other blood-borne pathogens, such as the more common Hepatitis B or C.
The ILO is committed to assisting China achieving its goals of a “Healthy China” by working on improving OSH for healthcare workers. But to reach this goal, there is a long way to go.
So far, ILO Safety and Health guidelines have been adopted by 10 major hospitals in China, reaching more than 25,000 healthcare workers.
“To some extent, the work-related illness and injuries faced by healthcare workers are even greater than those belonging to the manufacturing and construction industries in China,” says Tim De Meyer, Country Director of the ILO Country Office for China and Mongolia. “Healthcare workers who care for all, should also be cared for,” De Meyer adds.
The ILO provides technical support and facilitates discussions on policy changes with government officials, hospital administrators, representatives of healthcare workers, the Chinese Center for Disease Control and Prevention (CDC), and other international stakeholders like the World Health Organization (WHO), to encourage the inclusion of Hepatitis B and Hepatitis C into the National Occupational Diseases List.
In addition, the Chinese CDC has developed the National Implementation Guidelines on Management of Occupational Exposure to Blood-borne Pathogens, to provide practical guidance for healthcare workers nationwide to empower them to address OSH concerns in their own workplace, based on the Joint ILO-WHO Guidelines on HIV/AIDS and Health Services.
So far, these guidelines have been adopted by 10 major hospitals in Anhui, Gansu, Henan, Hubei, Shandong and Yunnan provinces, reaching more than 25,000 healthcare workers.
“All healthcare workers in this country should receive such training. Protecting the safety and health of healthcare workers is not only about protecting our lives, but also for the safety of the general public.”
More institutional changes should be made so that this large workforce of healthcare workers can be comprehensively covered with OSH training and receive the necessary supplies. At the same time it is important to ensure that their rights are protected and working conditions are conducive to safety.
Fortunately for Xu, his test results came back as negative. He did not get any infection. He feels “luckier” to be working in a hospital that has now joined the ILO training.
“Here I have the opportunity to learn and build my capacity to address our OSH challenges,” he says. “All healthcare workers in this country should receive such training. Protecting the safety and health of healthcare workers is not only about protecting our lives, but also for the safety of the general public.”