Guatemala City, Guatemala – Paty Chavez has had a rough few weeks.
A nurse at a regional hospital in the Indigenous highlands of Guatemala, she tested positive for COVID-19, recovered, protested against the hospital’s response to the virus, and then was fired – all in the span of 15 days.
“My colleagues are all scared. They say, ‘look what happened to the person who most spoke out’,” said Chavez, an Indigenous Maya K’iche mother of three who worked for four years at the El Quiche Regional Hospital, 137km (85 miles) northwest of the capital.
But as is the case with so many public health workers in Guatemala, basic labour rights eluded Chavez because she works on a contract basis, a problem that has been exacerbated by COVID-19.
As of Monday, Guatemala health authorities have reported 104,894 cases of COVID-19 and 3,651 deaths attributed to the novel coronavirus since the pandemic began – though some estimates have placed the death toll much higher.
In August, the National Registry of Persons, the government’s civil registry institution that records births, marriages and deaths, had registered 4,916 COVID-19 deaths.
Now, more than seven months since Guatemala reported its first case of COVID-19 in mid-March, healthcare workers continue to raise alarm over poor working conditions, unpaid salaries, and the backlash many face for organising and speaking out about how their workplaces have handled the virus.
Chavez came down with headaches and a runny nose late last month.
While she no longer worked in the dedicated COVID-19 area of the hospital, she said she still had contact with patients who were infected by the virus. Chavez tested positive and isolated at home, where her symptoms worsened.
“The worst thing was that I infected my children,” she told Al Jazeera at a protest march last week in Guatemala City.
The day after Chavez tested positive, she said the hospital’s human resource department sent her an email indicating she needed to submit paperwork in person related to her employment as an individual contractor. She coordinated things from home and got other people to drop off the documents.
A worker who stands up and speaks out is the worker who faces retaliation. They are a worker who is branded a subversive. They are branded a socialist, a communist. It is a terrible situation here
Chavez and her children, aged 12 through 17, all recovered from COVID-19 without any serious complications. She returned to work and to her role in the leadership of a hospital workers’ union that she and about 150 of her colleagues in El Quiche established four months ago.
On October 12, Chavez participated in a health workers’ march to protest the hospital’s response to the pandemic. Two days later, when she was on shift, she was called into a meeting with human resources and fired.
Chavez said she was told she was fired because she failed to pay a performance bond while she was home, sick with COVID-19, but she said she was not notified that a payment was due.
El Quiche Regional Hospital director Salomon Delgado did not respond to Al Jazeera’s numerous requests for comment via phone and text.
Chavez’s case is not unique, however, said Daniel Reyes, head of the workers’ rights unit of the Office of the Human Rights Ombudsman, an independent state institution.
The office has visited hospitals and other healthcare facilities around the country to document conditions during the pandemic, monitor complaints, and make recommendations to the government.
“A worker who stands up and speaks out is the worker who faces retaliation,” Reyes told Al Jazeera. “They are a worker who is branded a subversive. They are branded a socialist, a communist. It is a terrible situation here.”
Reyes said retaliation for labour organising is common in Guatemala and he has documented reports of layoffs, transfers, and other acts of retaliation against health workers.
For example, security workers at the Roosevelt Hospital, a public hospital in Guatemala City, have been assigned tasks outside the scope of their duties as punishment when they speak up about conditions.
“They were tasked with sweeping the entrance of the hospital. They were tasked with transporting cadavers, a situation for which they are not trained,” Reyes said.
The lack of adequate personal protective equipment (PPE) for health workers was particularly acute in the early months of the pandemic – and has been a major source of complaints.
Some front-line hospital workers fabricated homemade face coverings. Others wore rubbish bags over their scrubs.
The ombudsman’s office and the San Juan de Dios General Hospital Workers Union, a national health workers union, filed a series of legal actions during the first two months of the pandemic against the Ministry of Public Health and Social Assistance over that lack of PPE.
In May and August, the country’s top two courts issued protection orders instructing the government provide them with adequate supplies.
But health sector unions say the response is still insufficient. Reyes said the government has largely complied when it comes to front-line workers, but some administrative staff are only issued one disposable mask for a two-week period.
“The ministry has complied with the [court-ordered] protections,” ministry spokeswoman Julia Barrera told Al Jazeera in a written statement.
The government said 44 health workers had died from COVID-19 as of September 25. Carlos Noe Santos, general secretary of the San Juan de Dios General Hospital Workers Union, told Al Jazeera the total is nearly 10 times higher across the public health sector, however.
Health authorities did not provide Al Jazeera with the total number of health workers who have died from COVID-19 since the pandemic began. The query is being processed as a freedom of information request.
Reyes said he has also been unable to obtain the statistic, though he believes the official figure is a severe undercount. The government’s management of personnel staffing temporary hospitals treating COVID-19 patients has also been a mess, he said.
Front-line health workers and administrative staff at a temporary hospital set up in the Parque de la Industria convention centre in Guatemala City were hired without being vetted, Reyes said, and have faced long delays in getting paid and having their contracts renewed.
Workers at that temporary COVID-19 hospital rallied outside the facility on Thursday in protest of the fact that more than 600 workers, including doctors and nurses, have not been paid since late July when their contracts were up for renewal.
Barrera, the health ministry spokeswoman, told Al Jazeera that contract renewals require an administrative process and take time. The Finance Ministry approved the transfers, she said.
Union leaders say the non-permanent contracts that many Guatemalan healthcare workers are hired on, contribute to the precarity and risk they have faced during the COVID-19 pandemic.
Guatemalan health authorities said they were processing Al Jazeera’s inquiry regarding estimates of the total number of public health workers and the percentage of them employed on a contract basis as a freedom of information request.
Santos said more than half of the approximately 50,000 health workers in Guatemala work from contract to contract, often without health insurance or other labour rights, such as paid holidays.
“The pandemic arrived and highlighted and exacerbated the precarity,” he told Al Jazeera.
Santos’s union is still fighting for protections for health workers who are over the age of 65, pregnant, or at risk due to chronic health conditions. It filed a lawsuit against the government and a court ruled in its favour, but the government appealed and a final ruling is still pending.
Despite the retaliation some health workers face for speaking out, many continue to organise and protest their working conditions.
Marta Hernandez, an x-ray technician at El Quiche Regional Hospital and secretary of conflicts in the local union, is one of them.
“I was motivated by the disparity in rights,” she told Al Jazeera in Guatemala City’s central plaza at the tail end of last week’s protest march, where she and her colleagues wore traditional-style blouses in their union’s colour – bright turquoise.
“We are against the mismanagement of the pandemic.”