•No cause for alarm – FAAN
By Chioma Obinna
The nation’s health sector is in crisis. With the shutdown of federal and state health facilities, patients are groaning. The situation is dicey. Reason: The facilities mostly serve the common man who doesn’t have the resources to access medical care in private hospitals. Meanwhile, his accessing healthcare in public institutions now is like the camel passing through the eye of the needle because the institutions have been shut down by striking health workers.
Whereas the affluent and our political leaders catch the next available flight to Europe, America, India, China, among others, for medical tourism with tax payers’ money, the common man is at the mercy of the health workers who are on indefinite strike following the Federal Government’s failure to honour the agreement it purportedly signed with them.
Government claims to have met 14 of their 15 demands, but the workers, under the aegis of Joint Health Sector Union, JOHESU, say their flagship demand (adjusted Consolidated Health Salary Structure, CONHESS) must be met before they return to work. The situation took a twist when doctors, through the Nigerian Medical Association (NMA), threatened to down tools should government listen to the health workers. The NMA said listening to the non-medical staff will trigger unrest in the health sector. Although doctors and nurses are not on strike, there is little they can do to meet the needs of patients in the face of a critical segment of the health sector embarking on industrial action. For instance, the implication of the JOHESU action is that doctors and nurses cannot proceed with patients needing laboratory tests because officials manning the laboratories are members of the striking union.
And although the country has no common boundary with DR Congo where new Ebola Virus Disease (EVD) is raging with seven of the 19 victims dead, the experience of 2014, which saw a victim from Sierra Leone bringing EVD to Nigeria, is still fresh in mind and has left many Nigerians asking if they are safe especially amid the health workers’ strike.
Strike bites harder
Entering some of the government-owned facilities as the health workers’ strike bite harder last week, you will imagine how Nigeria got it wrong? A walk round the waiting areas and corridors of the facilities, where a handful of helpless patients were seen waiting hopelessly, will move you to tears. Many general and teaching hospitals that used to be a beehive of activities were virtually ghost towns. For some of the critically ill patients who usually thronged the hospitals, the option must have been to relocate to private hospitals, even if it means paying through their noses. The ones seen around were obviously patients who had no means to look for succour in private hospitals.
“God, help me. Don’t let my enemies laugh at me”, one of the embattled patients was heard soliloquising when Sunday Vanguard visited Lagos University Teaching Hospital (LUTH) on Friday.
A word with the woman, who later identified herself as Mrs. Joan Ebuka, showed that she had come all the way from Imo State for a laboratory test for an undisclosed ailment for her seven-year-old child. The little girl, in pains, was a pathetic sight and obviously in need of urgent medical attention.
Sadly, the strike had caught up with the little child as officials, who should do the test are on strike, the mother told Sunday Vanguard in a tone reflecting her helplessness.
She said she was turned back and told to return whenever the strike was called off.
“My daughter is dying. I hope the strike is called off soon so that she can do the test to facilitate her treatment. Our health system is in shambles and a strike of this nature can only worsen the situation for poor people like me. I appeal to government to negotiate with the workers so that we can be attended to”.
Although, doctors at the hospital were seen attending to some patients, health workers, who would have filled the gap for a seamless operation, were nowhere to be found.
As of 2pm when Sunday Vanguard left the premises, some patients were still hanging around hoping to be attended to.
The relative of one of such patients, Kazeem, told our reporter that they never had any idea there was a strike going on before coming to LUTH.
At Igbobi Orthopaedic Hospital, the Federal Medical Centre, Ebute Meta, among other health institutions owned by the Federal Government in Lagos, the situation was not different. The few patients around were not attended to, even when doctors and nurses were ready to work.
Health workers at the Lagos State government-owned hospitals were also in total compliance with the JOHESU strike. As of the time of visit to the hospitals, only skeletal services were offered by consultants and resident doctors.
From the Lagos State University Teaching Hospital, LASUTH, to the Island Maternity Hospital, Lagos Island Hospital, Randle General Hospital, Surulere and Akerele Primary Healthcare Centre, the situation was the same.
The health records, pharmacy and laboratory departments of the hospitals were closed and no nurse was seen at their duty posts including the wards.
At the laboratory department of LASUTH, it was found that only few tests were being carried out by doctors on ground since laboratory scientists were not there.
Some patients, who spoke to Sunday Vanguard, lamented that government had failed them following incessant strikes in the health system.
Some of them, who had rushed from Federal Government hospitals to LASUTH, were disappointed as they had no premonition that health workers in the hospital were also on strike.
One of them, Ade Adedayo, said: “We were at LUTH last Monday, but because of the strike we decided to come here. On getting here, they said health workers are also on strike. I just wasted my resources and time coming here”.
Adedayo said he came because he urgently needed the services of a physiotherapist because of a hip issue.
“I am sure many people have died because of this strike. Why is our government doing this?”
At the Lagos Island General Hospital and Lagos Island Maternity Hospital, when Sunday Vanguard visited, the various departments, including the eye clinic, emergency centre, radiology section, paediatrics unit and the administrative section, were paralysed as JOHESU members stayed away from work.
Some old patients were, however, seen waiting to be attended to by doctors at the emergency section of both hospitals.
At the maternity session of the Island Maternity Hospital where nurses are always on ground to help pregnant women, no nurse was seen. Only pregnant women were seen waiting to see doctors.
Some of the pregnant women appealed to government to urgently attend to the demands of the striking health workers as they claimed they will soon give birth.
One of them, Mrs. Nkechi, who said she was almost due to be delivered, stated: “I want to have safe delivery. I don’t want to have complications during child-birth especially because I know that doctors cannot do it alone”.
No new patients
A doctor in the hospital said workload for him and fellow doctors and nurses arising from the health workers strike was enormous but pointed out that they were trying to cope.
“Health workers are on strike but we are attending to old patients and emergencies. We are not admitting new patients in my department to ease the pressure”.
Also at Primary Healthcare Centres, PHCs, nurses, who were usually seen, were conspicuously missing.
Effects of strike
The Chief Medical Director (CMD) of the Nnamdi Azikiwe University Teaching Hospital, NAUTH, Nnewi, Prof. Anthony Igwegbe, vividly revealed the effect of the strike when he said that though doctors in the hospital were working, they operated only at insignificant level of 20 per cent of their capacity because of the JOHESU strike.
Igwegbe said the effect, in terms of services and income, was enormous on the hospital. While appraising the situation within the referral medical institution, he appealed to the striking workers and government to consider patients’ plight and resolve the disagreement.
Since the strike, which started precisely on the midnight of Tuesday, April 17, hospitals across the country have been shut down. This is not unconnected with the fact that JOHESU members comprise about 90 per cent of the health workforce. The members are drawn from five associations namely the Senior Staff Association of Universities, Teaching Hospitals, Research Institutes and Associated Institutes, SSAUTHRIA, Nigerian Association of Nigerian Nurses and Midwives (NANNM), the Non Academic Staff Unions, NASU, Medical and Health Workers Union, NHWU, and the Nigerian Union of Allied Health Workers, NUAHP.
The workers are demanding, among other things, the adjustment of the Consolidated Health Salary Structure, CONHESS, implementation of court judgments and upward review of retirement age from 60 to 65 years, payment of arrears of the skipping of CONHESS10, and employment of additional health professionals.
In a related development, NMA threatened to resume its 2014 suspended strike should government accede to the demands of the striking health workers. The National President of the association, Dr Francis Faduyile, and Secretary General, Dr Olumuyiwa Odusote, in a press statement, said their position was informed by the extension of the strike to states and local government- owned health facilities.
They also warned that no award should be given to non-medically qualified health professionals as it will violate the agreements of 2014 NMA entered into with government.
The JOHESU demands have seen government going back and forth with the Minister of Health, Prof Isaac Adewole, saying government had no agreement with the union only to reverse himself by claiming that government had met 14 of the 15 demands of the workers while the last demand was being addressed.
No going back
Speaking on the strike, the Vice Chairman of JOHESU, Com. Obinna Ogbonna, said the workers’ patience had been over stretched and could no longer be taken for granted.
According to him, they decided that unless government met their flagship demand, the strike would continue.
He accused the three Ministers of Health and Labour and Employment of being biased on the issue as they are doctors.
“The flagship demand is the adjusted CONHESS. If they do the right thing, we will resolve the problem immediately. But we don’t want a situation where the Nigerian Medical Association, NMA, will be the one deciding what government gives to us”, he said.
“They (NMA) cannot subjugate or suppress us. When they were making their own demands, nobody stopped them. Now that we are doing our own, which is not even up to what they collected and government is considering it, they are blocking us. Please let the average Nigerians know the truth”.
Asked if government had met the 14 demands as claimed by the Minister of Health, Ogbonna said none of the demands had been addressed.
“Yesterday at our meeting with government, we asked the minister pointedly where the circular for the 14 demands they met emanated from. He was taken aback. These are political statements to make the people believe that JOHESU is evil.
“The CONHESS cuts across every one of our demands. When they do it, we will reconsider going back to work but that is not to say we are jettisoning our other demands. We will sit down and look at the rest so that the pressure will no longer be on them.
“But we will get alert before we go back to work”.
Ebola: Risk of outbreak
As the Federal Government, JOHESU and NMA continued their war of words, health watchers fear that EVD may be next door.
They also fear that judging from the last outbreak in Nigeria, identification of a case of Ebola anywhere in the world, not to talk of a country as near as Congo, remains a challenge which should spur all the members of the health community to sheathe their swords and put their house in order before the country is caught unawares like it happened in 2014.
Instructively, the Chairman of JOHESU, Biobelemoye Joy Josiah, failed to allay that fear when he warned that “none of our members will be involved in any Ebola screening until government does the needful.”
The Chairman of the union at LUTH, Com. John Adetokumbo Shaba, echoed similar sentiment. “During the period of Ebola crisis in 2014, the NMA was on strike and heaven did not fall. For us, when we get to there we will know how to cross the bridge. Let the government do the needful”, he said.
As a precautionary measure, the Federal Government had, last week, ordered screening of travellers from Congo and neighbouring countries after the fresh outbreak of the haemorrhagic fever in Congo.
Port Health Services workers at the airports who, apart from giving vaccination against yellow fever as a major requirement for travelling to many African countries, help with the health screening of passengers, are JOHESU members.
But investigations by Sunday Vanguard showed that only top officials of the Port Health Services are carrying out skeletal services because of the strike.
However, the General Manager, Corporate Affairs, Federal Airports Authority of Nigeria, FAAN, Mrs. Henrietta Yakubu, recalled that since the first recorded case of the virus in Nigeria in 2014 through an American-Liberian, Patrick Sawyer, who flew in from Sierra Leone, the agency had not relaxed its surveillance at the airports in order to forestall re-occurrence.
“All the equipment and personnel used in combating the virus in 2014 are still very much at the airports. We have always had thermal scanners in our airports that monitor temperature of passengers and capture their pictures”, Yakubu said, last week.
As of 13 May, according to the World Health Organisation, WHO, a total of 39 Ebola cases had been reported in Congo .