NMA’s STRUGGLES FOR IMPROVEMENT IN HEALTHCARE

The struggle by doctors for better conditions of service and noticeable and sustained improvement in the country’s healthcare delivery system has been on for several decades now. This agitation is one that can safely be described as old as the apex union in the health sector itself, the Nigeria Medical Association, NMA.

As medical students in the 70s, we witnessed several strikes against the regimes of Yakubu Gowon, Mohammed/Obasanjo. Most strikes occurred during the military regimes because at that time, the Nigerian Medical Association, NMA, was the only pressure group that could dare the government of the day. The activities of courageous and great doctors like Etim Eyo who, at that time was the President of NMA and also personal physician to Yakubu Gowon, readily come to mind. In Lagos state, the battle was between Beko Ransome Kuti and the then Governor Ndubuisi Kanu. During these strikes which covered the whole country and very successfully, doctors were always asked to return to work or park out of government quarters. As students, we would surround the doctors during these meetings, urging them not to surrender.

Over time, many NMA presidents have come and gone with each leaving his imprints on the sands of time. Among them were Dr Thompson Akpabio and Dr Oye Oyediran. Generally, the professionals have not relented in the quest that the authorities do things right to enable Nigerians benefit optimally from this critical area. Under the aegis of the NMA, they have continued to say that the right atmosphere and necessary infrastructure must be provided if only to allow the health sector excel especially in the new millennium. In the present democratic setting, the agitations of NMA cannot be less important, moreso, with President Umar Yar’ Adua’s declared intention to put necessary structures on ground to position Nigeria as one of the world’s first 20 economies by the year 2020. To achieve this lofty objective, it must be agreed, the country’s health sector must be properly reformed. And the time is now, if anything, to provide the best in this area for the teeming population since a nation’s economy is as good as the health of her citizens. For sure, Nigeria cannot qualify for the 2020 dream if her citizens, in 2008, cannot access quality and affordable healthcare, the major plank of the doctor’s agitation.

As mentioned earlier, resident doctors have suffered one form of humiliation or the other in the hands of authorities in the attempt to advocate for changes in the system. It will be remembered that at one point, the entire executive of the NMA was sacked by the government for daring it and embarking on an industrial action to press home their demands. Apart from making legitimate demands concerning their welfare and conditions of service as professionals, doctors are known to have severally called on the authorities to re-evaluate the importance of health as a sector with a view to appropriating adequate budgetary allocations to cater for the needs. Going by Nigeria’s rising revenue profile, they have argued, what makes it easy for government to neglect a critical area such as health? Why is government, by her actions and inactions, unwittingly encouraging brain-drain in the health sector? It is known that Nigerian health professionals have continued to flee the country in search of greener pastures elsewhere. Prominent among these are doctors. The story is same for Nigerian nurses, physiotherapists and other professionals whose services are said to be in hot demand in the US, UK and Canada.

The current face-off between the government and the National Association of Resident Doctors (NARD) is a sad reminder that something definite and satisfactory is not yet done concerning the age-long demands of medical doctors in Nigeria. The bone of contention, among others, is the are  the conditions of service and funding for residency programmes.

Over time, different health ministers have come and gone with each doing one thing or the other during his tenure to influence policy decisions in the sector. These included world-class specialists in various fields of medicine apart from career technocrats. But what is thereon ground to show that their being in government ever rubbed off on the system? How far they were able to turn around the system to fall in line with NMA’s demands remains a different issue. Discontent among professionals has continued to hold sway in the sector. If, on the whole, they did the right things at the right time, and their inputs allowed to endure, would NMA still be making demands even today, asking for fundamental reforms? Perhaps, no! Among these ministers was Dr Emmanuel Nsan who served under the Buhari/Idiagbon regime. Others included erudite paediatrician, late Professor Olikoye Ransome Kuti, Prof ABC Nwosu , Dr Tim Menakaya, and Professor Eyitayo Lambo who handed over to Professor Adenike Grange who was disgraced out of office for reasons best known to the government of the day.

Professor Chukwu has been in charge for about two years but not much can be said to have changed On the 1st of October,2013, Resident doctors embarked on an indefinite nation-wide strike demanding the very same demands they made several years ago. The fight between the different healthcare professionals is still on. NOTHING HAS CHANGED. The hospitals are still the same, the health indicators are no different. In a recent television interview the minister said the his ministry alone cannot change the health of Nigerians, that is very true. The health of a nation is determined by a myriad of sectors.