As resident doctors strike amidst Covid-19…

SAMSON BENJAMIN in this report looks at the impact of the nationwide strike embarked upon by the National Association of Resident Doctors of Nigeria (NARD) as the nation continues to battle the Covid-19 pandemic. 

The National Association of Resident Doctors of Nigeria (NARD) on Monday this week commenced a nationwide strike after the expiration of a 14-day ultimatum it issued to the federal government.

Its national president, Dr. Aliyu Sokomba, had in a circular last week said the association found it necessary to take “the painful decision” following the inability of the federal government to meet its demands.

“Consequent upon the 14 days ultimatum duly served the federal government for indefinite strike action, in accordance with the resolution of the ordinary general meeting of the association on the May 29, we hereby notify you that all resident doctors, medical officers below the rank of principal medical officer and house officers across all the federal and state hospitals in Nigeria, shall be embarking on a total and indefinite strike action effective 12:01 am on Monday, June 15, 2020.

“It is important that you make alternative arrangements for the care of the patients as the strike shall be total and indefinite. No service of any kind, be it emergency, care at Covid-19 isolation and treatment centres shall be exempted. We sympathise with the patients and the Nigerian populace,” the circular read in part.

NARD’s demands

Dr. Sokomba listed the demands of NARD to include the lack of PPEs for health workers, reinstatement of all 26 resident doctors sacked by the management of the Jos University Teaching Hospital (JUTH).

“For purpose of clarity, the demands on which the ultimatum was predicated include the following; Provision of grossly inadequate appropriate Personal Protective Equipment (PPEs) for all health care workers; immediate reversal of the illegal disengagement of all 26 resident doctors in Jos University Teaching Hospital, and the payment of all salaries owed them, in keeping with provisions of the Medical Residency Training Act.

“Universal implementation of the Medical Residency Training Act in all federal and state hospitals and ensuring pay parity among doctors of equal cadre; immediate implementation of the revised hazard allowance and payment of the Covid-19 inducement allowance as agreed with by the federal government and health care workers three months ago,” the circular further read.

The association also advocated the provision of funding for Medical Residency Training in the 2021 Appropriation Bill, as well as payment of all arrears, owed its members in the federal and states tertiary health institutions, arising from the consequential adjustment of the national minimum wage.

FG’s reaction

However, the federal government Monday said the decision of the NARD to go on strike was ill-timed and could result in the loss of lives of Nigerians. Cautioning on the doctors’ move, the federal government noted that the timing was wrong, just as it said it could lead to severe loss of lives at this time the nation was contending with the Covid-19 pandemic.

The Minister of Health, Dr. Osagie Emmanuel Ehanire, said this while fielding questions from journalists during the update by the Presidential Task Force (PTF) on Covid-19 in Abuja.

 He said: “We held a meeting today (Monday) with the chairman House Committee on Health and president of the resident doctors, and others were in attendance. At the meeting, we clarified issues raised. I said this is not the time to go on strike, make your demand and continue to work. Lives to be lost are not replaceable.

“Some of the demands date back to many years. There were a series of demands. The issue of BPE has been dealt with and welfare of health workers is being attended to. The National Assembly is doing a fantastic job.”

Patients groan

Meanwhile, many patients seeking health care services in different public-owned hospitals in Abuja were stranded as a result of NARD’s nationwide industrial action.

When Blueprint Weekend visited Kubwa General Hospital in the Federal Capital Territory, it found out that although some doctors, especially consultants, were seen offering skeletal services, even as patients who had turned up in large numbers were turned back due to the strike.

Many of the patients were disappointed as the hospital turned them back as the strike drastically affected the capacity of the hospital to provide health services.

Further findings by this reporter revealed that the hospital was only able to render skeletal services at the Accident and Emergency departments of the health facility. Few of the patients that were attended to, were forced to register under emergency.

Speaking with this reporter, Mr. Samuel Iliya who came from Bwari, a satellite town in the FCT, said he had come to the hospital on appointment.

“It is so sad that despite the increase in transportation we are experiencing there was no text message from the hospital to inform us that doctors were on strike. In the past, they used to send text messages to inform us.  We don’t know why they let me waste my transport money,” she said.

The situation was the same in most government-owned hospitals, as patients were left unattended to. Only a few consultants and some managerial health workers were seen attending to patients.

Another patient who identified herself as Mrs. Bucky Ajala said she was told to stay back till around 3:00pm as negotiation was still on-going between the management and the striking doctors.

 “I am pregnant and I need the services of a gynaecologist. One of the nurses told me to stay back; it’s like negotiation is on-going between the management and the doctors,” she said.

Covid-19 struggles

In his reaction, the president of the Nigerian Medical Association (NMA), Prof. Innocent Ujah, called on the federal government to start responding early to the demands of health workers and not to wait until strike is declared before doing the needful.

Ujah, who stated this in an interview with The Punch, said government should have responded to the 14-day strike notice given by the resident doctors. He said “a strike is not good for the health sector, especially now that the country is battling the Covid-19 pandemic.” He said the government should be proactive and not wait until health workers resort to strike before responding to their demands.

Prof. Ujah urged the government to do the needful, stressing that the strike if not called off would impact negatively on the on-going fight against Covid-19 in the country.

“The government has to respond appropriately. The government should not wait until a strike is declared before responding to the demands of health workers. It is not very nice.

“There are so many promises that have been made by the government to health workers and they are yet to be fulfilled. So, the government should do the needful. A strike is not a very palatable thing for health workers.

“Government should play its role and ensure that the strike is called off. We don’t want any strike now because of the Covid-19 pandemic,” he said.

Continuing, he said, “Government should stop reneging on its promises. I think that is the issue. Although, some are being sorted out like the issue of hazard allowance. The government should be proactive in its response. I know there are challenges, but the government must be proactive. If the government makes a promise and fails to fulfil it, what does the government expect them to do?”

Ujah said many health workers were putting their lives on the line “at this critical period of fighting the Covid-19 pandemic,” adding that “what the government should do is motivate them.”

“Some of them have contracted the disease; some of them have not been with their families for some time, it is like wartime. I believe the government would appropriately respond to the needs of NARD so that the strike action would be called off. There should be no strike at this time.”

The NMA president also urged the government to ensure that adequate personal protective equipment is provided for health workers.

Similarly, Dr. Ajoke Adebayo, a health worker, told Blueprint Weekend that the strike would have a negative impact on the fight against Covid-19.

She said, “The fight against the Covid-19 pandemic in Nigeria may suffer a set back as a result of the strike. Nigeria cannot afford any reduction in the number of available doctors, now that the country is faced with the Covid-19 pandemic. Right from the beginning of the pandemic, health systems in countries across the world have been over-stretched. We need more health workers in the fight and not less.

“Health workers have been at the frontline of providing care to patients and maintaining routine health services. A reduction in the number of medical doctors could affect the quality of care provided to Covid-19 patients as well as Nigerians suffering from other illnesses.”

Criticisms 

In his view, a public affair commentator, Mr. Bright Iyoha, described the strike as “selfish, unethical and illegal.” He told Blueprint Weekend that the strike was a well-calculated and orchestrated plan by the doctors to divert patients to their private clinics to milk them of their hard-earned resources.

He advised the federal government to stop all government employed doctors from establishing private clinics for the benefit of the citizens of this nation while still in government employment.

“They should be called to order because their incessant strike is a gimmick to further divert innocent patients to their private clinics where they (doctors) stand to benefit. The government should have a rethink on the undue attention they give them and do what is right.

 “The government should revert to the era when administrators administered the hospitals/health facilities while health professionals, including doctors do their professional duties that they are being paid for,” he said.

 Govt’s order, threat

Meanwhile, the federal government has directed all medical directors in the country to open attendant registers for striking resident doctors. The government gave the directive as the meeting between its representatives and the leadership of the NARD ended in a deadlock on Tuesday.

 The health minister stated that the Federal Ministry of Health would issue a directive to all medical directors in the country to open a register by 7:00am and record those who come to work and those who fail to come.

He frowned on the decision by the resident doctors to down tools in a crucial period when the world was struggling to combat the Covid-19 pandemic, saying Nigeria was the first country in the world where doctors went on strike during a pandemic.

“One day, you will be sitting where we are sitting; you will be going through the same thing we are going through; it is a circle of life. In other countries, we have seen retired doctors and workers come out of retirement. Nigeria is the first country in the world where health workers went on strike during a pandemic.”

 While urging the striking doctors to read up the Labour Act and regulations of the International Labour Organisation (ILO) on essential services, the Minister of Labour and Employment, Dr. Chris Ngige, said he hoped the resident doctors would see reason and resume work “without delay.”

But Dr. Sokomba insisted that the strike would only be called off when the federal government came up with a tangible outcome.

 According to him, the major issues that necessitated the strike were lack of life insurance for resident doctors, and the non-availability of protection.

Sokomba said, “We have chosen to embark on an industrial action because of the challenges we have always been having that date as far back as 2014, which some of them came up later in 2017 and recently, August 2019. We presented the same challenges to the speaker of the National Assembly, he pleaded that we should reconsider extending the ultimatum and that led us to extend it to January.

“The most important issues that bother resident doctors to go on strike include the issue of protection and security and safety of doctors, which is the issue of life insurance.”

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