Resident doctors leave patients stranded in hospitals, as the nationwide strike takes its toll on the country’s health sector

By JULIANA EZEOKE

It was double tragedy. Edet Ikpi, commissioner for health, Cross River State, had earlier warned residents of the symptoms of cerebrospinal meningitis, which had started plaguing some individuals in Calabar, the state capital, as a result of the prolonged heat in the state. He had urged those who noticed such symptoms as headache, fever and vomiting to report at government-owned hospitals for free treatment. The advice was taken seriously. But as residents hurried to the University of Calabar Teaching Hospital UCTH for treatment last week, the music changed. There was no doctor to attend to patients. Reason: the Association of Resident Doctors, ARD, had embarked on an industrial action. The result was that such residents with high hopes of getting free treatment went back home with the ailment, which Ikpi said resulted in very high mortality. The disease kills within two hours if treatment is delayed.

Adeola Osofisan, a patient on admission at Obafemi Awolowo University Teaching Hospital, OAUTH, Ile-Ife, Osun State, had never been so devastated. With a forlorn look at no one in particular, she lamented the plight of patients. “We are the ones bearing the brunt of this strike. We could not afford the cost of private clinics and that’s why we are here. Now, see our fate,” she said. Nkemakolam Egbo, a cancer patient at the Lagos University Teaching Hospital, LUTH, Idi-Araba, Lagos State, too, sat dejectedly on a long bench at one of the verandas. During her last visit to the hospital in March, the doctor had fixed April 17 for another meeting. But before the appointed date, the strike started. An aged woman and convinced that her doctor would honour the appointment, Egbo visited the hospital as scheduled. But to her chagrin, the doctor did not attend to her. Her pleas that he had pity on her did not change anything as the doctor stood his ground to obey the association’s order. “I am only resting here for a while and after which I will go. I hope nothing happens to me before they call off their strike,” she said. At the University College Hospital, UCH, Ibadan, Oyo State and the University of Ilorin Teaching Hospital, UITH, Ilorin, Kwara State, it was the same sad song. At Ladoke Akintola University of Technology, LAUTECH, Teaching Hospital, Osogbo, Osun State, almost all activities were put on hold last week. Patients already in hospital were abandoned to their fate while new patients were not admitted. Jumoke Adegoke, a patient at LAUTECH, could not hide her pain. “Government hospitals are our last hope,” she said.

The strike, which kicked off on April 15, could have been abated if government had implemented the agreement it reached with the association earlier. Last year, the federal government had agreed to implement the Consolidated Medical Salary Structure, CONMSS, which is one of the three demands of the association. That was after the group threatened to go on strike last September. The other two demands, according to Yinka Atilola, NARD president, are residency training fund and relativity in the salary of health workers. As Ibezim Emeka, vice president of ARD, LUTH, explained, the residency training fund was demanded to enable resident doctors who are undergoing training at teaching hospitals attend seminars and workshops both within and outside the country. In the meantime, he said, the cost of such training is borne by doctors themselves, as government has no budget for such training. And because resident doctors only receive allowances, it becomes a burden on them to fund such training, which they are supposed to do for six years before they become consultants. Again, resident doctors are not comfortable with the current relativity in the salary of health workers. Before now, the ratio of the three recognised categories of health workers, which include the doctors, pharmacists and nurses and other health workers was 4:2:1.72. But such relativity in salaries had been eroded as, according to Emeka, all health workers on the same level earn the same salary, a development that is not obtainable anywhere in the world. 

Government has offered some reasons for reneging on its promise. Aliyu Idi-Hong, minister of state for health, premised government’s failure on the fact that the 2010 appropriation bill had not been passed into law. 

That was also the same reason given last year by Babatunde Oshotimehin, former minister of health. But NARD does not see such a reason as cogent enough for government to hold up the implementation of CONMSS. Emeka argues that the law allows government to spend up to 50 per cent of the budget even when it has not been passed. “We also know that in this April we are in, the supplementary budget is allowed to run for three months. It ended in March. So, what are they spending in April? Where would they get the money from if not from the budget that has not been signed into law?” he queried. Arguing that the NARD was being considerate in its action as “no doctor would want to watch a patient die,” the vice president of NARD, LASUTH chapter, said the association was aware of the “pranks” of government that “we will no longer succumb to.” 

Ordinarily, the touted salary is insignificant; it should not have constituted a major issue of discourse. In the 2010 appropriation bill, according to Emeka, all it would take to pay all the doctors in the country amounted to N10 billion, even with the CONMSS. Yet, government "spent about N70 billion for the overseas treatment of President Umaru Yar’Adua." The most annoying thing, according to him, is that while doctors are fighting for a paltry N50 billion, lawmakers are smiling to banks with billions. “What is the educational qualification of a senator or local government chairman? They think they can always run abroad to get treatment for headache but fate has a way of catching up with them,” he said. 

However, it appears that the NARD strike does not affect all teaching hospitals. Pokop Bupwatda, president of ARD, University Teaching Hospital, JUTH, Plateau State, who maintained that the strike was declared by some “dissidents” in the south-western part of the country, said that teaching hospitals in the North were not involved. He explained that NARD had met in Minna, the Niger State capital, and agreed that the issue relating to the implementation of CONMSS should be shelved at the moment in view of the "political climate" of the country. In the communiqué that came at the end of the meeting, which the Southwest doctors boycotted, the group had agreed to shift implementation to the end of April with arrears, since the federal budget was still awaiting the accent of Acting President Goodluck Jonathan. If government fails to implement the agreement at the end of April, NARD, according to Bupwatda, could take a decision. 

As the strike continues, the sufferers are the poor masses. Though Emeka admits that government also loses billions of naira, as patients now patronise private hospitals, he says it is patients who lose their lives in the long run. That was also the argument of Atilola who said NARD regretted such loses that might occur. But such considerations notwithstanding, Sunday Ekanem, ARD president, UCH, Ibadan, said, “There would be no going back." Wale Lasisi, ARD president, OAUTCH, Tokunbo Olajumoke, his counterpart at LAUTECH and Bassey Umoh, president of the ARD, UCTH, also share his opinion. And Emeka maintains, “The strike can only be called off when government wants it (called off). The strike can last for as long as government refuses to pay us.” 

Ikpi: Worried.

Idi-Hong: Gives excuses that striking doctors call “pranks” of government.