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Strike: Should we return home and die?

•Striking doctors turn critically ill patients, others back from hospitals
•TUCN raises the alarm: They are deploying ‘casual doctors’ in hospitals

By Chioma Obinna

For the past seven days now, services at public hospitals across the country have been practically crippled following a nationwide strike embarked upon by members of the Association of Resident Doctors, NARD. The NARD members, who are doctors in the employment of federal teaching hospitals and medical centres, are demanding the payment of their emoluments among other issues.

•A wardmaid wheeling a patient at LUTH, Lagos where authorities said patients are not being discharged.

Consequently, the hospitals have been discharging patients on admission while refusing to admit new ones irrespective of their condition.

Sadly, neither the striking doctors nor their employers (government) appear ready for a quick resolution of the dispute. The striking doctors have remained adamant on their demands in the face of the plea by government, citing limited resources at its disposal, for understanding. According to them, it is 100 per cent compliance with the strike. Not even emergency cases in the hospitals will be attended to.

When NARD officials and representatives of the Federal Government met last Wednesday to look at the doctors’ demands, the meeting ended in a deadlock.

Health watchers are worried that government, on its part, has been slow in responding to the issues raised by the doctors. They are also worried about the directive of the Minister of Health, Prof Isaac Adewole, that Medical Directors and Chief Medical Directors of the hospitals affected should engage locum doctors and National Youth Service Corps, NYSC, members to fill the vacuum created by the NARD members’ strike.

While the Minister, in a circular with Ref. No. C. 3132/Vol. V/116, had directed CMDs/MDs of federal hospitals to immediately engage the services of locum doctors to augment the services of consultants, NYSC doctors and doctors on internship pending the resolution of the strike as a measure to cushion the effect, NARD blamed the strike on the failure of government to honour agreements dating as far back as 2014.

Meanwhile, an offer by government during a meeting held sometime ago with the doctors was that they should give it time till November 2, 2017 to look into their six-point demand. The offer was rejected by the doctors.

The aggrieved doctors also claimed that they embarked on the strike because they were tired of hearing ‘I will do this’ from government, saying what they wanted to hear is ‘I have done this.’

According to the Secretary General of NARD, Dr Aneke Emmanuel, who urged the general public to bear with the striking doctors, the inaction of government caused the strike.

“The fact is that our members don’t want to hear ‘I will do this’ from government. What they want to hear is ‘I have done this’ because we have been on ‘I will do this’ for the past two years. We are not going to pay house rent, school fees among others with government appeal”, Emmanuel said.

Government, he stated, should address the issues raised by the NARD before they can call-off the strike.

He went on:”We have a lot of demands but we extracted a few that can be taken care of urgently. They need to pay our salary shortfalls and arrears, pay in full our salary from August to the end of the year and all the outstanding.

“They also need to release a circular placing our House Officers at the appropriate levels while promotion should be implemented. The idea of no work no pay should be stopped and they should place us back on pension scheme.”

With the doctors position not to return to work until all their demands are met, preventable deaths are likely to be recorded particularly from emergency and referral cases.

However, since the release of the Adewole (Minister) circular, directing locum and NYSC doctors to take over the duties of the striking NARD members, reactions have continued to trail it.

One of the reactions so striking was that of the Trade Union Congress of Nigeria, TUCN which described the directive as reckless, unguided and unexpected of a Minister.

The TUC President, Comrade Bobboi Bala Kaigama and Secretary General, Comrade Musa-Lawal Ozigi, expressed disappointment that at a time nations are building strong health sectors, ‘the giant of Africa’ sees the engagement of casual workers as recipe to the challenge in the health sector.

“The best of Nigerian doctors are abroad doing great; in fact, they treat our politicians who seek medical help abroad. And do you know what? They left this country because of some of the issues that led to the present strike. In other climes, issues that border on health are not treated with kid gloves, because lives are involved. But the reverse is the case here.”

The TUCN argued that asking consultants to work overtime while negotiations continue with the NARD members was dangerous because the situation involves human life.

The union asked if the consultants are factory workers. “How do you persuade a medical doctor that is fagged out to perform a surgery? We are going through enough pains already, trading lives for government’s complacency is most unreasonable. The Minister should realise that the hospitals they patronise abroad are not manned by casual doctors”, it said.

Hospital situations 

With the hospitals paralysed following the doctors’ strike, patients are no doubt in for tough times.   A visit by Sunday Vanguard to some of the hospitals, last week, revealed almost a hopeless situation. The strike, no doubt, has shown how indispensible resident doctors are in healthcare provision.

In Lagos, the strike, which started gradually, has taken its toll on affected hospitals. The development took a critical dimension on the third day when the hospitals stopped the admission of new patients and halted attendance to emergencies.

From the Lagos University Teaching Hospital, LUTH, to the National Orthopaedic Hospital, Igbobi, the Federal Neuro-Psychiatric Hospital, Yaba and the Federal Medical Centre Ebute Metta, same scenario played out.

However, the LUTH CMD, Prof Chris Bode, insisted that the hospital remained open to the public regardless of the strike. “Such untruths can aggravate the suffering of our people, so I will caution the media to pin down the peddler(s) of such falsities and ask them to prove their claims.”

Patients account

Sitting outside the doors of the Accident and Emergency Department of LUTH was an elderly man brought to the hospital by his 25-year-old daughter.   He had elevated high blood pressure.   “He can’t walk. His blood pressure is very high.   Back pain, leg pain – I hope he survives”, the daughter said.

LUTH was the second hospital they had been to, looking for a specialist who could evaluate his condition only to be turned away.

“They asked us to go to a private hospital as doctors in teaching hospitals are on strike. We are just coming from one and we are now being sent back at LUTH. We have spent so much money without any result. One of the doctors we met said we can also go to Randle or Gbagada General Hospital.”

She feared time was running out to save her father.

They were not alone. A cancer patient, who simply identified herself as Grace, said: “I am beginning to see these doctors as killers.   I thought they have a medical oath.

“It is still like a dream to me that I cannot be attended to again.   I lost my mother in a situation like this during the Lagos doctors strike few years ago.

“My mother died from the delay in getting treatment for her pneumonia despite the efforts to give her the best treatment we could offer.   By the time we rushed her to a private hospital, it was too late.   She died on the way to the next hospital”.

She appealed to the striking doctors to return to work.

Confirming that LUTH had stopped admitting new patients, a consultant on duty at the Accident and Emergency Department, who pleaded anonymity, told Sunday Vanguard: “Our resident doctors are on strike and we don’t want a situation whereby we would admit new patients who will not be attended to on time and relatives will be shouting. So what we do is to refer them to Randle Hospital or Gbagada General Hospital”.

When Sunday Vanguard went round the hospital’s wards, some workers were seen rendering palliative services.

Doctors’ demands

According to the President, LUTH-ARD, Dr Sekumade Adebayo, the doctors are demanding, among other things, immediate enrolment on the IPPIS platform, full implementation of the National Health Act, circularisation of House Officer entry point, reversal of the plan to stagnate the promotion of resident doctors, delay in the payment of salary shortfalls experienced between January and May 2017 as well as outstanding shortfalls from 2016.

 


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