Despite being on strike for 107 days this year, doctors, nurses and other health personnel at the University of Ilorin Teaching Hospital still collected their salaries. Ravaged by strike, the relevance of tertiary hospitals across the country is increasingly being questioned by the public.
This was what the Chief Medical Director of UITH, Abdulwaheed Olatinwo, realised recently and became apologetic. He felt that public trust had taken flight and promised to ensure that services were not disrupted in future. If Olatinwo has a vaccine against the strike epidemic at UITH, there is no gainsaying the fact that it will remain an armour against the non-implementation of a raft of demands that include improved wages and provision of facilities for a better service-delivery. The Association of Resident Doctors proved just that on December 19. In a communiqué issued at the end of its meeting, it gave the Federal Government 21-day ultimatum to address its grievances or face “a total indefinite withdrawal of service.”
But it is worrisome that labour unrest has become perennial at our referral centres. The great costs to patients and the country are irredeemable. While the personnel at UITH might have sheathed their sword, this spirit of renewal or rededication to duty is not widespread.
At the Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State, where medical personnel began their strike on September 28, 2015, the atmosphere remains eerie. In spite of the fact that the strike was called off in June, January salary was reportedly paid in August. The N198 million monthly subvention it used to receive has been reduced by the government to N94 million, with an instruction to the hospital management to be creative for self-sustenance.
It took the intervention of the Speaker, House of Representatives, Yakubu Dogara, for the ARD to suspend its nationwide strike on June 24, which its President, Muhammadu Askira, said was to give room for further negotiations. He lamented that 25 out of 54 branches of the union were suffering from government’s breach of an agreement on paying arrears of remunerations due to its members as of August.
While federal and state governments have been irresponsible by failing to discharge their obligations of adequately funding their hospitals and signing agreements with heavy financial implications with unions, which they are not prepared to honour, the doctors too have not been blameless. The strikes have become too frequent for comfort.
The usual victims are patients, many of whom die in the process. It was a cruel fate that befell one Margaret Edobor, who was admitted to the University of Benin Teaching Hospital over injuries she sustained from a fire accident. She had been on a hospital bed for one month before a strike embarked upon by the ARD at the hospital on August 5 resulted in her untimely death. According to the brother, she “was getting better until the doctors’ strike started. Because they left her unattended to, she contracted an infection, which led to her death.”
This is painful. Thousands of lives may have been lost under similar circumstances. Such unconscionable display raises some ethical questions that are clearly in breach of the Hippocratic oath that doctors swear to uphold when they are officially enrolled in the profession. A change of heart is badly needed. A doctor’s primary responsibility is to save lives. This should be sacrosanct as a life lost is gone for ever.
Imagine what would have been the fate of Nigeria if the military and police – essential service workers too – were to embark on strike, or do so as often and as prolonged as the doctors do. They are equally victims of the same irresponsibility in governance. Many of the soldiers fighting Boko Haram in the North-East were once deployed in battle fronts with rationed bullets under the last administration. Many of them have been killed as a result; and those that questioned the authorities, court-marshalled.
In civilised parts of the world, workers on essential services such as doctors exhibit restraint. They hardly go on strike and if compelled to do so, only on a limited number of days, just to make a point. In some instances, unions or civil society symbolically do it for them. This is done because of the critical nature of their job. It is a practice our doctors should emulate to stop avoidable deaths in tertiary hospitals that are triggered by labour disputes.
Nevertheless, it is shameful that our teaching hospitals, especially those at Ibadan, Enugu, Zaria, Lagos and Maiduguri, which the Federal Government had graded as “centres of excellence” a few years ago, do not, by any stretch of imagination, epitomise such distinction. They are grossly underfunded and ill-equipped. This is the reality at the University College Hospital, Ibadan; University of Nigeria Teaching Hospital, Enugu; and Ahmadu Bello University Teaching Hospital in Zaria, designated as specialist centres for neuroscience, cardiothoracic disorders and oncology and radiotherapy respectively.
If these tertiary medical centres had served the purposes they were meant to serve, Nigeria could have reversed its ugly medical tourism profile, which shows that 5,000 Nigerians travel abroad monthly for treatment, as the Nigerian Medical Association once revealed. It is a fact the then Nigerian High Commissioner to India, Oyebola Kuku, corroborated with a revelation that out of 25,000 Nigerians given visas in 2011, about 20,000 of them went for medical treatment.
That our tertiary health institutions and others remain “mere consulting clinics,” 33 years after they were so designated by the military when it toppled President Shehu Shagari’s government is a sad commentary. The country should do better in the 21st century, conscious of the fact that a healthy populace bodes well for productivity and wealth creation.
