Following the intervention of some Nigerians, the National Association of Resident Doctors (NARD) recently suspended its two-month old industrial action. The strike, which commenced on August 2, 2021, lasted for 63 days. It also disrupted activities in the nation’s health care delivery system and led to avoidable deaths.
The resident doctors went on strike because of the failure of the government to implement agreements reached with them. Some of the issues include non-payment of salary arrears and allowances to some of their members, as well as non-implementation of life insurance for those treating COVID-19 patients.
The doctors also want the government to release their residency training fund and the placement of their members in the appropriate salary structure. While announcing the suspension of the strike, the President of NARD, Dr. Dare Godiya Ishaya, explained that the decision was informed by the substantial progress recorded in the implementation of the Memorandum of Understanding (MoU) reached with the Federal Government. He also stated that NARD has given the government another six weeks to implement the agreement and avert another industrial action.
We commend the resident doctors for suspending the strike and urge the government to do the needful to prevent another strike. The government should henceforth learn to implement all agreements it fully entered into with striking workers, including doctors and other health workers. Reneging on such agreements has one way or the other led to more strikes in education and health sectors.
Before the suspended strike, doctors had gone on industrial action in April. Last year, medical practitioners went on strike three times over welfare issues such as non-payment of allowance for treating COVID-19 patients and increment in basic salary. Any strike by doctors will always lead to avoidable deaths and disruption of healthcare service delivery. Health care in Nigeria is already in crisis due to years of neglect and infrastructure collapse. The frequency of strike in the health sector exacerbates the already bad situation.
It is commendable that NARD has given the government a six-week window to address its demands. we urge the government to use the opportunity and settle the matter once and for all. With the ravaging impact of COVID-19 and other diseases, Nigeria cannot afford another strike in the comatose health sector. Nigerian doctors and other health workers embark on strike due mainly to welfare issues and ill-equipped hospitals. To address the situation, our doctors must be paid competitive salary and the hospitals adequately equipped. The poor salary paid to Nigerian doctors is solely responsible for the brain drain in the sector. Our doctors daily migrate to Europe, America and Middle East where they are better rewarded and appreciated. Unfortunately, the government is not doing anything to stem the tide of such migrations.
According to the Nigerian Medical Association (NMA), approximately 2,000 doctors leave the country each year. It added that the average number of doctors trained in Nigeria and currently practising in the United Kingdom (UK) increased significantly between July 2020 and May 2021 – ranking Nigerian doctors the third highest in the UK. The exodus is worrisome and adds to the poor doctor-patient ratio in the country.
A World Health Organisation (WHO) report indicated that Nigeria has a doctor-patient ratio of 4 doctors per 10,000 patients and five hospital beds per 10,000 patients. With over 200 million people, it would take Nigeria about 25 years to produce enough doctors to cater for its huge population, the NMA added. This calls for concern.
Resolving the perennial doctors’ strikes in Nigeria requires comprehensive action that entails fiscal and ethical solutions as well as a moral commitment to improving health and welfare of all Nigerians. There is need for increased funding for the health sector by both the federal and state governments. The current budgetary allocation to health is low. According to 2018 World Bank statistics, Nigeria spent only about 3.89 per cent of its budget on health. This is a far cry from the 15 per cent budgetary expenditure for health recommended by African heads of State during the Abuja Declaration in 2001.
Apart from revamping the health sector, government should train more medical doctors. Doctors must be paid enhanced salary as a way of stemming the brain drain. Doctors are important for the health and development of any nation. Let government honour all agreements reached with NARD. We also urge the doctors to always remember their Hippocratic oath and try to prioritise treatment of patients before other material considerations.