New Telegraph

December 6, 2023

NARD strike: NMA, GMD, MDCAN, others count cost

Doctors’ incessant strike is due to government’s insincerity –Ekpe
We lose our best brains in medicine to Western nations, says Babalola
‘The nonchalant attitude of the government, affect the doctors’

Secretary General of the Nigeria Medical Association (NMA), Dr. Philips Ekpe, has said that doctors have never embarked on any strike for the joy of it. According to Ekpe, doctors’ incessant strike is due to government’s insincerity and unwillingness to attend to their welfare despite over 15 meetings to reach a compromise. Similarly, Dr. Olufemi Babalola, president, Guild of Medical Directors (GMD), said it is unfortunate that the country’s young doctors feel compelled to go on strike from time to time to press home their demands. Meanwhile, president, Medical & Dental Consultants Association of Nigeria, Professor Ken Ozoilo, has said that the nonchalant attitude of the government to the health sector and those that work in it is greatly affecting the doctors.

The health sector in Nigeria, he further said, cannot compete with that of any other country in the world due to the poor state in which they are. Another professor of Veterinary Medicine and Clinical Virology at Michael Okpara University of Agriculture in Umudike, Abia State, Maduike Ezeibe, believes it’s the duty of trade unions to negotiate better conditions of service for their members.

The Labour minister, he also said, has a duty of labor to do what is possible and negotiate what the government can presently afford. In the meantime, the hardship and deaths of patients, doctors’ disillusionment and eventual migration abroad, as well as the subsequent lack of a solid healthcare system, the medical experts say, are some of the cost of these incessant strikes. For the past two weeks, the National Association of Resident Doctors (NARD), have been on strike over the government’s failure to honour all agreements as contained in the Memorandum of Action signed by both parties on April 10. One week after the government resolved to invoke Section 43 of the labour laws “No work No pay” order, resident doctors in the country are still maintaining a defiant stand on the nationwide strike until their demands are met.

However, as the day goes by, the number of patients in public hospitals keeps declining, as patients and family members seek other alternatives to health services. Although consultants and other health workers have stepped in to manage the situation as best as they could, only a few patients are being attended to.

At the National Hospital, Abuja, for instance, the majority of patients seeking care were turned back, as only 20 patients were attended to per day. Even with the poor number, the services are so slow to the extent, patients among the privileged 20, who were counted before 8am, were still waiting to be attended to as at 3:28 pm on Thursday. Also, at the Kubwa General Hospital, Maitama and Wuse district hospitals, the outpatient units were practically empty, except for persons hopeful of getting care. Our correspondent observed that while the majority of persons in need of healthcare have quietly embraced private clinics, a good number of the few persons in public hospitals were those enrolled in the National Health Insurance Scheme (NHIS). But, not many can afford quality health services in standard private hospitals known for charging exorbitant prices.

The majority of the private hospitals charge a minimum of N5,000 just to access their hospital card, some even exclude the consultation fee. This has increased the number of preventable deaths and complications that may arise, as people without such an amount of money are now turning to pharmacies, herbal treatment, prayer houses and poorly structured private health facilities where charges are affordable. Ekpe blamed this situation on the government’s insincerity and unwillingness to attend to their welfare despite over 15 meetings to reach a compromise.

He said: “Some house officers and doctors are being owed. Since the country decided everybody should be paid in IPPIS they refused to migrate them to IPPIS and so they still owe them three to four months. “They are not doing any other thing. So, how are they going to survive, feed their families and still come to work and concentrate? “It’s not fair, these are some of the reasons NARD had to, unfortunately and regrettably, embark on a strike, not because they are not aware of COVID-19.” In a similar vein, Babalola said it is unfortunate that the country’s young doctors feel compelled to go on strike from time to time to press home their demands.

“Something is wrong with the way the welfare of doctors is addressed in our nation. We need to all sit back and re-imagine the dynamics of this relationship. “We train our best brains in medicine only to lose them to Western nations. And this has a deleterious effect on our health care system.

“I appeal to both the government and our young doctors to come back to the negotiation table so we can move on from this unfortunate situation,” he said. However, Professor Ozoilo has said that the government, who designed the sector, do not take into consideration that they are humans working in the system and treat them unacceptably.

He noted that there is a high rate of dependence on any working Nigerian and when they are denied their salaries at the right time, he said, many people will be affected. According to Ozoilo, the government prefers to import doctors, and pay them in dollars. The continuous decadence in the system, he further said, has also affected the output of the doctors as they cannot carry out their duties effectively due to fear of insecurity and the weight of their responsibilities.

He said: “With the present state of the healthcare system in Nigeria, it is not surprising that medical workers are leaving the country in droves in search of better working conditions in advanced countries. “When the working conditions in other countries are reviewed in comparison to what is operated in Nigeria, nobody can fault the health workers, who leave the country.

“The doctor to patient ratio is overly imbalanced and this leads to most of the caregivers being overworked. “Their plight should also be considered because they have responsibilities and obligations to take care of but due to the poor state of the health system, they are not able to make ends meet. “This is one of the reasons why they have decided to look for better and more lucrative working systems outside Nigeria.”

He added: “No law stops doctors from leaving the country if they get better jobs in other countries. “The only way to reduce the number of doctors leaving the country is for the government to implement and fulfill its promises towards health workers. “They should use their political power to put things in place to better the working conditions of the doctors and to also to make sure they get reasonable salaries as at when due.” Professor Ezeibe in his contribution said he is disappointed that the Minister of Labour, Dr. Chris Ngige, was threatening instead of negotiating. Ezeibe said: “He has no other business in government than to negotiate.

Thank God, the National Assembly is intervening. “I urge him to use that opportunity to start doing his work (do what is possible and negotiate the ones he cannot afford now). “There is never a time when everything we need or deserve will be met. I know; our doctors know this fact. “So, once the government explains the true situation of things and shows commitment to keep promises, they will back down.” The professor also believes that mak-ing Nigerian hospitals a tourist destination is possible if “we drop the inferiority complex and announce to the world that viral and abnormal cell diseases, which are said to be ‘incurable’ can be cured in Nigeria. “That will make our economy ‘research based instead of resource based’. That feat belongs to Nigeria, not to any individual. “To continue politicking with scientific inventions is to encourage brain drain.”

A Public Health Physician, Dr. Doyin Odubanjo, said such strikes are a good indication of how seriously the government views healthcare in Nigeria. “Have we heard of strikes (and if so, how often) even in other African countries? Strikes are unfortunate in a critical sector like health and no health worker I know of takes it lightly. “However, since the health worker has to survive, he will seek employment elsewhere. “Also, other countries have come to realise that we don’t value our health professionals as we should (and they think highly of Nigerian ones) and so are readily making offers to them. “We are in a health crisis and we still have strikes because of unpaid salaries to health professionals. Nigerians need to become louder in calling the government to order,” Odubanjo said.

Another public health expert, Dr. Ken Okonkwo, raised concerns over the negative implications of industrial strife in the health sector, saying that the Nigerian government has failed to make health a priority. “It’s beginning to sound like lip service. Health should be number one, but unfortunately, the health sector in Nigeria is in shambles. “Doctors have second hand value; beside the poor welfare and remuneration, there are no standard facilities or equipment that doctors can work with,” he said. Dr. Joe Abah, also a public health expert, noted that when there are no good tools to work with and the environment is too hostile to permit optimal output, doctors are left with no choice other than embracing other climes where they will be celebrated. Abah said: “It’s no longer news that in terms of doctors’ ratio to patients, we have a huge gap.

“These frequent strikes, government issuing warnings and threats of not paying salaries to the extent of considering suspension of doctors, who refuse to return back to work, will only help to escalate the matter. “When your workforce leaves your employment in any given opportunity, it is only normal that you single out the issues, and address them squarely.

“Not issue threats or pat them on the back when they are aggrieved, or make promises and fail to keep to them.” National Coordinator, Africa Health Budget Network (AHBN), Dr. Aminu Magashi, crowned it all when he said: “There has been poor investment in the private health sector such that the system has remained weak despite attending to over 60% of the Nigerian population. “Government’s insincerity and indecisiveness in most instances provoke the strike actions witnessed in the public health sector.”

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