March 14, 2014


Strike, the only language govt understands –NMA

WHAT are the reasons for the on-going strike by the National Association of Resident Doctors?

It is unfortunate that strike actions seem to be the only language that the government understands. As it is now, the polytechnics and Academic Staff Union of Nigeria Universities are on strike. Education is the bedrock of everything and without education, doctors cannot be trained. But the reason why the National Association of Resident Doctors has decided to go on this strike is because of certain issues which have not been addressed by the government.

We have been engaging the government on the payment issue, the Integrated Planning and Performance Reporting System, a new system which is very okay. But what does it take to capture people’s name and pay them according to their hierarchy?  There are so many other things. For example, there was a time some cadres of doctors were not included in the IPPRS and because of that, when they paid other doctors, they were not paid. We thought it was going to be for one week or month, later it became three, four, five months, and so on. There is no association that will continue to work like that, especially doctors. It is so sad that we have a situation like this in the medical profession. In some other countries, the first people to be paid are the security and health personnel. And because of the lopsided payments, the NARD felt this is an issue too many. They have been engaging with the government, but the government doesn’t seem to budge and have failed to keep their promises. We are not actually on strike; we are not just working, because you don’t expect someone who doesn’t get paid to continue to work.

What are the other issues?

There are other issues such as residency training, budgetary allocation to training and other disputes. Then, Nigeria is having a brain drain, doctors are leaving the country every time, and we are saying no to this trend. Let there be training so that we can have specialists that can take care of the masses. Our people are dying of common ailments because there are no doctors. Specialist doctors are not available. These are the reasons.

You said the association is not “actually on strike, but you‘re “not just working. “What‘s the difference?

Well, that’s what we believe. You go on strike when you want something done and when it is not done, you want to withdraw (your services) so that the parties involved can come to a roundtable conference. We have not been paid; there is no money to go to work. Feed or fuel our cars.

If the NMA had money, it would have just have distributed it and told the doctors to go back to work. But we don’t have the money. All we can tell them as NMA is that they should sheath their sword. But then, a hungry man is an angry man.

Nigerian doctors have a good reputation as one of the best in the world, especially when they go abroad to work, but our health sector is in dire straits. What do you think of this anomaly?

It is not only in the medical sector. Even our athletes don’t have training equipment here. But when they go abroad, they get sponsorship deals and are provided with equipment and good facilities, then they start winning for other countries. This is because there are good resources for them to work with in a very conducive environment. Abroad, the doctors can access the latest research and investigations being conducted all over the world just by the click of a button. In those countries, you don’t have to run helter-skelter before you can get blood samples, test tubes, universal bottles, needles, and simple things like that. You become frustrated with situations where things don’t work. An environment that is conducive will bring the best out of our doctors. That is why they can be more productive when they are well paid and are comfortable. These are places where they don’t have to travel a three-hour distance from where they live to their work place, and then become tired. They don’t have to see 50 or 100 patients in a day because there are no doctors in the hospitals. We have many problems, starting from remuneration to security, resources to work with, patient load, training, research and so on.

What is that one thing that must be addressed as a matter of urgency?

It is training. Government should facilitate the training of doctors. There should be opportunities for doctors to go abroad for training or they should bring people from the Diaspora with the equipment to train doctors here. If, for example, they bring some machines from the US or UK, those machines will just waste away, because the doctors have not been trained to use them. That is why training and research are the first things. Once this is done, then the sky is the limit and Nigerian will have the best set of doctors. Our doctors should be trained further so that they can better the country.

What has the NMA done as a body to ensure that some of these things you mentioned are put in place?

The NMA has been working. Remember there was a time the NMA gave the government an ultimatum for them to meet and talk. I believe they are talking now, although it is slow, at least, they are talking. There are many issues in the health sector now that, if care is not taken, it will worsen the sector. Some committees have been set up and those committees will submit their reports soon. So, the NMA is actively engaging the government, although some issues which are not supposed to take more than a month (to resolve) are taking years.

How long do you think this current situation will last?

We believe what President Goodluck Jonathan said on October 1, that he has re-committed himself. Recently, he fired some ministers and appointed new ones. So, we believe in the new agenda of Mr. President, he means well and we know that he will not allow us to stay away for long. He will quickly answer us.

Are you not worried about the health of patients in the hospitals?

That is what happens each time we want to go away from work like this, we are always worried. In fact, an average doctor will almost cry that, ‘oh my God, I‘m not going to work today, what will happen?’ It‘s not our desire at all. We are praying that Mr. President and other people in power should quickly do the things that we want as matter of urgency, so that we can quickly go back.

What would you say is the biggest achievement of the NMA in the last five or 10 years?

In the past 10 years, the NMA has been able to do a LOT. One that readily comes to mind is that they have been able to encourage the young ones from running away and so reduce brain drain. Salaries of doctors are now better, even though it’s like 10 per cent of what we asked for. But at least, that 10 per cent of what we required has been sorted out. Two, there has been a level of improvement in some hospitals, but it can be better. Primary healthcare is still in shambles, but NMA has engaged the government and that is being rejuvenated. NMA has ensured adequate practice over time. The era of doctors doing what they liked and killing patients is over. You have to do what is right. NMA has ensured that doctors update their knowledge regularly. For example, you cannot get your practice licence by December if you don’t have certain Continual Medical Education points. That singular act alone, through the Medical Council and NMA, has removed mediocrity among doctors who finished schooling in the 60s or 70s and are still using the same knowledge. Such doctors would have to go fo CME every year before they would renew their licence. NMA also helped with medical outreaches during its annual or state programmes, where thousands of patients have been reached. Through this, it has also complemented the efforts of the government by going to rural areas,. We have helped missions, surgical operations and so on. We shall continue to do more.

On a scale of one to 10, how would you rate the public health sector in Nigeria today?

We are not doing badly. I will give an average, five. That means it’s not been a total tale of woes. We have had discoveries and inventions, but 50 per cent for health is not a pass mark.