Thursday, July 17, 2014

Striking doctors and irresponsible government

It is 16 days since the Nigerian Medical Association called out its members on a total and indefinite strike. In the course of that period, the death toll at most of the government-owned hospitals has risen. Families of patients who could afford treatment at private hospitals within and outside of the country have had to take the painful option of seeking help there. Those who have no money resorted to faith clinics, herbal homes or simply entrusted their fate in the hands of ‘chemists’ and ‘pharmacists’, some of whom are charlatans.
Many commentators have poured invective on Nigerian doctors for their decision to embark on the strike. I actually hold an opposing view to this. I blame the government. The question we need to ask our imperial government is why it fails to implement agreement reached previously with the doctors? Why the perpetual poor funding of the social sector like education and health? Why has the National Assembly failed to pass the National Health Bill?
The health statistics in Nigeria are saddening. The prospect of the country meeting any of the health-related Millennium Development Goals in 2015, which is only a few months from now, is dim. What with the high incidence of maternal and child mortality, the inability to roll back malaria after many years of the campaign, the needless deaths from preventable diseases like cholera and dysentery as well as the inability to eradicate polio. According to Angela Adeboye in a July 6, 2014 ThisDay article, titled, The Paradox of Nigerian Health care, “The World Health Organisation ranks the Nigerian health care system amongst the worst in the world. Specifically, its most recent report places Nigeria at the 187th position of 190 countries. This is only ahead of the Democratic Republic of Congo, the Central Africa Republic and Myanmar. Even Zimbabwe and Burundi, which are amongst the poorest countries of the world, rank at least 30 places ahead of Nigeria. Yet, Nigeria has the largest Gross Domestic Product on the continent and many significant mineral resources.”
Instructively, the Nigerian government has refused to fix the rot in the country’s health sector because its officials are able to access the best medicare abroad at the country’s expense. Even their medical check-ups are done overseas which says a lot about their disdain and distrust for the country’s medical services.
Many private citizens have had to seek medical assistance in India, Egypt, Europe and America all because our government failed woefully to put the needed infrastructure in place to provide word class health care services for its citizens. This is not a rocket science; but corruption and selfishness will not allow our own government to do it. South Africa offered the best medical facilities to Nelson Mandela at home all the period he was sick till his death. Fidel Castro of Cuba is being treated in-country while he battles his debilitating terminal sickness. In Nigeria, even local government chairmen and councillors use public funds to access health care services abroad let alone the big ‘ogas’ at the state and federal levels.
The malaise plaguing our health sectors are numerous and well-documented. Top of which is the lack of adequate funding. Others include defective policy guidelines and legislation; insufficient infrastructure and equipment; a dearth of manpower; corruption and insecurity, among others. It is long overdue for the National Assembly to pass the National Health Bill pending before it since the inauguration of the current legislature in June 2011. Three years down the line, the bill has yet to be passed. The passage of this all-important regulatory framework is among the 24 points demand currently being made by the NMA on government.
Other requests include the Universal Health Coverage to cover 100 per cent of Nigerians and not 30 per cent as currently prescribed by the National Health Insurance Scheme; appointment of Surgeon General of the Federation; the need for government to set up a health trust fund that will enhance the upgrading of all hospitals in Nigeria and that the position of Chief Medical Director/Medical Director must continue to be occupied by a Medical Doctor as contained in the Act establishing the tertiary hospitals. The doctors are also demanding an upward review of some allowances and payment of certain benefits. These are normal demands which if addressed will make our health providers to give their best. If truth must be told, doctors in government hospitals are overworked and face a lot of risks including physical assault by relatives of patients.
We must be mindful of the fact that failure on the part of government to frontally tackle the challenges of the health sector has led to brain drain as many of these health professionals have either left the country for greener pastures abroad while others have left medical practice entirely for more rewarding vocations like politics and working for local and international non-governmental organisations. There is no gainsaying that there currently exists a frosty relationship between medical and non-medical staff in public owned hospitals. This rivalry is unhealthy. Nurses, pharmacists, laboratory scientists and other ancillary staff in the health sector should recognise the primacy of the doctor as the head of medical institutions. This however does not diminish the importance of the roles played by non-medical staff, because the neck and other parts of the body are as vital as the head.
As reported by this newspaper on Tuesday, though government is owing doctors about N6.7bn in accumulated entitlements, the striking doctors through their president, Dr. Kayode Obembe, said the real bone of contention was not money but the decision of the Federal Government to throw open the headship of hospitals to those it described as non-medical doctors. Obembe was quoted as saying that, “Relativity and skipping are not negotiable; these must be resolved or doctors will not return to work. The tradition of medicine is being challenged dangerously in this country. That is the major issue and not money.” My appeal is that the Federal Government through the Minister of Health, Onyebuchi Chukwu, needs to bring all the feuding parties to a roundtable, if possible with the leadership of the National Assembly, so that the leadership tussle is resolved once and for all. The arrears of all benefits being owed the doctors should also be paid without further delay while the doctors themselves should show sympathy for the suffering masses who are at the receiving end of this industrial action and return to work while these issues are being resolved.