JOHESU strike: Impartial negotiators wanted, by Jerry Uwah




At the best of times, Nigeria’s healthcare delivery system is decrepit. The hospitals are far-flung, under-staffed and poorly equipped. In some rural communities the nearest hospital is 40 kilometres away. Nigeria is not investing in its human resources. Bill Gates, the world’s richest man and co-founder of the Bill/ Melinda Gates Foundation which has fl ushed billions of dollars down Nigeria’s bottomless healthcare system, recently testified to that. If the system was that bad at the best of times, the fiveweek strike by the Joint Health Sector Union (JOHESU) has only worsened a bad situation. Ironically, the showdown between JOHESU and the Nigerian Medical Association (NMA) is only deepening to the detriment of the deprived people of Nigeria. The warring factions are not willing to sheath the sword.
Rather, there were reports last week about NMA and JOHESU members engaging in avoidable physical assaults to press home their conflicting points in the worsening encounter. As NMA toughens its stance in the showdown, JOHESU on its part is digging in for a long-drawn combat. Last week, the union appealed the ruling of a National Industrial Court which ordered it to end the strike within 24 hours. There is no end in sight.
The federal government appears to be watching the worsening encounter on the sidelines as negotiations breakdown seemingly irretrievably. The negotiation with JOHESU has become protracted and inconclusive because the federal government has abandoned the deal to people with vested interest in the dispute.
Isaac Folorunso Adewole, the minister of healthis a fanatical member of NMA. He does not hide his sympathy for the association’s controversial stand in the dispute. When under pressure, he misleads the public with half truths and blatant lies about JOHESU’s demands. For instance, the minister’s claim that JOHESU is fl aunting minutes of meeting rather than an agreement with the federal government as evidence of its demands, is an insidious lie. On September 20, 2016, the Head of Service of the Federation issued a circular to the minister of health conveying the approval of the National Council on Establishment for implementation of some of JOHESU’s demands.
The circular was received and stamped in Adewole’s office on September 27, 2016. The circular was forwarded to the director of nursing with the directive: “treat as urgent”. Several months after the directive to “treat as urgent”, the council’s approval is still waiting to be implemented. It is equally not true that JOHESU wants pay parity with doctors as Adewole and NMA claim.
The CONMESS pay structure fashioned out for doctors puts the entry pay of a fresh doctor at N260,000. It has since been reviewed to N313,000.
Ironically, nurses who spend five years in the university and graduate with BSc. in nursing science still enter service at grade level eight which amounts to N118,000. Adewole and his colleagues in the NMA have refused to implement what was approved by the council. That would have allowed nurses to enter service at grade level nine. Even if that is implemented, a nurse with a university degree would have to spend 10 years to earn what a fresh doctor collects at entry point. That is not parity. Adewole’s claim that JOHESU demands pay parity with doctors is an illcontrived lie. The next member of the federal government delegation in the negotiation with JOHESU is Chris Ngige, the minister of labour.
Like Adewole, Ngige is a medical doctor. He has not displayed Adewole’s fanatical support for NMA, but everyone knows his position in the dispute. The federal government has inadvertently handed men with vested interest the weighty responsibility of settling the simmering dispute between two warring professional segments of the nation’s healthcare delivery system. That explains why the negotiations are intractable and inconclusive. The umpire is a party to the dispute. No one expects impartial ruling from such judges. What is needed now is for the federal government to constitute an independent team of negotiators who have no interest in JOHESU or NMA.
The body would then study contemporary trends in global healthcare delivery systems and make recommendations that would ease the tension created by a senseless dichotomy in Nigeria’s health system. The issue of consultancy for pharmacists and nurses is allowed in many countries including some highly developed economies. The NMA feels Nigeria is not mature for that. It is only an independent panel that can examine the matter dispassionately and draw mature conclusions based on merit rather than sectional bias.
The strike has lasted for too long and no one in the federal government is counting the casualties because those dying as a result of the strike are the inconsequential, voiceless majority living below the poverty line.
It is obvious that NMA’s position in the dispute is selfish and detrimental to team work in the industry. That explains why some states have dumped the federal government’s graveyard silence on the dispute and are implementing JOHESU’s demands. States that are playing ostrich with the mounting casualties of the strike are merely avoiding the financial cost of doing what is right.

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