Medicine: Mercy’s sister
I don’t mind good news interrupting my sleep because the goodness in the news is an act of compensation for my loss of sleep. But the news I received in the morning of Sunday August 8 was not good at all. “Your senior sister is dead,” said the caller in a tone that bore no emotion that was remotely related to the sorrowful event. I didn’t think it was a joke because people do not joke about events such as this. Besides, the information came from someone who came from the womb of the dead woman.
The next day I got another bad news: “your stepmother is in a coma.” That wasn’t too bad because she could be made to exit from that coma status everything being equal. But everything was not equal because doctors were on strike in the best available hospitals, which are government owned. Most private hospitals in Akwa Ibom State are just a room-and-parlour affair with one doctor or two struggling to fill the medical gaps left by the better hospitals around. A few hours after the call, my stepmother died. Two deaths within the family. Two deaths within two days. One cloud is enough to darken the sky. But what we have here is double jeopardy, which makes the sky doubly dark.
Since Nigeria is a country that is disdainful of statistics we may never know how many people, young and old, men and women, have involuntarily gone to meet their Maker, as we love to put it. But it is obvious that many of our countrymen and women are dying daily, and their relations are wrestling with sorrow while the striking doctors and the various governments, state and federal, play hard ball. Both sides are now in the eye of a tornado while we the people wither in self-scrutiny, asking no one in particular what we may have done to deserve this calamity.
The Federal Government signed an agreement with the Nigerian Association of Resident Doctors (NARD) sometime ago. This agreement was for the Federal Governments to pay the outstanding salary arrears and residency training fees for two years. On July 22, 2021 the doctors were said to have had a conciliation agreement meeting with the Federal Ministry of Health. The Federal Ministry of Health says it has met most, but not all of their demands. The doctors want all of their demands met. In furtherance of this they started a strike on August 2, 2021. The Minister of Labour and Productivity, Dr Chris Ngige has weighed in with two responses. He has invoked the ancient labour crisis ritual of no-work-no pay as if the doctors cannot make money through private practice. He has also dragged the doctors’ association to the National Industrial Court for arbitration saying that members of the medical profession are regarded as essential services workers, who are not expected, or permitted to go on strike.
These two approaches are purely legalistic and academic and do not respond to how people can be saved from dying. Both sides will jaw-jaw at the Industrial Court and as they make their opening and closing arguments many human bodies are on their way to mortuaries. The most important step is not a big stick approach but how to soft-pedal and get the strike halted. I sympathise with the Federal and State Governments because there is shortage of money. The Federal Government now spends, I hear, about 70% of its revenue on debt servicing which makes it difficult for it to meet some of its financial obligations. COVID-19 has made the economy to walk back into recession and this has complicated matters for everybody.
The Minister of Health, Dr Osagie Ehanire, thinks the NARD fellows ought to understand that the time in which we are afflicted by the virulent version of COVID-19 called Delta is no time to go on strike. That is correct. He thinks that the action of the doctors can be described as an act of wickedness, which remark I consider to be a little over the top. Words spoken in anger can linger for long and damage relationships even after the problem that gave birth to the anger has been resolved. In response, the President of NARD, Dr Uyilawa Okhuaibesuyi has remarked that the issues are not new, that NARD had issued several ultimatums before embarking on the strike. In response to the no-work-no pay threat he said: “they can keep their money,” which means that they too will keep their stethoscopes in their pockets instead of on their necks. He also said that the government is wicked for not meeting its demands.
The ordinary man on the street probably thinks that both sides deserve the word “wicked” even though such an exchange of insults will not bring the dead back to life. While this is going on the Nigerian Medical Association (NMA), which is sitting like a coil waiting to spring to action says that if the issues are not resolved quickly it will join the strike. Please don’t. Don’t join the strike because that will compound the country’s problem immeasurably except you have already built more mortuaries to take in the millions that will die. Apart from COVID-19, cholera is now scything through populations. It has already killed 816 people in 22 states since January. If you join the 16,000 resident doctors already on strike you will turn calamity into cataclysm. Please don’t. Please wear the white garment of honour by not sacrificing human lives on the altar of bread and butter.
The situation is very fragile, as fragile as porcelain. Right now Nigerians whose loved ones are sick are a fountain of tears. They have wrinkles of worry as the elephants fight, as they hear the sting and clash of battle, as they smell the rancid odour of frustration. Please don’t add to our woes. I am sure it is not money per se that brought you into medicine. I am sure you chose medicine advisedly, carefully, as carefully as people choose an engagement ring. I am sure when you chose medicine you wanted to be in a position to heal people, to save people from dying because death is an irreversible event of no return. There is yet no substitute for a dead human being. New babies may be born but they are no substitutes or replacements for the dead. The dead are dead, stone dead, no coming back, no Lazarus miracle.
About 4,528 Nigerian medical doctors who were trained in Nigeria are reported to have relocated to the United Kingdom to practise. In 2015, this figure was a paltry 233. In 2019, it rose to 1,347 doctors. This is an indication that the operating environment here is awful and we all must nudge the various governments and private sector big wigs to help our health industry to grow to a standard where medical tourism will be a thing of the past. It is my honest view that the doctors who have chosen to practise here instead of looking for greener pastures abroad are patriotic people of compassion, people who have decided to stay here and save us from some of our vices and follies which lead to poor health and death. They are men and women of mercy even if their exertions are not fully appreciated by those who run our affairs.
Medicine and mercy are conjoined like Siamese twins; they are inseparable; they share the same umbilical cord. They nurture each other, each giving life to the other. People who practise medicine must do so with mercy, not in the manner of mercenaries because the doctor/patient relationship is a human umbilical cord; it is a relationship that is more personal than impersonal; the patient trusts the doctor and allows him or her to touch his or her body, even the most intimate part of his body without considering it to be an invasion of his or her privacy. So medicine is not a regular nine to five job. It is a calling of mercy. No sane doctor leaves his patient on the operating couch simply because it is time for him to go home. He doesn’t go home except his job is done and his job is not linked to hours of work. It is linked to job completion, to the completion of his duty to his patient.
This is encapsulated in the Hippocratic oath, the article of faith that makes doctors who they are: healers of the sick. The Hippocratic oath is an oath of allegiance that must not be turned and twisted into a hypocritical oath because that is not what it was meant to be. Medicine is a selfless profession for selfless people who must get their spiritual fulfilment from saving lives of people in distress. That is a tall order but it is a worthy and worthwhile endeavour. I ask the government to make peace with the doctors and leave the Industrial Court out of this. Even if the government wins at the Industrial Court but doesn’t discharge its responsibilities under the agreement it freely signed with the doctors, that win will be mere Pyrrhic victory, an act in futility. That win will be worse than a loss because that will not prevent people from dying. Don’t forget that creditors have better memories than debtors.
If you sign an agreement you must discharge your responsibilities under that agreement. If you can’t, then quickly sort out what needs to be sorted out by a gentle act of persuasion so that you do not turn partners into firm foes by your actions or inactions. Both sides must come back to the circle of reason, the negotiating table and put sincerity before superiority. Both sides are as strong as tigers but we can do without this display of Tigritude.
Having said that, who am I to blame for the loss of my two loved ones? The government for not keeping to the agreement it signed? Partly yes. The doctors for putting money ahead of mercy? Partly yes. Me for not having the financial resources to fly my loved ones in an air ambulance to Dubai for treatment? Partly yes. God for not saving my kith and kin? Fully no, because God has given us everything with which to do what is right and we failed abysmally.
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