Health sector nears collapse as FG neglects resident doctors’ demands

• Only 11 Out Of 52 Public Health Institutions Paid Hazard Allowance
There are fears that the health sector and efforts to contain the deadly Coronavirus disease (COVID-19) might collapse as resident doctors may resume their suspended strike soon.

The doctors, under the aegis of the National Association of Resident Doctors (NARD), had on Monday June 15, this year, suspended a two-week strike and given the Federal Government four weeks to meet their demands.

They threatened to resume the strike at the end of the grace period, which expired last Sunday. Government did not invite the doctors for any meeting until Monday, July 20.

President of NARD, Dr. Aliyu Sokombo, told The Guardian that the government had not met their demands.

“In fact, the first meeting they invited us to after we called off the strike on June 15 was on Monday, July 20. They have not shown any seriousness, but we are determined to be patient with them. Nigerians can see what we are going through,” he said.

Sokombo explained that the Federal Government has not met 90 per cent of their demands, saying they suspended the strike for the sake of the patients and to give government the benefit of the doubt.

He added that the only demand the government has met was the payment of hazard allowance for April and May to only 11 out of 52 public health institutions in the country, noting that the N9 billion released by the government was to settle the hazard allowance of all health workers not just that of resident doctors.

Meanwhile, President of the parent body for all medical doctors, the Nigerian Medical Association (NMA), Prof. Innocent Ujah, commended NARD for suspending the strike despite most of their demands not being met, saying strike is avoidable and the end of a process.

Ujah, a former director general of the National Institute for Medical Research (NIMR) in Yaba, Lagos, said: “I am happy that the Federal Government has accepted some of the requests of the resident doctors and that NARD is listening. We encourage government to negotiate with NARD. These things are avoidable, especially after signing a MoU.

“Already, our health system is weak and we do not want anything to jeopardise some of the progress we are making, especially on polio elimination from Nigeria and in containing COVID-19.”

Minister of Health, Dr. Osagie Ehanire, did not pick his calls or reply to questions sent to him regarding efforts to meet the resident doctors’ demands.

Nigerians fear that the frequent strikes by health workers could worsen the COVID-19 fight and state of health care delivery in the country.

A social media influencer, Aladeloye Adetoye, said: “Doctors going on strike at this trying time is uncalled for. It is normal to protest, but not in a situation like this that the world is brought on her heels to contain a deadly virus.

“For me, I feel the core reason they signed up for the profession is abandoned once they go on strike, because going on strike means they have no value for human lives that they are to cater for.

“If they remain persistent on the strike action, of course, it would worsen the health situation of so many innocent citizens and bring the nation to a state of irreversible destruction.”

National Publicity Secretary of Action Democratic Party (ADP), Adelaja Adeoye, said the incessant strikes by doctors during this period of COVID-19 pandemic does not favour anyone, not even the doctors themselves, saying they too have family members who must be attended to.

He said: “It must be noted that several people lost their lives during these strikes, as there were no medical treatments and access for them. These are avoidable deaths, but when there is no doctor on duty post, these deaths will happen.

“Of course, we cannot entirely blame them for downing tools, as their demands to government may have suffered. What is important is that government should give top priority to the demand of the medical community in this country, because the essence of being in government is to make life better for the citizens. So, everything that will preserve their lives and wellbeing should be the focus of government.

“The Federal Government, through the ministers of Health and Labour and Productivity, should put in place measures that will end the frequency of strike actions by the medical doctors.

“The poor working conditions are part of the reasons they usually abandon Nigeria to seek greener pastures abroad and this makes our health sector to suffer and vulnerable.

“It will amount to a serious service breach on the part of the government that their officials run abroad anytime they need medical assistance, while the sector in their own country is in total comatose.”

To a corps member, Ewendomen Fredrick: “It is a huge blow to our medical team in this trying period and they really need the government’s help and a 100 per cent commitment in fighting the pandemic.

“Government seems to treat the doctors who are putting their lives in the way for us to have our normal life back bad. It is not fair at all. Government needs to wake up to their responsibilities and start treating doctors and nurses well to enable them work effectively. The doctors have no other choice than to let the government know by embarking on strike. It has really affected the common man.”

A fitness trainer, Michael Rotimi Johnson, posited: “How would I blame the doctors for the repeated strikes when our health sector is nothing to write home about? Government officials should be ashamed of themselves honestly.

Ehanire

“They should at least look into this repeated strikes and the doctors’ demands. Government officials are looting public funds, so they should pity and spare the lives of the masses.

“While the world is taking profound measure to tackle this deadly COVID-19, we are playing with people’s lives.”

Obianuju Lillian Ikegbune, a communication and strategy executive, stated: “The COVID-19 pandemic has exposed how weak the Nigerian healthcare system is and how compassionate and professional healthcare workers have taken their call to service to save lives.

“It is so sad that doctors here in Nigeria who have decided to commit to their oath of profession are not well equipped to carry out their jobs.”

“The impact of the incessant strikes on the masses and patients are misdiagnosis, as doctors are scared for their lives and don’t want to spend time diagnosing any patient. As we know, the symptoms of COVID-19 has a wide range and can be similar to other non-communicable diseases.”

Director General of NIMR, Prof. Babatunde Salako, believe the strikes are not only affecting COVID-19 fight, but also the health system generally, as NARD members constitute a formidable workforce that must handled carefully.

“The leadership of NARD should also tread carefully and put the interest of their patients and nation first,” he said.

To curb frequent industrial actions in the health sector, especially by resident doctors, Salako, urged government to stop signing agreements it cannot fulfill, adding that unions should be patient to negotiate especially during peace time.

A fertility expert and joint pioneer of In Vitro Fertilisation (IVF) in Nigeria, Prof. Oladapo Ashiru, stated: “If the government does not meet NARD’s demand, it shows what the government’s prioritises are. In such a situation, I think NARD should look for a more convenient platform to dispense service to humanity.

“Government and its people must decide if health is a priority and put money on it as is done all over the world. The truth is that resident doctors cannot be produced overnight and they are seriously needed for smooth and effective health care delivery.”

Ashiru bemoaned that strikes by healthcare workers was becoming popular despite healthcare being essential, saying if strike was the language the government understands, then doctors should speak it when the need arises.

On how to end frequent strike by resident doctors, Ashiru charged government to promote policies that could improve healthcare funding and welfare of practitioners, as well as revamp the hospitals.

He added: “All medical tourism by government officials must be stopped. They must all be seen at government hospitals, while training and retraining of all cadres of staff should be taken seriously. Adequate remuneration, career progression and job satisfaction are the condiments to retaining the manpower we produce.”

Consultant public health physician and Executive Secretary, Enugu State Agency for the Control AIDS (ENSACA), Dr. Chinedu Idoko, said frequent strikes have their demanding effects, not just on the COVID-19 fight, but also health care delivery in general.

He added that it would do the country good if the issues in contest would be resolved for sustained services doctors’ to the people.

Idoko called for sincerity on the part of government to commitments they consent to, actual implementation of agreements and resolutions to avoid strike coming up after issues were discussed by both parties and a certain agreement obviously reached.

A former NMS president and President, Association of Professional Bodies of Nigeria (APBN), Dr. Omede Idris, said it was unfair to believe that frequent strikes by health workers was worsening the COVID-19 fight and state of health care delivery in the country, insisting such strikes are borne out of failed promises. He reminded that those working in isolation, investigative and case management centres for COVID-19 are exempted from such actions.

He noted that it is expected that government would not allow the situation to degenerate to the point of NARD or NMA calling out members, including those taking care of COVID-19 patients.

The medical doctor further explained: “The fact remains that the fight against COVID-19 is not confined to health workers alone. Failure in the fight would be a reflection of total and multifaceted systemic and institutional failure of both non-medical/non-pharmaceutical and medical/pharmaceutical components. Medical here implies doctors, nurses, laboratory services and care.

“The nonmedical/non-pharmaceutical approach through communication, sensitisation, awareness, care of surfaces, social distancing, soap and water hand washing, avoid handshaking, controlled movement etc. will reduce the number of positive cases of COVID-19 and by extension symptomatic cases that will require core health team intervention.

“Since the opening of interstate travels and increase in test centres, there has been significant daily raise in number of confirmed cases, admission and death. The more the positive cases the more the fix and make shift facilities are stretched, so also the available health workers. They too are human who must take care of their health and so the absence of ideal or proper personal protective equipment PPE will also hamper their response to work. In essence the worsening does not reside within the scope.”