At least 197 formal resignation requests from specialist doctors were submitted on August 31 to Paraguay’s Ministry of Public Health and Social Welfare, after the five-day national strike ended on August 28. The National Medical Union (Sinamed) says the action involves more than 300 professionals, while Senator Lilian Samaniego cited 443; the figures have not yet been officially consolidated.
The list submitted to the ministry includes 41 pediatric intensive-care specialists, 40 pediatric surgeons, 41 pediatric intensive-care doctors from Acosta Ñu Hospital, 24 from Itauguá, 19 from the Trauma Hospital, 12 from Ciudad del Este, as well as anesthesiologists, pediatric trauma specialists and specialists from the Institute of Tropical Medicine. There is a discrepancy in scope: another count indicates 39 pediatric surgeons across the public system, while the administrative list records 40. Juan Marcelo Estigarribia, chief of staff at the Ministry of Health, attributed the differences to the need to analyze each employment relationship individually, since some doctors hold two or three contracts.
At Acosta Ñu Pediatric Hospital, 22 of the 28 anesthesiologists joined the action. In Ciudad del Este, 12 pediatric intensive-care specialists resigned, potentially leaving just one professional on the team. At the Trauma Hospital, 18 of the 22 neurosurgeons submitted resignations but said they would comply with the legal notice periods to avoid immediately abandoning their shifts. In Coronel Oviedo, 30 specialists at the General Hospital formally submitted their departures, while another 30 pediatricians and neonatologists at the Maternal and Child Hospital merely made their positions available. In Itauguá, directors, the medical director and department heads account for around 100 positions made available — this is not an estimate for the entire system.
The pressure also reached hospitals in the interior. In Caacupé, consultations resumed, but patients reported shortages of losartan and furosemide. Santiago Durañona, a specialist in gynecology, obstetrics and perinatal medicine, communicated his intention to end his employment relationship; director Hugo Cañete said he had not yet officially received the notice. There were demonstrations or support for the stoppage in Carapeguá, Villarrica, San Juan Bautista, San Ignacio and other cities.
At Itauguá National Hospital, cancer patients, relatives and health workers protested shortages of medicines, equipment and supplies. María Estela Galeano, of the Breast Cancer Patients Association, said there was no mammography or CT scanner, that ultrasound examinations were reportedly being scheduled for January and that surgeries had been suspended. She also reported shortages of losartan, telmisartan, furosemide and dextrose for preparing chemotherapy, saying families were turning to raffles and events to buy items at private pharmacies. These are the patient’s statements, not an independent hospital audit, but they illustrate the crisis’s direct impact on people awaiting treatment.
The doctors are demanding better working conditions, the appointment of contracted workers, double pay on holidays and an increase from G. 5 million to G. 8 million for 12 hours per week. Economy and Finance Minister Óscar Lovera considers a across-the-board raise unfeasible amid fiscal constraints. Minister María Teresa Barán supports creating a health-care career structure, a proposal the union says would not replace an immediate correction to the minimum salary.
The government says it intends to regularize 2,390 contracted doctors and has presented US$760 million for medicines and supplies as a proposal for the 2027 General Budget of the Nation — US$260 million more than the budget approved for 2026. The amount still depends on the budget process and does not represent an allocation that has already been approved. The executive branch also says it plans to address debts to suppliers separately. Estigarribia said the ministry was assessing a plan to fill vacancies and measure the impact on services, without detailing a definitive solution.
Barán, Deputy Minister Saúl Recalde, the director of Human Resources and representatives of the legal advisory office attended a meeting at the Mburuvicha Róga Presidential Residence. At another engagement, President Santiago Peña received Isaías Fretes, president of the board of the Social Security Institute (IPS), the social security entity that is also facing complaints about shortages. Senator Eduardo Nakayama proposed eliminating private health insurance paid for by the state and directing between US$100 million and US$120 million annually to public health; he cautioned that the measure should not simply shift the pressure to the IPS, whose own crisis would require a specific design.
The Federation of Workers in Paraguay’s Public Higher Education (FETPESPA), which brings together unions from public universities and institutes, declared a national alert. The lecturers are demanding that the 2027 budget include a single salary-leveling scale and an adjustment linked to inflation measured by the Consumer Price Index of the Central Bank of Paraguay. The group has not ruled out a national mobilization.
For appointed employees, labor lawyer Jorge Luis Berni explained that a resignation does not result in automatic departure: the ministry may take up to 10 days to respond and, because of service needs, keep the professional for up to 30 days. For contracted workers, the period depends on the employment relationship. Sinamed called an extraordinary assembly for September 3, when it may discuss another stoppage.