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Resident doctors in the country have commenced an indefinite nationwide strike following the expiration of the 14-day ultimatum issued to the Federal Government.

Among the demands of the doctors are immediate implementation of the revised hazard allowance and payment of the COVID-19 inducement allowance as “agreed by government and healthcare workers” three months ago. They also want an immediate payment of all arrears owed doctors in federal and state tertiary health institutions, arising from consequential adjustment of the national minimum wage.

Meanwhile, there is fear that the industrial action may worsen the poor doctor-to-patient ratio and increase the number of deaths due to coronavirus infection, although Sokombo said doctors treating Covid-19 patients were not going on strike immediately.

Several studies have shown that frequent healthcare workers’ strikes result in the closure of public healthcare institutions, thereby preventing Nigerians’ access to quality health services.

It was gathered that the resident doctors, who are the ‘militant arm’ of the Nigerian Medical Association (NMA), the umbrella body of all doctors in Nigeria, represent about 40 per cent of physicians in the country.

Contrary to the World Health Organisation (WHO) recommendation of 1:600 doctor-patient ratio, Nigeria currently has one doctor attending to 6,000 patients.

According to the NMA, there are 72,000 registered Nigerian doctors with over 50 percent practicing outside the country. Consequently, there are less than 40,000 doctors in an estimated population of 196 million.

This means that with the number of resident doctors in Nigeria put at about 16,000 (that is 40 per cent of 40,000), it will leave the country with just 24,000 doctors, including consultants and those in private practice. The situation will further reduce the country’s doctor-to-patient ratio from 1:6,000 to 1: 10,000.

Indeed, Nigeria is still far from the recommendations of the WHO on the required number of medical personnel to cater efficiently for its teeming population. However, figures from the Federal Government differ: the ratio of doctor-to-patient is 1: 2,753, which translates to 36.6 medical doctors per 100,000 persons.

Figures from the Federal Ministry of Health (FMoH) indicate that 74,543 medical doctors are registered with the Medical and Dental Council of Nigeria (MDCN) as at March 4, 2020.

The National Universities Commission (NUC) had in January 2020 said Nigeria needed about 300,000 medical doctors to meet the doctor-patient-ratio of 1:600 recommended by the WHO.

The Executive Secretary, NUC, Prof. Abubakar Rasheed, said the current “doctor-patient ratio in the country stands at 1: 3,500.”

According to him, the nation’s medical schools produce about 3,000 doctors yearly and this is not enough to achieve the WHO standards to deliver on health care services.

President of the National Association of Resident Doctors (NARD), Dr. Aliyu Sokomba, who announced commencement of the strike at a press conference yesterday in Abuja, said NARD’s members attending to Covid-19 patients at designated treatment and isolation centres were exempted from the strike for two weeks after which, if their demands were not met, they would also be co-opted to join the industrial action.

He explained that the exemption was in recognition of the intervention of the speaker of the House of Representatives, the chairman of the House Committee on Health Services and other stakeholders as well as a demonstration of NARD’s goodwill to Nigerians.

Meanwhile, there is fear that the industrial action may worsen the poor doctor-to-patient ratio and increase the number of deaths due to coronavirus infection, although Sokombo said doctors treating Covid-19 patients were not going on strike immediately.

Several studies have shown that frequent healthcare workers’ strikes result in the closure of public healthcare institutions, thereby preventing Nigerians’ access to quality health services.

It was gathered that the resident doctors, who are the ‘militant arm’ of the Nigerian Medical Association (NMA), the umbrella body of all doctors in Nigeria, represent about 40 per cent of physicians in the country.

Contrary to the World Health Organisation (WHO) recommendation of 1:600 doctor-patient ratio, Nigeria currently has one doctor attending to 6,000 patients.

According to the NMA, there are 72,000 registered Nigerian doctors with over 50 percent practicing outside the country. Consequently, there are less than 40,000 doctors in an estimated population of 196 million.

This means that with the number of resident doctors in Nigeria put at about 16,000 (that is 40 per cent of 40,000), it will leave the country with just 24,000 doctors, including consultants and those in private practice. The situation will further reduce the country’s doctor-to-patient ratio from 1:6,000 to 1: 10,000.

Indeed, Nigeria is still far from the recommendations of the WHO on the required number of medical personnel to cater efficiently for its teeming population. However, figures from the Federal Government differ: the ratio of doctor-to-patient is 1: 2,753, which translates to 36.6 medical doctors per 100,000 persons.

Figures from the Federal Ministry of Health (FMoH) indicate that 74,543 medical doctors are registered with the Medical and Dental Council of Nigeria (MDCN) as at March 4, 2020.

The National Universities Commission (NUC) had in January 2020 said Nigeria needed about 300,000 medical doctors to meet the doctor-patient-ratio of 1:600 recommended by the WHO.

The Executive Secretary, NUC, Prof. Abubakar Rasheed, said the current “doctor-patient ratio in the country stands at 1: 3,500.”

According to him, the nation’s medical schools produce about 3,000 doctors yearly and this is not enough to achieve the WHO standards to deliver on health care services.

Sokomba faulted the non-payment of the Covid-19 hazard inducement allowance to all health workers across the country in spite of repeated promises by government. He alleged insincerity of officials of the executive arm of government in paying the outstanding salary shortfall of 2014, 2015 and 2016 under the guise of appealing the decision of the National Industrial Court.

The NARD president expressed concern over the plight of members of the association in state hospitals such as the non- domestication and non-implementation of the Medical Residency Training Act, the non-implementation of appropriate salary structure, non-payment of salaries, and recently, the slashing of salaries of doctors and other healthcare workers by Kaduna and Kogi states.

Sokomba decried the sorry state of the healthcare delivery system in the country which, according to him, is characterized by perpetual unavailability of personnel protective equipment for workers in the hospitals with the attendant increase in infection rates and unnecessary suffering of patients and their relatives following the use of obsolete equipment, machines and technology.

NARD urged the governments to provide adequate personal protective equipment for all healthcare workers, ensure universal implementation of the Medical Residency Training Act in all federal and state hospitals and ensure pay parity among doctors of equal cadre.

The association advocated provision of funding for medical residency training in the 2021 Appropriation Bill even as it called for stoppage and immediate refund of all illegal, unjust and callous cut in salaries of its members by Kaduna and other states.

“We will continue to appreciate President Muhammadu Buhari for his commitment to the welfare of Nigerians. We appeal that he calls relevant agents/agencies to order from deliberately creating chaos to destabilize his administration. We appeal to our fellow lovely Nigerians to bear with us and understand this as a battle to save the almost dead health sector.

“NEC noted the commitment of the National Assembly to implementing the Medical Residency Training Act by ensuring inclusion of the residency funding into the reviewed 2020 budget.”

In a similar development, there is fear of scarcity of pharmaceutical products, especially those needed during this COVID-19 pandemic, as pharmacists in the country are planning to down tools in 14 days.

The Pharmaceutical Society of Nigeria (PSN) yesterday petitioned President Buhari over the appointment of A. T. Mora as chairman of the Pharmacists Council of Nigeria (PCN), instead of Alhaji Yaro Budah whom it recommended to the minister for the position, threatening to go on an indefinite strike in two weeks if the decision was not reversed.

The PSN, in the petition titled “Rejection of A. T. Mora as Chairman Pharmacists Council of Nigeria (PCN)”, urged the Federal Government to indefinitely suspend or cancel the inauguration of the PCN governing council with Mora as chairman.

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The novel coronavirus (COVID-19), a respiratory infection which according to the World Health Organisation (WHO), causes fever, tiredness, sore throat and in severe cases, shortness of breath and respiratory difficulty, is the most challenging health issue the world has experienced in the past few decades.

WHO and other global public institutions have confirmed that the severity of COVID-19 infection is heavily linked with the overall state of the body’s immune system, a reason why people with pre-existing health challenges are said to be most vulnerable to the contagion.

It is, therefore, not surprising that since earlier this year when WHO declared COVID-19 a global pandemic, people are now increasingly mindful of the state of their immune system.

For instance, the shopping lists of households across different parts of the world, including Nigeria, have revealed changes remarkably. CNN reported that the United States retail sales of orange juice jumped about 38 percent in the four weeks ending on March 28 when compared to the same period last year. Also, the Florida Department of Citrus disclosed that there was a spike in demand for 100% orange juice within the same period. The department forecasts a considerable increase in the short-term demand for the commodity.

Just like in the United States, there has been surplus demand for fruit juices in every other part of the world. During the five weeks the Federal Capital Territory, Lagos and Ogun were on lockdown, shops and supermarkets had run out of orange fruit juice stock in the first two or three weeks of the restriction.

In fact, less than a week into the lockdown, my favorite 100% Real Orange Fruit Juice, which would have made the stay-at-home less boring for me, had rapidly been purchased off the shelves in Lagos. The scramble for unavailable raw fruits in the open markets started in earnest. That the restriction on movement cut off a large chunk of the supplies did not help matters.

This major spike in the demand for pure fruit juice, especially the orange category, could be attributed to the immune-boosting power of orange juice. Peter McCaffery, a professor of biochemistry at the University of Aberdeen, said vitamin C, which is contained in orange juice, helps to strengthen the immune system to fight off bacteria and virus infections like the one the world is currently grappling with.

There are still relatively very few studies on the effect of nutrition on the human immune system. Yet, Harvard Medical School in its Harvard Health Publishing says deficiency in zinc, iron, copper, folic acid, Vitamin A, B6, C (which is contained in large quantity in fruit juice) and E have negative impacts on immune responses. Fruit juice contains the vital micronutrients needed to boost immunity.

However, fruit juice intake is just one of the ways to boost one’s immune system. There are several other things one can do to achieve this – adequate sleep, thorough cooking of meat, maintaining good hygiene, moderate intake of alcohol and regular exercise.

There are lots of herbal mixtures on the shelves of local stores with labels containing ‘support immunity’, ‘immune booster’ etc. So far, there is no evidence that such substances can strengthen immunity.

Regular exercise is an essential component of healthy living. It improves cardiovascular function, helps control body weight, removes toxins in the body, increases blood circulation and lowers blood pressure. The result of these is a strengthened immune system that protects the body against infections and diseases. Regular exercise is most valuable when one shuns junk food and sticks to healthy eating habits and balanced diet.

Individuals are often advised to ‘eat well’ as protection against the risk of infection. This advice has become even more relevant since the outbreak of COVID-19. What is missing in this counsel is the real definition of ‘eating well’. It is good to fill your stomach, but at best, that may only give you energy. What about ‘going green’?

Fruits are also an awesome option, but you also need to be sure you are not eating trouble. You really might not know how many hands must have touched the mango or apple you want to eat. Pure fruit juice contains the same nutritional value as raw fruit. So, if you can find a pack of trusted and healthily-processed 100% fruit juice on the store shelf, you will be making a smarter choice considering the prevailing health challenge.

*Malomo is a nutritionist

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The World Health Organisation has identified late diagnosis of Lassa fever patients as the reason for the high mortality rate of the disease in Nigeria.

In a statement on Monday, the health agency gave an official breakdown of the number of Lassa fever cases in Africa and called on governments and stakeholders in affected countries to commit more resources to early diagnosis of the viral disease.

It stated, “Lassa fever has killed more than 160 people in West Africa, most of them in Nigeria, since November 2015. Nigeria, Benin, Sierra Leone, Liberia and Togo have reported more than 300 cases of Lassa fever and 167 deaths.

“Nigeria accounts for the majority of the cases with 266 cases and 138 deaths reported in 22 of the country’s 34 provinces as at 21 March 2016. Benin has recorded 51 cases and 25 deaths. Many of these lives could have been saved if a rapid diagnostic test were available so that people could receive treatment early.”

An expert in haemorrhagic fevers at WHO, Dr. Pieere Formenty, stated that late diagnosis would lead to the death of 60 per cent of patients that have contracted the virus.

Formenty said, “Without early diagnosis and treatment, one in five infections result in severe disease, where the virus affects several organs such as the liver, spleen and kidneys.

“We need resources to invest in diagnostics to easily, accurately and safely test for Lassa fever as we do for malaria and HIV. Without a proper diagnosis, many people do not receive the correct treatment and that is why we see so many people with Lassa fever dying each year.”

PUNCH.

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