By Cosmas Omegoh (Lagos), Okey Sampson (Umuahia),Billy Graham Abel (Yola), Tony Osauzo, Ighomuaye Lucky (Benin), Olanrewaju Lawal (Birnin Kebbi), Gyang Bere (Jos), Emmanuel Adeyemi (Lokoja), Femi Folaranmi (Yenagoa), and Chijioke Agwu (Abakaliki).
For the teeming Nigerian poor, the last 10 days were the worst time to be ill. This is because the majority of resident doctors in the government-owned hospitals went on strike. Therefore, those who had the misfortune of being ill and visiting public hospitals indeed had a rough time. In them and indeed every other person, the age-long line of a poet “the harvest is full, but the labourers are few,” came alive as resident doctor were no where to be found. But yesterday the doctors suspended their strike.
Sunday Sun investigations revealed that many patients then abandoned the major public health facilities across the country. Those who were there before on admission were compelled to look elsewhere for help as the doctors to attend to them – members of the National Association of Resident Doctors (NARD) were on strike. Any of them who happened to be around by chance did not attend to anyone. Only the very senior doctors who are consultants managed to sustain services.
NARD had sustained a deadly strike in protest of Federal Government’s failure to listen to it and accede to its demands. Both are familiar foes who for long have been treading on a familiar turf.
Over the past decade, both NARD and the government have been weaving in and out the trenches. It is either one is refusing to agree to the terms tabled by the other or reneging on the spirit of the agreement. A no-win war has been raging, leaving the poor badly bruised and the remaining strand of confidence in the Nigerian healthcare delivery system brutally battered.
Then, poor patients who in their numbers had besieged the available hospitals in the hope of accessing healthcare were groaning. The ones who had no means of switching to private caregivers were left distraught and inconsolable. One could almost feel their pain and grief, their agony and their disappointment – disappointment in the society, disappointment in the system, disappointment in the whole set up.
NARD is the “umbrella body of all resident doctors in institutions where residency training is offered in in Nigeria.”
Wikipedia says Residency training started in Nigeria in 1966, but NARD is believed to have been birthed about 1978.
“A resident doctor in Nigeria is a fully registered medicalpractitioner undergoing further training in an institution accredited by either the National Postgraduate MedicalCollege of Nigeria and/or the West African PostgraduateMedical College.” So, NARD members who are specialists in training are an important component of the country’s healthcare delivery chain. It was learnt that they make up a large number of doctors is various hospitals.
According to NARD president, Dr Uyilawa Okhuaihesuyi, the body’s demands included: “Immediate payment of all salary arrears, including March salaries for our members in all federal and state Tertiary Health Institutions across the country especially ASUTH, IMSUTH and UNIMAIDTH.
“Upward review of the current hazard allowance to 50 per cent of consolidated basic salaries of all health workers, and payment of the outstanding COVID-19 inducement allowance especially in state-owned tertiary institutions.
“Payment of death-in-service insurance for all health workers who died as a result of COVID-19 infection and other infectious diseases in the country.”
But in one of the latest responses, the Federal Government through the Minister of Labour and Employment, Dr Chris Ngige, also a medical doctor, urged the doctors to respect their Hippocratic Oath, which placed patients’ welfare first.
Ngige said: “NARD made some of the demands in ignorance. They didn’t have the full picture. Maybe they wished for a strike or their president pushed them into strike so that his name will go into the annals of NARD as one of the tough presidents that have taken them on strike. That’s wrong.
“The unilateral repudiation of the Memorandum of Action (MoA) by NARD’s president is unknown in Labour negotiation. He didn’t participate in most of the discussions last Wednesday because he fell ill not quite long after the meeting started and had to excuse himself. He handed over to his deputy, the Secretary General and other officers of the association, who fully participated.
“The two parties to the negotiation signed the MoA. Four officers from government and three from NARD signed the document and the president, who was not at the meeting, but fully represented by deputies went to NARD’s NEC and disowned the paper because they were signed by his deputy and secretary general. There is what is called transmission of power.
“When a trade dispute has been apprehended, no party imposes a fait accompli on the other. We signed a memorandum that says NARD would go back to its members to educate them on what was agreed on, the timelines placed on them, with a view to not disturb the industrial milieu in the health sector. And we agreed to reconvene after four weeks.”
It was gathered that trade dispute between the Federal Government and NARD dates back to 1995.
Dr Olayinka Atilola said in August 2010, that “the agitations for a better training and conditions of service for resident doctors in Nigeria dated as far as the last 15 years. However, the intensity of the latest struggles increased because of the increasing disconnect between the leaders and the led in Nigeria.”
It was learnt that NARD had in 2010, issued a 21-day ultimatum to the Federal Government and embarked on a nationwide two-day warning strike between March 2 and 3, 2010. It later went on an indefinite strike on April 15, 2010. But the strike was suspended on Monday April 26, 2010.
In September 2017, NARD under Dr Onyebueze John as president also went on a 10-day strike, which it later called off.
Then in May, 2020, NARD amid the raging COVID-19 pandemic embarked on another indefinite strike under the watch of Dr Sokomba Aliyu, citing issues bordering on the Nigerian healthcare system and welfare of health workers.
Part of the demands of NARD were provision of adequate personal protective equipment, respirators, gloves, and others to the health professional to save them from the pandemic. They also demanded payment of their salaries, among other things.
But today, things are a bit different. Both NARD and the government have temporarily left the rings after their ding dong war. And sadly, the masses were left in the lurch.
When our correspondents visited the hospitals across the country, the pain and stories of the patients were the same – each bearing the marks of a system that has failed to serve its people.
Before the strike was suspended yesterday, our correspondents visited some public hospitals and spoke with consultants, NARD members and patients. Excerpt:
Adamawa: Consultants, patients, under severe strain
In Yola, consultants bearing the brunt of the shortfall in staff numbers as the resident doctors continued their strike at the Federal Medical Centre, Yola.
Speaking to Sunday Sun, Dr Ahmadu Baba Usman, admitted that the action by the resident doctors had put pressure on the consultants and prolonged the waiting period of patients.
Baba said that the task placed on the consultants was enormous because of the absence of the resident doctors; their work load had been increased by far.
Baba explained that the consultants were doing their best to see that all the service corridors in the hospital were being attended to.
Speaking on the effectiveness of the service delivery, he acknowledged how hectic the work had become lately.
But he assured that all the consultants were on ground to meet the needs of the patients, explaining that the clinical unit which is the main entry point into the centre, the Accident and Emergency units have four consultants while the labour units have five consultants.
Speaking on the impact of the strike, a patient at the Accident and Emergency unit, Azama Paul, who had been in the hospital for about 73 days said: “I’m not satisfied with how I have been attended to.
“Before the commencement of the strike, the intensive care had been consistent and more regular unlike what we have been having in the last few days since the strike began.
“I would like to call on the Federal Government to reach a compromise with the resident doctors, so as to ease the suffering of the common man.”
Another patient, Yosi Iliya said: “The required attention and care have not been given to my child who is at the Emergency and Pediatric Unit.”
Patients in Edo lament as strike paralyses UBTH
The NARD strike is having a very negative impact on the University of Benin Teaching Hospital (UBTH) as a visit to its Consultant Out-Patient Department (COPD) section revealed that it is a ghost yard with no patients.
Not also left out is the Ante-Natal Clinic. Although there were few pregnant women in the ward who were there for urgent attention, it was learnt that those whose cases were not serious were re-booked for a later date.
Paul Iyamu, who was earlier admitted at the hospital, lamented that he had no choice, but to seek medical care elsewhere due to the ongoing strike.
“I was forced to go home because of the ongoing strike. I decided to go to a private hospital so that I can continue my treatment. As we speak, I paid another huge sum of money.
“We can’t continue like this as a nation. There are several patients seeking for urgent medical care whose treatments were abruptly stopped because of the strike,” he lamented.
UBTH’s Public Relations Officer, Mr Joshua Uwaila, said that the hospital was still rendering skeletal services to patients.
“The National Association of Resident Doctors (NARD) embarked on a nationwide strike on Thursday, April 1, 2021.
“Since then, we have endeavoured to maintain skeletal services with the depleted human resources to mitigate the impact of the strike.
“In the meantime, several patients have had to seek medical care in other hospitals which are not affected by the strike.
“We are hopeful that the ongoing dialogue between the resident doctors and the Federal Government will be fruitful, and we count on your understanding as we pray for a speedy resolution of the ongoing industrial dispute,” he begged.
But the NARD chairman, Edo State chapter, Dr Ifeanyi Ofuani, said that the doctors were in full compliance with the strike, saying that they would never call it off until their demands are met.
Strike in full force in Kebbi
In Kebbi State, NARD members complied with the directives of the association.
Speaking with Sunday Sun, the union’s Chairman, Dr Abdulraheem Olayinka said: “Our members complied with the strike since Thursday last week. The demands of our national body are uniform across all the states. All the state chapters have the same challenges, ranging from non-payment of salaries for three months, lack of life insurances for members and many others as put forward by our national body. To us in Kebbi State, the strike is 99 per cent successful, and we hope that Federal Government would address these issues and do the needful”.
On the impact of the strike, he said that in many public hospitals, other medical workers are still carrying out their normal duties, but those patients who had appointment with doctors could not see their consultants.
Olayinka explained that the impact of the strike in the state was huge because the buck of work that was supposed to be done by the doctors had been stopped.
He added that other medical staff in the state could only do 10 per cent of the job, stressing that the earlier the Federal Government did the needful, the better for the development of the health sector.
Patients in Plateau groan at JUTH as strike bites
The medical wards were virtually empty as patients on admission at the Jos University Teaching Hospital (JUTH) were hurriedly discharged due to the strike.
At the moment, the patients left at the wards are groaning as the doctors press home for their demands.
When our reporter visited JUTH, few patients with critical ailments were seen. They were faced with sad option of either being referred to the private hospitals or remaining unattended to. Only few nurses rendered skeletal services.
Only security guards securing structures and facilities were visibly on the ground.
Worried over the pathetic condition of patients at the wards, a group known as “Real Jos Kids” offered medical intervention to the indigents at the hospital to lift their financial burden.
Spokesperson of the group, Sarah Sanda, who presented the donation to the League of Friends of JUTH for onward delivery to the patients, expressed sympathy that there were patients who were confined in the hospital because they could not afford their medical bills.
The Executive Secretary, Nigeria Christian Pilgrim Commission (NCPC), Rev. Yakubu Pam begged the resident doctors to engage the Federal Government in a dialogue and call off the strike.
He said the strike should be called off in the interest of patients who were dying helplessly and unattended to in the hospitals.
Kogi strike witnesses full compliance
There is full compliance in Kogi State of the strike embarked upon by NARD.
When our correspondent visited the Federal Medical Centre, Lokoja, most of the patients were left unattended to except by consultants who were very few in number and some nurses providing helping hands.
Speaking with our correspondent, the state Chairman of NARD, Dr Joseph Enejoh, expressed sadness that Nigeria’s political leaders have continued to allocate huge resources to themselves while the critical sectors of the nation such as health are left unattended to.
He lamented that in the whole of the nation’s government hospitals/health centres, there were only six radiotherapy machines with none in the seven states that make up the North-central zone except in Abuja.
And out of these six, he said, only three were probably functioning well, a situation he said was seriously killing the health sector, declaring that it was unacceptable.
He revealed that in the whole of Kogi State, there is no CT scanning machine and patients have to go to neighbouring states before they could carry out comprehensive tests.
The NARD chairman said it was sad that his members who had sacrificed everything for the nation were still being owed some salaries, stressing that the Federal Government was only paying lip service to the health sector.
He stressed that the condition of medical doctors especially in Kogi State was so appalling that when some of them are sick, others have to contribute money for them to be treated.
This and many more, he said, have caused serious brain drain in the country as many doctors are now running abroad for greener pastures, adding that if the government does not quickly arrest this trend, in five years time capable hands in the health sector would have left the country.
Strike takes toll on Bayelsa residents
The national industrial action embarked upon by NARD is taking a toll on medical facilities, especially in the Federal Medical Centre (FMC) Yenagoa and the Niger Delta University Teaching Hospital (NDUTH), Okolobiri.
At the FMC Yenagoa, the human traffic had greatly reduced with only skeletal work being done as nurses were seen attending to non-emergency issues while some consultants were attending to other patients with critical issues.
An administrative officer who craved anonymity tasked the Federal Government to address the issues raised by NARD so that its members would return to work to avoid a health crisis.
“Every time NARD goes on strike, the Federal Government pleads with it and promises to address its grievances and the members return to work while the government would refuse to implement its own side of the agreement.
“It is unfortunate that the resident doctors are going on strike when the country is still battling COVID-19. See, many patients are suffering; many have been turned back. It is really sad.”
A senior nurse who simply identified herself as Gift said that the nurses and consultants were doing their best to keep the hospital running, but that was not enough as the resident doctors do the bulk of the work.
The Chairman, NARD, FMC chapter, Dr Divine, said that there was 100 per cent compliance from his members.
According to him, the strike would go on as no progress had been made in the negotiation with the government.
At the NDUTH, Okolobiri, nurses and few consultants were seen attending to patients with many of the patients wearing long faces due to the long time it took before they were attended to.
The Chairman of NARD, NDUTH, Dr Oru Inetsol Oru, said that the strike was one which the branch had to join in.
He explained that the action would go on since the national body had not given a contrary directive.
Dr Oru said there was full compliance at the NDUTH in solidarity with the issues raised by NARD to salvage healthcare delivery system in Nigeria.
Consultants to the rescue as hospitals in Ebonyi are paralysed
The NARD strike paralysed activities in public hospitals in Ebonyi State. And now, members of the public can hardly access hospitals in the state.
Patients in some hospitals have been stranded while people seeking healthcare have been advised to go to private hospitals.
However, the case of patients at the Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA) is different as the management of the hospital has drafted consultants in different areas of medicine to attend to the people.
A nurse who gave her name as Ijeoma told our correspondent who visited the hospital that the facility was making efforts to ensure that patients in the hospital were not abandoned.
“The strike came at a wrong time. We have many patients in the hospital now. So, the management had to bring in consultants from different fields to stand in for the doctors, and attend to the patients. We cannot just discharge them like that. So, the hospital is still discharging its duties,” she said.
However, she admitted that she had not been seeing new patients being admitted since the beginning of the strike.
“People are already discouraged from coming to the hospital because of the news of the strike,” she said.
Abia strike hits residents hard
The strike by NARD is hitting hard on Abia residents.
Before the action by NARD, doctors at the Abia State University Teaching Hospital (ABSUTH) had been observing what one of them described as “partial strike.”
The action, the doctor said, was as a result of non-payment of their salaries which he added ran into severely months, but of which the government had promised to offset.
With the strike, the doctor, who is a gynaecologist, said that patients were asked to go home or to private hospitals, disclosing that he only goes to work on Fridays to attend to medical students.
“We are on strike presently, but out of the love we have for the medical students, some of us go to work on Fridays to teach them.”
A man, Chidi Ume, whose wife was sick and on admission at the health facility before the strike, said that he had to take his wife to a private hospital.
“It is unfortunate that the doctors will be allowed to go on strike. I had to take my wife to a private hospital so that she will not die.”
He called for a quick resolution of the dispute so that doctors would go back to their work.