… The agony of avoidable deaths

By Chioma Obinna

Thirty five-year-old Mrs Gladys Agbo would have been alive with her children if  doctors were available at the Lagos University Teaching Hospital, LUTH to attend to her when she was rushed to the foremost teaching hospital.

Gladys would by now, have been preoccupied with the nursing of her set of twins.  Unfortunately, it wasn’t to be, no thanks to  man-made factors bordering on the nationwide indefinite strike called by medical doctors under the auspices of Nigerian Medical Association, NMA, despite public outcry.      The set of twins which would have been the first off springs of the family, died along with their mother.

Their demise swelled up the already high number of neonatal deaths in the country. Available statistics show that Nigeria contributes 30 percent of the global deaths and 11 percent of the global burden of under- five deaths as well as the unacceptable high maternal mortality.

Gladys and her children are not the only victims of the ongoing strike.   Many casualties are being recorded almost every minute in almost all the hospitals across the country. Just last week, there were reports that three patients died as a result of the absence of doctors to attend to them in Delta State. Two of the patients were reported to have died at the Federal Medical Centre, FMC, Asaba, due to lack of attention from doctors while the third victim died at the Ekpan General Hospital in Uvwie Local Government Area.

Many more patients suffered the same fate like a Lagos-based librarian whose wife was admitted a day before the commencement of the ongoing strike.


An empty ward in a Lagos owned hospital due to the strike by the medical doctors
An empty ward in a Lagos owned hospital due to the strike by the medical doctors

“It is unfortunate that both the government and doctors are taking our lives for granted. I brought my wife here yesterday (Monday), only to be told that doctors are on strike today. Her sickness is somehow different and cannot be left in the hands of a nurse or student doctor. The doctor that is supposed to see to her case is not even near the hospital. We have no choice than to consider a private hospital to continue her treatment,” the husband of one  the patients told Vanguard Features.VF

Another heart- rendering story is the case of a five year old boy, Daniel, whose mother barely managed to raise the money for transport to the hospital that day.   The boy has a swelling on the neck. Little did they know that the doctors have withdrawn their services? “Who will I run to?”

The mother who later identified herself as  Mama Ruka , asked to no one in particular.

Situation in government-owned hospitals

The pathetic situation in all Federal and state-owned hospitals across the country left hundreds of patients, who turned up for appointments, hopeless.   Women, children and men who turned up at the hospitals, irrespective of their conditions, were left unattended to.

The situation in the hospitals was so bad that in some hospitals, nurses and pharmacists took over the duty of the striking medical doctors.     From Lagos, Abuja, Bauchi, Imo, Delta, Ekiti, Minna, and the rest of the 36 states of the country, the situation was the same.   There was total shut down of services by the striking medical doctors.

Lamentations of patients
Lamentations were the the sing-song in the various wards. Patients on admission continued to recount their woes.

The beehive of activities which the  Accident and Emergency, AE, departments are known for, were absent. Usually busy departments like Obstetrics and Gynaecology, Surgery, Paediatrics, Medical Out- Patients Clinics and Labour, were devoid of activities.

The frustration was so much that patients began to ask why strike had become too frequent ingovernment-owned health facilities. The sad aspect is that patients are always at the receiving end.

For these patients, strike should be outlawedin a sensitive sector as health. They argue that strike in public hospitals are usually to the detriment of the average Nigerian who can hardly afford to pay private hospital bills.

Yet, these are Nigerians whom, according to the Nigerian Constitution, have a right to good healthcare services.
Critical observers are of the view that unless there  is an urgent intervention many more patients, particularly pregnant women and their children and those who cannot afford treatment in the private hospitals, will continue to die in their numbers.

In the last one week there have been public outcry over the indefinite strike. To compound issues,neither the government nor the medical doctors is considering shifting grounds.

Even the nurses are left wondering how there will be a functional hospital when the doctors are nowhere to be found.

The father of a patient in an emotional outburst asked; “Is this the hospital a government would boast of? I know it will be costlier to take care of him at the private hospital, I have no other option; I will take him there.”
For now, it seems that strikes have become a way of life in Nigeria. Perhaps more worrisome is the frequencyof such strikes.

Health watchers are recommending that to meet the target of the Millennium Development Goals, MDGs, goal four and five, government should consider having more locum (contract) doctors to offer urgent services any time there is strike.

The NMA demands
In the letter, signed by NMA’s National President, Dr Kayode Obembe, the NMA  said that the post of Deputy Chairman Medical Advisory Committee, DCMAC, has been circularised and operational. “Rather than abolish it, the NMA hereby demands that four (4) DCMACs for teaching hospitals and three (3) for the Federal Medical Centres be appointed forthwith to assist the CMACs whose statutory responsibilities are too heavy for any single individual to handle. Directors in other government agencies are supported by several Deputy Directors, why not the CMAC who is also a Director? Such a DCMAC must have same qualifications as the CMAC .”

Obembe said that the NMA is opposed to the appointment of Directors in the Hospitals. According to him, this position distorts the chain of command in the hospital, induces anarchy and exposes the patient to conflicting treatment and management directives with attendant negative consequences.

“The NMA demands that grade level 12 (CONMESS 2) in the health sector must be skipped for medical doctors. Consequently no medical/dental practitioners should be on that grade level anymore,” he said.

The NMA also argued that the title “consultant” in a hospital setting describes the relationship between the Specialist Medical Doctor and his patient. Doctors said it will be a source of confusion if the title is applied to any other health worker who statutorily does not own patient. “NMA therefore declares with unmitigated emphasis that if “non-doctor consultants” are appointed, it will lead to chaos and anarchy in the health sector. This should not happen.

“Relativity in health sector is sacrosanct. The NMA hereby demands for immediate implementation of the January 3rd, 2014 circular. The NMA also demands the immediate payment of the arrears of the corrected relativity for 22 years during which her members were short changed.

“Much as we are not against salary increase for any category of workers, either in health or elsewhere, the NMA demands for immediate adjustment of the doctors’ salary to maintain the relativity as agreed and documented once CONHESS is adjusted.

“That Government should expedite the passage of the National Health Bill, NHB and extend Universal Health Coverage to cover 100 percent of Nigerians and not 30 per cent as currently prescribed by National Health Insurance Scheme, NHIS.

“ Surgeon General of the Federation must be appointed with immediate effect.

“ The entry point of the House Officer should be corrected to CONMESS 1 step 4 as originally contained in MSS/MSSS while the Registrar/Medical Officer is moved to CONMESS 3 step 3.

“Clinical duty allowance for Honorary Consultants should be increased by 90 percent of CONMESS amongst others.


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