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Effects of lingering health workers’ strike on Nigerians

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It is no longer news that patients in public hospitals across the country have come under severe strains as the nationwide health workers’ strike lingers.

The industrial action by the Joint Health Sector Union (JOHESU) has taken a huge toll on health services delivery in the public hospitals.

The challenges are enormous and the experience, nauseating and sad. Lives are being lost, while the lamentations and frustrations are unbearable.

Doctors are under pressure to salvage the situation to the best of their ability, but it appears their best is not good enough. The situation calls for urgent resolution of the strike, before it gets out of hand.

It is quite appalling that strikes have become a recurring decimal, especially in public health sector. More often than not, it is either doctors’ and nurses strike, or pharmacists and health workers’ strike.

As the strike continues, poor Nigerians are at the receiving end and those who cannot afford treatment abroad or in private hospitals within the country, either endure their ailments or die.

So disheartening is the fact the causes of the incessant strikes have remained unresolved for several years. They include disparity in salaries, allowances and promotion of workers in the health sector. Another major cause is government’s failure to honour agreements earlier reached with health workers.

Sadly, the industrial action is hardly about how to render best services to patients in the public hospitals. It is mostly about money and disagreements over leadership positions at the public health institutions.

To make matters worse, the whole thing has degenerated to supremacy and ego battle among different professionals and groups in the health sector.

Obviously, successive governments’ failure to effectively resolve these issues has contributed immensely to the continuing industrial unrest in the sector.

Patients Groan As Health Workers’ Strike Grounds Activities At UNTH
From Lawrence Njoku (Enugu)

ACTIVITIES at the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, are on the low side.

This is as a result of the strike embarked upon by the Joint Health Sector Union (JOHESU) in the last one month.

A visit to the hospital showed that almost all the departments have been deserted, except the medical wards. The hospital no longer runs full services, because services provided by striking members of the union are no longer obtainable.

The development is taking a toll on few patients, who have been retained at the hospital due to the severity of their health situation.

Emeka Ugwuoke, who was sighted at the premises, said he had not submitted the bill on the medical supplies he made to the hospital in the last three weeks due to the strike.

“I have been visiting in the last three weeks and there is nobody to attend to me. The entire stretch of the finance, purchases and supplies block is under lock and key.

I did that supply believing that I will get my money at the shortest possible time, but till now, I have not made any headway,” he said

The hospital’s Public Relations Unit is deserted. Dusts and cobwebs have taken over a larger portion of the area. One of the senior staff of the department, who was seen in the premises, said he came around to sort out a few things from the Chief Medical Director (CMD).

“I can’t stay in my office, because there is nobody there. My department joined the strike and you know it is a national thing.

We do not even know when it will end, because as we speak the Federal Government appears unconcerned over the workers’ agitation. So, we will resume when our union’s leadership said we should resume,” he said.

It was observed that cleaning of the wards have been made possible by hired private agents, to who the hospital management awarded the contract.

A relative of one of the patients in the male ward, Sunday Agbo, told The Guardian that, the strike has affected medical services stressing that, although “the doctors are at work, you should know that they don’t work alone.

“You must pay the bills, you must look for somebody that will administer the drugs and when the people concerned are not there, you will need to wait for any alternative the management will suggest.”

He said it took the intervention of the management for him to get blood when it was needed for emergency, adding that most things were being done from outside the hospital.

He said he would have loved to relocate his father to another hospital, but for the fact that his case needed special handling and he has experts at the hospital who have been managing him.

“The people here know about him and they have always attended to him, but the way it is, I am almost doing the work, which other paramedics should do.”

He said it has been difficult to find alternative power supply, whenever the public power supply goes off, because there is nobody to operate the generators.

“So, to me, it is not a good experience. That is why so many patients have been discharged.”

‘Patients Who Die During Strikes Cannot Be Brought Back To Life’
From Isa Abdulsalami Ahovi

At the Jos University Teaching Hospital (JUTH), constant expressions of lamentation, disappointment, suffering, dejection, despondency and sadness are written on the faces of patients and their relations in the hospital’s wards.
    
The general atmosphere there could only be described as horrible. The mood of patients and their relations was at best gruesome. They wore, long, gloomy faces. Some relations of the patients, especially the less educated ones, exhibited some level of aggression.

To that extent The Guardian reporter left quietly to avoid confrontation with them because they believed the reporter could not help them in their dire situation.

    
“What are you going to do with our answers to your questions? Are you going to ask the doctor to come and attend to us? Go away, please,” one of them said.
  
However, one of the enlightened relations of another patient, Bulus Yohanna told The Guardian that he was in the hospital because he had a patient called Edward Dickson. He said it was the worst experience that patients are passing through, especially in JUTH.
   
“This is a hospital that had experienced persistent strikes for over two years, as a result of disagreement between the hospital management on the one hand and the workers or resident doctors on the other hand. The hospital workers may be joining the national strike.
 
“It is either resident doctors who carry out most work in the hospital are on strike or the medical laboratory scientists are on strike or the entire Joint Health Sector Union (JOHESU). So, there cannot be efficient medical services.
 
“My patient who was operated upon two years ago is expected to have appointments with his consultant every month. But each time he comes here, the hospital is shut down due to one strike or the other.

So, he can’t even see the doctor. If the strike is called off and he is able to see the doctor, one complication is queried because the doctor is not available as and when due.

“The last time he went to see the doctor in JUTH, JOHESU members were on strike. Even those who were working could not trace his file, because the staff working in the record office later joined the strike,” Yohanna explained.
  
He added that his relation who was a patient in the hospital was lucky the other time to see the doctor but he could not get drugs, because the pharmacists were on strike and he had to go outside to buy them at exorbitant prices.
    
He said at another time when his patient went to the hospital, he managed to see the doctor but he could not run the prescribed test for him because the laboratory scientists were on strike.
   
“The worst experience was when the resident doctors were on strike. He waited at the outpatient department with over 2,000 patients waiting to see only one doctor and he was not lucky. He could not see the doctor.

The situation was worse with the patient’s colleague who was on oxygen in the Intensive Care Unit (ICU) and who was discharged forcefully later died.
   
“Unfortunately, after this prolonged strike, the workers will be paid their salaries, but those patients who died during the strike cannot be brought back to life.

“Government always fails to fulfill its own part of the bargain that it signed with the unions, leaving the patients suffering to death,” he said.

Pressure Mounts On Lagos Doctors, As Patients Patronise Private Hospitals

Nigerians Appeal To Government To Resolve Strike Issues
By Yemi Ajibulu, Shakirah Adunola, Maria Diamond and Henry Ekemezie

As the health workers’ strike lingers, Nigerians of all walks of life have been mounting pressure on doctors, especially those in Lagos to continue to help humanity with their services.

They have also appealed to the Federal Government to resolve the issues that have led to the industrial disharmony.

Chairman of the National Orthopedic Hospital, Igbobi, chapter of the National Association of Residents Doctors (NARD), Dr. Noah Oyedokun, acknowledged that the JOHESU strike has slowed down activities at the hospital.

He, however, added: “But we still try to work by attending to the patients we can attend to and the ones the system can accommodate and tell the ones the system cannot accommodate to come back.”

He revealed that the hospital lacked some basic amenities and services because of the strike, noting: “There is no water, no light and no generator is working, because the workers that make these available are on strike.”

Oyedokun advised Nigerian doctors to keep working and find means to make things functional in the hospitals, saying: “If we all stop working and let the health system collapse, it would fall back to us eventually, because we have links with the people on the streets, who are patients and so we need to attend to patients.”

A plastic surgeon/consultant and Chairman of the hospital’s Medical and Dental Consultants Association of Nigeria (MDCAN), Dr. Taiwo Oshinsanya, said the strike has brought about constraints in treating patients, because the processes of treating a patient requires a team work of professionals in the health sector.

He called on the Federal Government to invest more in the health sector and ensure that hospitals have enough facilities, saying: “Too many people travel abroad to treat themselves for illnesses that should have been treated in the country due to lack of facilities.

“So, government should give priority to the sector by purchasing health equipment and training doctors.”

Oshinsanya urged government to specify the duties of the various workers, so as to prevent confusion in the sector.

General Secretary of the association, Dr. Emeka Izuagba, said doctors were attending to patients at the hospital, in spite of the strike.

He said: “We are doing what we can in treating patients, especially in cases of emergency.”

Izuagba advised doctors to keep working and try their best to treat patients, despite the ongoing strike, as “not every patient can afford private hospitals or travel abroad to get treated, so the doctors should not say that a particular duty is for the nurses or others at this time and not do it.”

He also tasked government to commit more to primary health care, saying: “The health sector is under-funded, so government should invest more in the sector to encourage Nigerian-trained doctors to practice in the country, because not all the Nigerian doctors that travel abroad to practice are after money.

Some don’t have facilities to work with in Nigeria and, therefore, they go to countries that can provide those facilities for them to use in developing their skills.”

A patient at the hospital, Ayodele Adeniyi, while expressing displeasure about the strike, said: “The strike is affecting us negatively. I and other patients have been waiting in the hospital for hours and there are no nurses to attend to us.”

He appealed to government to resolve the issues with the workers and end the strike, so as to make all the medical teams available to carry out their respective duties in the hospital.

Also, at the Lagos University Teaching Hospital (LUTH), Ikeja, medical services are paralysed, forcing patients to relocate to private hospitals.

Doctors are rendering medical services to patients with emergency cases whose health challenges do not require the services of nurses, while those they cannot manage are advised to visit private hospitals.

A visit to the wards showed that most patients have left the hospital, probably to private hospitals. While some patients were seen waiting for their doctors at the consulting rooms, doctors were also seen attending to old patients.

They are rendering services, attending to patients in the ward, but new patients that need the services of nurses were not admitted.

Some wards are empty, while some have few patients without nurses attending to them.

A medical doctor said told The Guardian that they were attending to patients who do not require nurses attention and those that need to run laboratory tests were referred to private clinical laboratories. Patients are advised to come for treatment and go home.

A laboratory scientist, who pleaded anonymity, said a private laboratory within the premises was offering test to patients but it is expensive compared to LUTH laboratory.

Akinfenwa John said the strike was putting more financial strain on the patients, because their bills have increased.

Speaking, Akeem Olawale, urged the Federal Government to intervene in the ongoing strike, because most people can’t afford treatment in private hospitals.

Also, Ibukun Ojo, who had an appointment with her doctor, urged the government to grant health workers their demands.

A pregnant woman also pleaded with the government to urgently attend to the demands of the striking health workers to reduce the number of deaths, especially maternal-related ones.

Karim Aisha said she came to make enquiry on when the strike will end, because her elder brother had an accident and he is not responding to treatment at the private hospital where he was taken.

Another patient, Adanma Idika, who was not there on an emergency, said she came to run a scan and was being attended to.

It is almost as if patients have little or no faith in the doctors’ capacity to handle their health challenges without the health workers.

The medical outpatient clinic was deserted, as there were only few patients in the premises who looked devastated, confused and stranded.

A male patient revealed that he has been in the clinic since the early hour of the day with a few other patients, but the doctors were slow in attending them, because they don’t have helping hands.

“The same doctor attending to patients has been doing everything a nurse would have done. So, it is too much workload on limited workforce and I just have to wait for my turn.

“I must, however, commend the doctors. They are doing well because I was advised against coming to the hospital this morning because of the strike.

“My family insisted I go to a private hospital, but I only decided to give it a trial because I already have an appointment for today and discovered doctors are putting in their best to save lives,” he said.

The medical emergency unit had a number of patients, who desperately needed medical care, but they were all seated outside with no nurses or other health workers to attend to them as expected.

A young man who was in excruciating pain was sighted on the bare floor with no one to help him up to the appropriate care unit pending when a doctor attends to him.

Speaking to The Guardian, Secretary of the Association of Resident Doctors (ARD) in LASUTH, Dr. Ali Olusegun, explained that although JOHESU was on strike, the doctors were working hard to salvage the situation and ensure that patients get the best treatment.

He further explained that the reason the hospital environment looked scanty with few patients and activities was because a lot of people assumed that since health workers were on strike, doctors could not work.

“This has affected a whole number of things; the patient load has reduced, but those who are aware that doctors are working and have appointments still come around to see the doctors.

“The impression out there is that hospitals are not opened, because workers are on strike. So, some people stay back on hearing that health workers are on strike. They simply assume that no one will attend to them,” he said.

He said patients should not expect optimal service as long as the strike continues, because the health workers, nurses, laboratory attendants, pharmacists and others that suppose to complement the doctors were not available.

He, however, said he does not think the strike should go on for too long than it already has, as he expects the issues to be resolved and the workers resume work.

The situation is not different at the Federal Neuro-Psychiatric Hospital, Yaba, as patients continue to lament the effect of the lingering health workers’ strike.

Some of the patients said although doctors were attending them, they believed the strike had made things much more difficult.

A woman, whose relation was on admission, said the hospital management has been reluctant since the commencement of the strike.

She said: “Before doctors usually attend to patients, but today they just managed to show a little bit of attention. I come over to look after my brother. I hope the government can resolve the strike! Our people are suffering and dying.”

Samuel Okerinde, a consultant said: “A doctor is trained to do everything in the absence of other health workers, but they keep fighting the doctors on supremacy ground.

Our politicians do not even believe in the Nigerian health system. They always jet out to the United Kingdom, Germany, India and other countries to seek medical care.”

He, however, noted that although the strike has not affected the environmental health department since doctors and record staffs are on duty, the strike has limited the number of patients on admission because “we are unable to admit much as a result.”

According to a nurse who pleaded anonymity, the only language the Federal Government seems to understand is strike, which imposes a lot of sufferings on the masses.

“I am appealing to the government to accede to the requests of the striking health workers to end the sufferings of individuals who cannot afford treatment abroad.”

She said: “Patients are being attended to, those that need to be admitted are taken on admission. The consultants who are actually responsible to the patients are available. Other health workers are also not on strike, so, we will do our best to fill the vacuum created by the JOHESU workers.”

Consequently, patients in various wards at the facility were left in the hands of few consultants and nurses who, sources said, were finding it difficult to cope.

The few consultants available were unable to go round all the wards, leaving most of the patients unattended to. Officials of the hospital could not be reached, as some of them did not report for work.

Speaking on how the strike has affected health services, a doctor at the facility, Sanni Olayinka, said although some officials were not around, it was their duty to do more to accommodate their work burden.

“We are bending over backwards to ensure that the system runs, because we believe all stakeholders must come together to ensure the system works,” he said.


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