The recent nationwide strike embarked upon by the National Association of Resident Doctors (NARD) is one too many. Coming from a critical sector, the industrial action gives cause for serious concern as we cannot make progress as a country if we continue this way. Usually, these strikes are over welfare issues and government’s inability to fulfill its promises. Three times last year, the resident doctors in public hospitals embarked on a similar strike that almost crippled all the federal and state hospitals. They complained, among others, that they neither have life insurance nor death-in-service benefit for their families.
Their hazard allowances are also ridiculous. They demanded, among others, payment of arrears owed them in federal and state tertiary health institutions; the universal implementation of the Medical Residency Training Act in all federal and state hospitals and immediate implementation of the revised hazard allowance and COVID-19 inducement allowance. They called off the strike when government promised to look into their demands. Unfortunately, nothing much has changed.
This prompted the resident doctors to embark on another nationwide strike on Monday, August 2, 2021. The strike is over delayed payment of salaries and allowances including COVID-19 inducement allowances, shortages of manpower in hospitals, among others. National President of NARD, Okhuaihesuyi Uyilawa, said government had not reached out to the association despite the notice it gave for the action. The striking doctors and the government representatives had endorsed a Memorandum of Action (MOA) in April this year. This agreement led to the suspension of a week-long strike in early April. But government, the doctors say, has reneged on this agreement.
This is unfortunate. For many of these doctors, the number of years they spent in school and the huge resources deployed in training them do not equate to their standard of living. Some of them cannot even afford as little as putting their children in good schools.
Whenever resident doctors are on strike, it is the nation’s health system that suffers. And each time the strike takes place, for instance, patients bear the consequences. Many of them are discharged because doctors are not available to attend to them. Consequently, some of them die because they cannot afford the cost in private hospitals.
We had lamented the brain drain in the medical profession. Despite billions of dollars spent to train these doctors, a good number of them migrate abroad to practise. Experts estimate that over 4,000 Nigerian doctors practise in the United States of America. Many others also work in the United Kingdom, Saudi Arabia, Canada, Kuwait, Australia and the United Arab Emirates. Many of them who are still in Nigeria also nurse the ambition of practising abroad whenever opportunity beckons. This has affected the doctor-patient ratio which currently stands at about 1:5,000 in Nigeria. This is against the World Health Organisation’s recommendation of 1:600. Instability in the health sector is a huge setback in our journey to medical Eldorado. This is partly why wealthy Nigerians travel abroad for any slight illness because they don’t have any confidence in our health care system. Annually, Nigeria spends over $1 billion on medical tourism abroad.
In this era of COVID-19 pandemic, it is insensitive to allow doctors go on strike. The pandemic has taken a heavy toll on health systems across the world. The third wave of the pandemic is spreading fast even in Nigeria. Thousands of lives are in danger if something urgent is not done to call off the strike.
Government should get more serious with critical sectors like health and education. The less than five per cent average annual allocation to the health sector in the nation’s budget is grossly inadequate. Even with the ravages of COVID-19 pandemic, the Federal Government decided to effect over 40 per cent cut in health care spending last year.
Although there is a slight improvement in health funding in 2021 budget, it falls far below the 15 per cent of the annual budget which African countries agreed upon in Abuja in 2001. Government at all levels should increase the annual budget of health sector and also ensure that the funds are judiciously utilised. If our hospitals are equipped to world-class standards, there is no reason our President or any prominent Nigerian should go for medical treatment abroad.
Government should also begin to take welfare of doctors seriously. Let it address their grievances with a view to settling them amicably. It cannot continue to promise and fail. Whatever agreement it has entered with the doctors has to be fulfilled.
Good enough, the Minister of State for Health, Dr. Olorunmibe Mamora, has appealed to the leadership of NARD to return to the negotiating table in order to address outstanding issues. Doctors should consider the plight of their patients and heed this call knowing that they took the Hippocratic Oath to consider life first before any other thing. They need to be more realistic while pushing for their welfare considering the situation of things in the country today. Constantly going on strike will not help the health sector.