The recent strike by the National Association of Resident Doctors ended in a farcical and discreet withdrawal from the battle field.
Like the cowering Nigerian Army in the face of superior fire power of Boko Haram, the NARD retreated to the wards “because ex-President Olusegun Obasanjo intervened.’ For God’s sake, where was Obasanjo before you went on the stupid strike?
Yet, the reasons adduced for going on strike appeared satisfactory, at least on paper. According to Temitayo Olofinlua, writing from Ibadan (firstname.lastname@example.org), the Association of Resident Doctors in the University College Hospital, Ibadan, went on strike because of these issues as stated below:
- Deplorable state and poor conditions within the hospital
- Lack of resources for effective health care delivery
- Casualisation of doctors
- Unpaid arrears for medical doctors (skipping)
Temitayo broke it down with examples. He noted that most of the lifts at the UCH no longer work except the one that leads to the private suite (of course!). Ramps are now used to move patients to different parts of the hospital and many doctors feel that this is a slow, laborious process, especially when dealing with life-threatening emergencies.
Further, he said, there has not been electricity at the west wing of the hospital for a while. This wing houses neurology and psychiatric cases. Lack of electricity will definitely affect the quality of health care that patients can get at the hospital. In addition, the condition of the on-call rooms for doctors is deplorable. Many of the call rooms are not fit for purpose and largely uninhabitable: mattresses thrown on the floor to sleep on, broken water pipes in bathrooms that are not cleaned regularly and so covered with dust…
The doctors in UCH and many other hospitals recently on strike say that there are due remunerations that should be paid. This is the issue of ‘skipping,’ which many feel they are entitled to in order to maintain the differences in the salary levels between different cadres of civil servants.
Doctors are not happy that other people have been skipped to their level and they want to be skipped to a higher level (as promised by the government).
The spin doctors say that doctors are on strike to make life better for the patient. In effect, the strikes in many hospitals are due to a genuine concern of doctors about patients’ welfare. Doctors are actually concerned about the quality of care and comfort for the patients in their respective hospitals. Did you get that? Do you really believe that?
Of course not! Sadly, the average patient neither knows nor feels involved in the battle. In fighting a seemingly just cause with strikes on behalf of the patient, we are only applying ‘the weapons of mass destruction’ theory. Strikes, however, mean that the same patients are dying or being maimed daily due to lack of care. Perennial strikes are destroying any moral justification and further infuriating the public we’ve sworn to look after.
Money remains an important factor in strikes. Doctors are primarily or secondarily demanding their dues as assented to by the various governments. Recent strikes were used to request dues not paid by Chief Medical Directors of hospitals (who, incidentally, are doctors in the majority!). Hospitals where there is agreement to pay – or, in fact, paid dues – have not gone on strike. The fact that the noble objectives are mixed with pecuniary gains reduce the morality for doctors. Why are doctors seemingly so dense? Who is fooling who?
An elderly physician said we are supposed to be an intelligent lot. However, with repeated unsuccessful strike actions, we are using brawn, not brain. For an intelligent group, doing the same thing over and over again while expecting a different result is simply madness. Yet, this is personified by health care practitioners, some of whom are actually practising psychiatrists.
So, what are the solutions available and what can we do differently?
The first and absolute ‘must do’ activity is to inform all doctors about the issues at stake. We must endeavour to carry everyone along, especially doctors in private practice. All doctors must be able to articulate the issues demanding action. We must be able to speak with one voice, after adequate and widespread consultations.
Secondly, the situation where residents are thrown into battle alone, when all doctors will benefit, should stop. The NARD must stop being used for pecuniary gains. It demeans us all.
Thirdly, we need to stop muddling the waters. If it concerns patients, then the national body, Nigeria Medical Association, should be the focal point and the only association directing affairs. The public should be informed, educated, carried along with effective press, media sensitisation and an efficient social media campaign for maximum impact. We must ensure that patients, faith and civil society groups carry out the advocacy while we maintain a moral high ground.
There are also more creative ways to deal with government than making innocents suffer. For instance, why can we not stop treating civil servants and government officials? We can stop routine care for them in both public and private hospitals. I think this is worthy of some thought!
We need to clean up our act, work smarter and totally redefine medical practice in Nigeria. Our patients must be the heart and soul of our practice and we cannot go on like this.
NB: Next week, we will discuss the role of government. Well, this new government has not caused any problems yet, so send me your opinion and advice for them.