Stories by SOLA OGUNDIPE & CHIOMA OBINNA
TODAY, a visit to the Lagos State University Teaching Hospital, LASUTH and several other state government hospitals in Lagos shows empty casualty departments.

There are few or no cases waiting at the outpatient wards. In the admission wards, there is no sign of medical staff trying to attend to patients. The usual heavy rush of patients is absent. The beehive of activities which usually perpetuate the health scene has vanished. In short, the teaching hospital and its satellites have become ghost towns.

Empty hospitals

Certainly something is amiss. But the mystery is not far-fetched. All the members of the healthcare delivery team are present, but doctors, acknowledged as leaders of the medical team – are conspicuously missing.

Scenario in state owned hospitals

This scenario is played out severally in virtually all State-owned hospitals in Lagos. Hapless patients have had to cope with a semblance of health care services without doctors at their duty posts. With this development, hundreds of thousands of patients unable to access medical care and more disturbingly, the rising death tolls, despondency, desolation and desertion mildly describes the precarious situation at any Lagos hospital in the last two weeks or so.

It is no longer news that doctors employed by the Lagos State government have been on strike several times in the last three years over issues bordering on the Consolidated Medical Salary Structure. Records have it that it is difficult to ignore the number of days that the doctors, under the aegis of the Medical Guild, have been on strike, because it took a large chunk of the 1,800 days of the Governor Babatunde Fashola administration. Till this moment, Lagosians are still at a loss as to why the doctors and the government cannot reach an amicable agreement as responsible and responsive stakeholders in whose hands they have placed their health needs.

Negotiations between the two parties have hit a brick wall almost as many times as the physicians have downed tools, and the state’s health sector has been the worse for it. For so long have the Medical Guild and the Lagos State government been locked in battle over the CONMESS palaver, and at each time, Lagosians have been the worse for it. All too often, the dark clouds of uncertainty gather over the health sector in Lagos whenever doctors in the public arm of health sector exhibit their dissatisfaction. Their discontent and restiveness is so palpable. Strikes by doctors this year alone have had severe toll on the welfare of patients in addition to placing massive burden on ancillary health services.

Queries and summons

But Monday last week, the Lagos State government decided enough was enough. It summarily sacked 788 striking doctors. Chief among reasons given for the mass sack were allegations for failing to respond to the three queries and summons issued by the state Personnel Management Board. To replace those dismissed, an indicated 373 new doctors are being recruited. The sacked doctors were asked to vacate their premises through an eviction notice issued from the office of the state’s Head of Service. They complied, but though the Governor has issued a counter order, and the affected doctors authorised to ignore the eviction notice, the Medical Guild, nevertheless, has gone to court.

Actually, it was the Medical Guild that drew the first blood in the face-off. Prior to their sacking, the doctors embarked on a nerve-wracking three-day warning strike to protest the non-implementation of the full CONMESS. The warning strike, which brought healthcare services in the state to its knees, set off a chain reaction. Intended to be followed by an indefinite strike to press for the doctors’ demands, the warning strike was called off on schedule, but the people were yet to heave a sigh of relief when the restiveness in the sector escalated as the doctors were queried and summoned to appear before a disciplinary panel, a move that precipitated the indefinite strike which lead to the sacking of the doctors.

But even as implications from the agony of the doctors’ sack hangs more threateningly over the State even much more than the threat of their indefinite strike, the issue of strike remains a permanent feature in the nation’s health industry. And worse may be yet to come if the threats by the Nigeria Medical Association to embark on a nationwide solidarity doctors’ strike as from Friday May 18 are anything to go by.

Hippocratic Oath: Is it still valid?

My patients shall be my primary concern.” This part of the famous Hippocratic Oath sworn to by doctors on graduation from medical school is no doubt the key to the essence of medical practice all over the world. In the healthcare industry, the patient is king. The patient is the reason for medical practice in the first place. Without the patient there will be no doctor, nurse, pharmacist or any other medical professional. But of late, the patient has become a pawn with which to bargain or settle discord. And such bargaining episodes are certainly not in the patient’s interest.

In the wake of the crisis currently bedeviling the Lagos State health sector, occasioned by the face-off between doctors under the Medical Guild and the state government, a big question mark lies on the Hippocratic Oath. Is it still relevant? Most especially must I tread with care in matters of life and death. Are doctors treading with care today in Lagos and Nigeria as a whole?  From the way and manner doctors go on strike, can they truly be said to be treading with care?

Another part of the Oath states: “But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.” When doctors go on strike, what is the implication? Could it be that they have declined to save lives or are exercising their power to take lives and playing God in the process?

It is questionable whether the part of the Oath which states: “I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient,” is still valid considering that the whole essence of the strike is about the welfare of the doctors and their social standing.

“May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.” The validity of the declaration of this part of the Oath is currently in doubt. Multitudes of patients in Lagos have been seeking to obtain healing which they have been promised. But their cries have been in vain as the doors of the health houses have remained firmly shut against the key essence of the physicians’ practice.

“If I do not violate this Oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. I make these promises solemnly, freely and upon my honour”. Today, the Hippocratic Oath may have been reduced to mere words.