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One of the greatest problems limiting union growth in Chile has been the extreme fragmentation of the labour movement - a direct result of the laws passed under the dictatorship in Chile.

Over the past 12 months, UNI has worked to support unions in the private health sector to create a new federation to take on the challenges of raising standards and organising in private clinics. This federation will become a strong platform for coordinating collective bargaining and a larger voice to participate in a national dialogue about the health care system. The federation now represents the five largest private health care unions in Chile representing 6,000 workers in the sector. Another 20 other unions are currently holding votes on affiliation. 

The success of the new federation to date is partly down to the dedication and tireless work of Cecilia Grau. You can read Cecilia's story below, as captured by journalist Tansy Hoskins earlier this year. 

A New Federation in Chile

Tragedy intervened in the first of these interviews with Cecilia Grau, calling her away in a stark reminder of the continued importance of trade unions. One morning in early March 2015, two Santiago private health care clinic workers and an outside contractor were killed when they opened a neglected septic tank and were hit by a build-up of toxic gas which collapsed their lungs.

“Clinics should have a regular maintenance schedule to take care of things like this,” Cecilia explained a week later, adding that this particular clinic is not part of her Federation and that they have no union because the workers are currently too scared to form one. “Unions play a key role as an ‘inspector general’ policing occupational health hazards – without them there is nothing.”

“It’s outrageous that you have an organisation that is supposed to be providing health care to the community but is causing the death of its own workers,” added Claudio Aravena, Chile Coordinator for UNI Global Union. An investigation is ongoing into the incident but Cecilia and Claudio believe criminal charges are likely to be superseded by a civil settlement between the clinic and the families.

Creating a union network that can protect workers in Chile’s private healthcare sector is hampered by fragmentation within the sector. Unions are organised by company and it is commonplace for there to be multiple unions within each company and each clinic. In a workplace of 2,000 staff you can find five different unions. Clinics are also divided up into separate corporate entities and there are yet more divisions between ‘professional’ and ‘non-professional’ staff.

This division is a hangover from the Pinochet dictatorship, a brutal regime that was fervently in favour of neoliberalism and against workers. Before the dictatorship, workers negotiated sector by sector and had what Cecilia describes as “one baseline contract for healthcare”. Now the law is skewed in favour of employers and fragmentation and each group must negotiate for its own interests.

In 1980, Cecilia joined Clínica Alemana in Santiago as a secretary in the emergency room, the clinic had just managed to unionise on its third attempt. Having been a student activist she sought out the labour movement. By 1986 she was an elected leader in the Sindicato Nº 1 for Clínica Alemana. Cecilia describes the sector in the 1980’s as small with good pay, now, 25 years after the end of the dictatorship, it is a huge sector and jobs are low paid and precarious.

It is in this climate, in November 2014, that the decision was taken to re-launch a moribund health care federation and create FENASAP as it is today. It was a plan developed with UNI Global Union’s support. Adriana Rosenzvaig the Regional Secretary of UNI Americas, describes meeting Cecilia three years ago: “We started to ask her about the other unions in the different hospitals. We said ‘Do you think that we can coordinate with all of them?’ When she said yes, we started to work with her to call other unions to a meeting.” More than 100 leaders attended the meeting and Adriana describes it as leaving people wondering why they had not met before.

“The Federation is a real example of Sí se puede, meaning yes, we can be together; yes we can live our differences and build unity,” Adriana explains. “The new Federation is a strong message not only for the workers in the health care system, but to all the workers of the country. UNI was the bridge, but it was strong, well respected women, who were determined to build something new.”

The challenge now is to create a private health care Federation that can be a strong platform for coordinating collective bargaining and a larger voice to participate in a national dialogue about the health care system. The Federation now represents the five largest private health care unions in Chile who have a total of 6,000 members. Cecilia is waiting for 20 other unions to hold their assemblies and vote on whether to join the FENASAP. Her current work includes travelling across Chile to talk with unions about the Federation and encourage them to join. “The sector hasn’t been organised since the 1980’s when we were very small,” she explains. “Now we are very big so we have to organise ourselves so we can have a voice.”

Knowing a little of Cecilia’s history, the seeds of the FENASAP Federation were planted long ago. As a student she lived with her family in the city of Concepción, a place where, when Salvador Allende was overthrown by Pinochet in 1973, the axe of repression fell especially heavily. Many people, including Cecilia’s brother, were imprisoned in stadiums or disappeared and tortured. Cecilia herself was detained and questioned as a student leader – not least because part of her leadership role had been constructing a Student Federation of likeminded groups to push forward reforms.

The years of dictatorship, between 1973-1990, were a time when repression all but outlawed unions. It was also a time that saw the public healthcare system purged of anyone felt to be a Leftist threat to the regime – a twist of fate that sent militant public health care workers into jobs in the mushrooming private sector where they began to organise instead.

Under the dictatorship there was no access to the Government or other national labour organisations. Working for worker rights was a “complex and risky,” struggle that saw union leaders like Tucapel Jimenez killed. Whilst negotiations could be held between workers and employers, there were crack downs on anything public like demonstrations. “The union movement was very atomised,” Cecilia explains. “Deals had to be quietly done between union and employer – there could be no larger movement.”

There was also “a floating threat” against everyone in the union. Attempts were made to isolate union employees, with Cecilia herself sent to work in a basement, and then to a surgery where she’d have no contact with other employees. There was no recourse to justice when the complaints mechanism led ultimately to the Pinochet Government.

Now that the dictatorship is defeated and a Left wing government has been elected in Chile, big labour reforms are on the horizon. This does not however mean anyone has time to relax. Pay and working conditions are the two key issues for the Federation as well as something which Cecilia describes as “a new wave of repression”. Big private holding companies run many of the clinics, private companies who are not in favour of labour reforms that may compete with their profits. Workers are being subjected to a crackdown comprising of people being fired, having their shifts meddled with, and the withholding of overtime payments – “all designed to repress workers” – and, of course, to stop them organising.

Shaped by years of repression and resistance, Cecilia is prepared for this new step. Remembering times past she recalls how: “During the dictatorship, in spite of the repression, people had to move forward and the student and labour movements did. Every time there was new action there was new repression and labour leaders were killed, but we kept going forward.”

Cecilia is confident that the new national Federation will keep moving forward as the vehicle for workers to stand up to this repression, and organise for a better future for Chile’s health care workers.