Sunday, December 26, 2010

The Actual Contract for Medical Officer in MOH Maldives...

The Actual Contract for Medical Officer in MOH Maldives.

I will write down the basic facts which are going to affect you as a Medical Professional in this country; The Contract, The Term & Conditions & The Untold.
Main points in the contract which you will see, all are written in the negative form or enslaving form. Even the language is harsh. I will write the focus of contract, word to word as written in the main document. I have only put bracketed italics in between as my own words. Don’t have the scanning facility with me or else would have shown you all how they compel us to put our thumb prints on every page of the contract, just like a laborer.

1.     The Work Location: The principal place work is MINISTRY OF HEALTH AND FAMILY (which is in Male’ and which is your contracting facility only. There is never any doctor posted there actually. They will send you to places where there are no shops to buy groceries without any hesitation). The employee will generally be expected to undertake the Programmed Activities at the principal place of work (a colossal lie)  but the EMPLOYEE may be required to work in other locations including sites in other islands if requested by the EMPLOYER (they save themselves by this clause. And not only that, they expect you to be always ready to be a nomad as you can be sent to any place for a month or so to relieve another doctor who is going on leave. Just pack your bags and go there. For example if you have hired a place at the so called principal place of posting, you can be sent to another place for a month and for that period you need to leave your this accommodation and find a new one at the new place along with a new gas cylinder and all. I was sent to another island not long ago for which they cut my rent for those many days and sent it to the other health centre directly. I had to pay rent there, and at my place too as where will I keep my things??? Here ofcourse. And for that I have to keep this room for me as well. It is not that easy to get rooms near hospital or health centre. Plus that island has a generalized leprosy, leptospirosis and filariasis patiens there. You can imagine the level of fear that 1 month stay at that new place generated inside me).

2.    Disciplinary Matters: Wherever possible, any issues relating to conduct, competence and behavior should be identified and resolved without recourse to formal procedures. However, should we consider that the EMPLOYEE’s conduct or behavior may be in breach of any laws and regulations of the Republic of Maldives and/or the accepted work place norms of the Corporation or that the EMPLOYEE’s professional competence has been called into question, the EMPLOYER shall resolve such a matter through the EMPLOYER’s disciplinary action procedures wherever practicable.

3. The EMPLOYEE shall be entitled to three (03) days of paid paternity leave following his spouse’s delivery and to avail this leave EMPLOYEE shall provide documentary evidence. (only 3 days. In that you are supposed to go to your home place and come back to join duties, or tell your wife to deliver on that particular date when you are there, if you somehow reach her anyway. Delay in returning back means your 1 month’s salary absorbed and a new contract will be signed).

4. Costs and arrangements involving domestic transport from EMPLOYEE’s place of local residence to the EMPLOYEE’s place of work even if it is for work specified in this Agreement shall remain the responsibility of the EMPLOYEE except while on call. Though it is the responsibility of the EMPLOYER to provide transport for attending calls, the EMPLOYEE should not fail to attend the call in a timely manner for want of transport. (even while it is raining they don’t even try to send ambulance to pick me up, even f we request. I have to manage with the stormy rain, a lot of times I am really wet by the time I walk those 50 meters to the Health Centre, and if somehow I don’t reach fast to attend the call, they start calling from administration for explaining the delay)

5. If the EMPLOYEE wishes to renew this  Agreement before the expiry of the term of this  Agreement he / she shall communicate this intention to the EMPLOYER’s relevant Department and the same shall be copied to EMPLOYER’s Human Resources Department. The said letter should reach four (04) months before the expiry of this Agreement.
But if the EMPLOYER is not desirous of renewing this Agreement with the EMPLOYEE before the expiry of the term of this Agreement, such a decision should be communicated to the EMPLOYEE one (01) month before the expiry of this Agreement. The said one (01) month is inclusive of the annual leave period if that is planned for by the EMPLOYEE at the end of the term of this Agreement. ( This means they can tell this to you just before you are leaving for your annual leave. They can dismiss you just like that. And you all will be very happy to know that all these decisions are made by family or community health workers only. They judge your performances.)

This Agreement may be terminated by the EMPLOYER through giving the EMPLOYEE due notice or money in lieu of notice. In the case of a continuation of this  Agreement, the length of notice or the amount of money in lieu of notice required are as follows:
a)                 Length of notice 01 (one) month.
b)                Money in lieu of notice: One month’s salary. 
The EMPLOYER reserves the right to terminate this Agreement during probationary period without notice or compensation if the EMPLOYEE is found to be incompetent for the post he/she is employed or if he/she is deliberately neglectful in his/ her duties. In such a situation the EMPLOYEE shall  be repatriated at his/her own expense.

If the EMPLOYEE decides to resign from his/her post the EMPLOYEE should give three (03) months notice to the EMPLOYER in writing and will not have to pay amount to the EMPLOYER. However.
i)                With in the 3 months notice period if the employee decides to resign after completion of two months then the EMPOYEE  shall agree to pay the following to the EMPLOYER
a)                 One month’s salary.
b)                Work permit fee amount for the remaining term of the Agreement.
ii)           With in the 3 months notice period if the employee decides to resign after completion of one month then the      EMPOYEE shall agree to pay the following to the EMPLOYER.
a)        Two month’s salary.
Work permit fee amount for the remaining term of the Agreement
If the EMPLOYEE decides to resign from his/her post under mutually acceptable circumstances/reasons the EMPLOYEE shall give one (01) month notice to the EMPLOYER in writing and also should agree to pay the following to the EMPLOYER
a)                 two months salary.
b)                Work permit fee amount for the remaining term of the Agreement.
c)                 Cost of one month’s accommodation as per prevalent accommodation rates.

If the EMPLOYEE decides to resign from his/her post in an emergency situation, the EMPLOYEE shall  give immediate resignation to the  EMPLOYER in writing and also should agree to pay the following to the EMPLOYER
d)                three months salary.
e)                 Work permit fee amount for the remaining term of the Agreement.
f)                  Cost of one month’s accommodation as per prevalent accommodation rates.
If the EMPLOYEE decides to terminate this Agreement on medical grounds, a registered medical practitioner (who is holding a post not lower than consultants’ post at Male’ Health Services Corporation Limited in the relevant specialty) shall certify that the EMPLOYEE is permanently unfit for the type of work he/she is been engaged or should certify that the EMPLOYEE’s medical condition is such that it will take more than thirty (30) days for the EMPLOYEE to return to normal work. If the medical condition leading to termination is the result of undisclosed pre-existing medical condition/s at the time of application for the post, he or she will be required to pay the following to the EMPLOYER..
a)                 One month salary.
b)                Work permit fee amount for the remaining term of the Agreement.
c)                 Cost of one month’s accommodation as per prevalent accommodation rates in Male’.
d)                Initial ticket money which was refunded.
If the EMPLOYEE and his/her spouse are in shared accommodation and if the spouse is also an EMPLOYEE, then one should pay the cost of accommodation shall both parties terminate their Agreement with the EMPLOYER.


The EMPLOYER may summarily dismiss the EMPLOYEE without notice or money in lieu of notice if the EMPLOYEE:
i)                   willfully disobeys a lawful and reasonable order; or
ii)                misconducts himself/ herself; or
iii)              is found guilty of fraud or dishonesty; or
iv)              is deliberately neglectful in his/her duties
v)                is generally observed to be incompetent; or
vi)            violates any law or regulation of the Maldives.

8.     During the month of Ramadan the EMPLOYEE is not permitted to consume food or smoke in public under any circumstances.

9.     Non Muslims are not allowed to practice their religion in Public. Even talking about any other religion except Islam is prohibited and you can be tried in court for it.

10.                         The medical care of the dependents will not be born by the Employer.

11.                         Emergency leave is for ten days- which will be granted for death of father, mother, spouse or children. Please note brother, sister, uncle or aunty doesn’t qualify as family!! Marriage is not a reason for emergency leave!!! Emergency can be availed once in a year`s contract. It used to be deducted from the annual leave as well. You will be expected to deposit a sum inclusive of a month`s basic pay and allowance, migration allowance which will be refunded on arrival back in time.

12.                        There is no extra salary given based on the seniority. There is no gratuity or PF.

The Term & Conditions:

The Untold:

1.     There is a 15% deduction from everything (basic salary, all the allowances, Overtime, even the rent and electricity allowances) which has been written in your contract. This is not written anywhere but it will be done. We are contacted personnel here but they will consider us a their so called ‘Civil Services Staff’ and this 15% cut was forced by the president of this country in September 2009 over the Civil Services Employees. So, you will have to pay for it. And very interestingly when you read their offer letter, it is written in the lower end of it that there is 15% cut going on in salary & allowances since September 2009 but they don’t clarify that the salary and allowances which they have actually mentioned above is before cut or after cut. So you see it as an after cut amount which happens to be a wrong notion. And in contract they don’t even mention this cut and all. But they do cut it.

2.     And the most important of all. NEVER….NEVER…..NEVER in your whole life, trust a Maldivian. These people are born out of treachery. They may look simple, Try to call themselves fishermen to the developed world to beg,  but they are never trustworthy. You trust and they will betray you without failing. It is actually the success of their existence.

3.     You have to call the In Charges as ‘Sir’ or ‘Madam’ or else they’ll become very rude with you. These In-Charges are actually Community Health Workers who have completed at least 9th grade in their rubbish school system (I have told in my blog somewhere about the Oxford Educational Board here. The Maldivian 10th class pass, if going to India for further education, will be accepted in class 6th only according to their knowledge base) after which they go through a training in Sri Lankan Hospitals for 1 year or so to become Community Health Workers (now a days they call themselves Community Health Officers and Community Health Supervisors. In coming days they may name themselves Community Health Ministers or Community Health Presidents as well. Who knows??). They will take your name in response( i.e. Vimal  or yes Ramesh, what’s up?. Kinda that.).

4.     You should never tell any local staff that he or she is wrong. This may make you their enemies and they will go to any extent to take revenge. Can even get you thrown out of your residence (as was the case of our dear Surgeon here. He came as a new fellow and these management people helped him get a room which in turn was owned by one of our local staff only. After 2 or 3 days he complained about something to the landlord but they did not do anything about it. Upon reminding that in spite of charging the money and all this or that was not made available till date, they told him to immediately vacate the room at 6 hours notice. The poor surgeon tried to get his logical complain explained but at last by the next morning he was forced to find a new room as management denied to mediate the truce).

5.     You can hear slogans like “If you are true Hindu then you actually don’t know that basically you are Muslim, only this thing is not in your knowledge” (this was told to me on my face on the occasion of Eid by a guest of my landlord). Interpretation: The Hindu System is based on Vedas and Vedas describe the God as Shapeless and supreme as ‘Niraakar Bramha’. Just as is said in Islam. So Hinduism is basically Islam with the fact that we have strayed a lot with our bogus ideas of ‘Devtas (Gods)’. So, we are Kaafirs now.
Similarly a true Christian is a Muslim by birth already because Jesus Christ was an Islamic Prophet who was basically sent to preach Islam by Allah but he betrayed Him & created a different religion which is why Muhammad as a last Prophet was sent to re-correct us earth people. (Now we can understand why Christians and Muslims are fighting at so many places in the entire world) No one will tolerate such a kinda attack on their believes man. 
(At the health center where they threw me for a few weeks not long ago, the Ambulance driver sits in front of the building of the health center in the morning and welcomes the staff nurses (1hindu and 1 christian) by loudly calling Kaafirs everyday. That Staff nurse broke into tears telling me this. It was really horrible. And someone throws dry coconuts or stone on her room's roof (tinned roof) precisely around 2 am just to disturb her. I myself tolerated this roof hitting for the period I was there. They missed only one night. We all used to wait till 2 am to go for sleep. There is no way to counter these things. You complain to anyone (to In-charge or local staffs) and they will label you a liar and Maldivian hater or even Anti-Islamist.)

Don’t you dare to resist these ideas. Don’t even think to try. In the Contract it is clearly written that doing anything, which does not support or contradicts Islam, in public is an offence and the offender can be tried in their court.

No one can tell these people that Hinduism is in existence since more than 6000 years (being one of the oldest system of living along with the Greek system and hence bears similarity with Greek Mythology as well) and Christianity is in known existence since 2000 plus years (we are in the year 2010 starting the count from the Time of Jesus I believe) whereas the Islam has come merely 1400 years back and that too copying most of the characters and events from  Bible’s stories in it’s Quran’s stories. They themselves sometimes claim to be the most modern of all religions.

But you don’t resist these talks. You can say “maybe…” or even “…hmmm….” In reaction and better remove yourself from the scenario immediately.

6.     Never show the calculation mistakes in the Salary of yours. It (the mistakes) will be there. They calculate and re-calculate it for an entire month just trying to see if anything else they can cut down from there. In the end there may be some mistakes unaddressed and usually they under calculate it (means you get less than your salary which will be corrected if you protest and will go un-noticed if you don’t do so). But if you decide to react over this matter, do it on your own risk. I tried to reason with them sometimes ago and as a result was deputed here and there for 3 months (I had to go on different reliever duties over different islands for 10 – 15 or even 30 days for each stay) with a bag in my hand. It was difficult. Now if the mistake is of 10 – 20 dollars (means I am getting in $10 – 20 short in a month), I don’t object.

7.     Never…never complain about anybody to anyone. All, living over a single island are relatives between themselves. Your translator may be using foul language (even with the ‘F’ word in it) about someone in front of you but if you say something against the behavior of that very fellow who by the way has just farted in your cabin while coming to consult, this will be duly told to him, the manager, the receptionists etc that the Doctor has so many absurd complains against Maldivians in general and hence not fit for living in Maldives.

8.     Don’t suggest any constructive ideas correcting their current procedures. Your ideas may be brilliant but it will make you infamous among them. There is no one better than them. There is no one who can say anything to them. You can have a logic but their logic is always supreme. What’s interesting that they sometimes walk & come to you to ask “Doctor, what do you think about this or that?” and you have to reply back with “it’s ok.” Without failing. Even if they are asking you how to do this or that, and that particular thing is already being done in a particular way, you don’t have to start exercising with your grey matter. They actually want to hear praise from you about their own things. The smell of a toilet tank may be coming from their water supply, the drinking water they’ll give you in a glass may be containing the mosquito larva (all really true instances which with myself. I saw the larva happily swimming in the glass when I had almost touched the glass with my lips and was going to start drinking. You can not imagine my psyche. I still look in a water bottle for larva or it’s fecal matter first and then only drink it) but you need to praise their life style. One negative remark and it will be followed by laughter and bad naming.  Better to go and buy a packed drinking water bottle from the shop.

9.      Never discuss your things with Maldivians in secret. Money, house, culture or anything. By the time next evening comes, entire island will know that you had loose motion (if you told about it). This is the way thieves come and rob you. One doctor was staying at Male’ Tour Inn in Male’ (the usual staying place for employees of Ministry of Health) [this instance happened in November’ 2008 as told to me] carrying the money of his 2 month’s salary plus 2 month’s salaries of the 2 nurses from his Health Centre which he had taken to deposit in their respective accounts in State Bank of India, Male’ branch. The day that fellow reached Male’ it was already late to go to the bank so he was going to do all this the next day. In late evening when he was roaming on busy Male’ streets 4 people came to him, put a knife nicely on his back, asked for the money mentioning ‘we know you are carrying this much sum with you’ which obviously he was not carrying in his pocket, took his key per force, taken him in hostage for 3 hours and in between went to the Male’ Tour Inn, opened his room, took all his luggage, including all of his belongings, citing to the hotel people that doctor such & such has given the key to his room and asked to bring his belongings. Those hotel people should have called the Doctor as at that time it was only at a very few places that travelling doctors were allowed to stay and that too was fixed by the ministry only. On road also no one intervened in the proceedings and in hotel as well there was no resistance so as a result this beautifully planned robbery was done. No one other than his island’s informers could tell someone in Male’ that this person who looks like this is carrying that kinda cash (it was almost $7000/- in his bag at that time) to Male’. You can yourself imagine how could this have happened.  Only Health Centre Staff could have got a whiff of this money courier. Rest is history. The police couldn’t do anything as there was no break in etc. That doctor stayed for almost 10 days in Male’, suspending his India travel for a few days, but to no avail. This kinda things are difficult to solve in Maldives. Although if they could do some detective work on the calls made from Health Centre Staff or their known people over that island (the usual population of a small island is within 1 thousand as an average) and to Male’ they could have easily pinned the robbers. But in a country where there are drug abusers roaming on roads, where there is no punishment for a Murder (only change of island is the penalty for 1 murder) what do you expect from it’s police?

10.                        Never ever fall prey to girls who come to you and try to sit in your lap sometimes. They try it though. Anyone who even falls for this open sexual invitation will be duly converted to this stupid religion and married to that girl officially. These people may have sex with as many, may stray here and there in the hiding of their ‘Burka’ (No one can notice which woman is entering which house in Burka during darker hours). It is impossible. I have treated at least around 50 children about whom it is known to people that they are products of sex between a brother & sister (or at least the translator said so). One case with a known sterile boy having two kids from his young wife and his own father. These are only glimpses of their open society. They may be closing all Maldives 5 times a day during prayer times (all shops and everything closes and re opens up again and again during a day) and shouting ‘Allah…Allah’ from the rooftops of their maszids, as is done in entire Islamic world as if Allah will hear them more clearly if loudspeakered like this, all this 5 times daily is not making them closed talibanis. Although they are trying to emulate TALIBAN here. Every island may or may not have a school, but a school of Islamic studies is there where they dance like drugged ones and shout Allah in group. And by the like every other Islamic Country in the world this place is fast becoming the playground of Drug Smuggling, Drug Circulation, Alcohol black marketing, crime, prostitution etc. Male’ streets are full of low grade hookers during nights who will take you to their own rooms for money. And you can get stoned with Marijuana as well if you choose to. Twice I was stopped on the ‘Mazeedhi Magu’, the central street of Male’, and offered a special cigarette for $ 10.  I simply ran away from them frightened.   

11.                         During nights calls will come. A boy or a group of boys/men will tell that they want to talk to the doctor in private. They know English when they need it. And you can be sure of one thing…another addict story is on the ay to you. Doctor, I am taking such and such drug since this long and I want to actually get rid of it, kindly help me and give a shot of Diazepam or Midazolam. They even ask about Proxyvon and Cyproheptadine or Amytriptillin by taking their generic names. Tramadol, Corex D (with Ephedrine), Panadeine (with codein) and Cyproheptadine are very widely used over the counter drugs without any problem. So, just to get a shot they will come and request you. You have to be imaginative enough to tell stories that either the prescription for controlled drugs (which a different special prescription here) is not available or those drugs are not available. They will not believe you ofcourse, as their insider in the hospital has already told them that it actually is available. And you have a risk of angering them too as those are the fellows who wander on roads in nights and steal things. They can do anything to you as well. No police here…
So, all this is upon you to deal with every now and then.  

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