Confronting Medical Insecurity in Nigeria

IN THE ARENA

Given that medical security sustains the civilisation of any country, the unfolding decay and demoralisation in the Nigeria’s crucial health arena could spell disaster if not properly addressed, writes Louis Achi

Today, medical insecurity is spiralling dangerously in Nigeria. Worse, it is indifferently being watched by the authorities mandated to provide critical moderation.

It’s no secret that despite her strategic clout and eminent position in Africa, Nigeria is sadly underserved in the crucial medical arena. Health facilities – health centres, personnel, and medical equipment – are inadequate. This scenario is even more harrowing in rural areas.

Various reforms have been famously put forward by the federal government to address the wide ranging issues in the healthcare system but they are yet to be implemented at the state and local government levels.

Indisputably, the nation’s health care system remains weak as shown by lack of coordination, fragmentation of services, serial labour issues, dearth of resources, including drug supplies, inadequate and decaying infrastructure, inequity in resource distribution, and a very deplorable quality of care. This scenario is spawning medical tourism among the elite.

Worse, lack of clarity of roles and responsibilities among the different levels of government, have compounded the situation.

Almost two months after proceeding on strike action, the National Association of Resident Doctors (NARD) with over 16,000 members, has insisted that it would not call off the industrial action until its demands were met. The association held this position despite the Minister of Health, Dr. Osagie Ehanire’s meeting with its leadership on Monday last week.

NARD declared the strike action on July 30 at its National Executive Council meeting with the theme ‘The Nigerian doctor, an endangered species: grappling with a pandemic, poor workplace infrastructure and security threats.’

NARD National President, Dr. Okhuaihesuyi Uyilawa, had cited federal government’s failure to implement the agreements it signed with the union 113 days after it suspended the previous strike as the reason for the fresh strike.

The association had vowed to defy a recent ruling of the National Industrial Court (NIC) ordering its members to return to their duty posts. The order, which came almost seven weeks after the doctors embarked on the industrial action, was based on an application filed by the federal government.

Having appealed against the National Industrial Court’s judgment ordering members to resume duties, NARD is sustaining its seven-week-old nationwide strike.

The government had sought an order of interlocutory injunction restraining members of the striking NARD across the country from further continuing with the industrial action. The government is also seeking to legitimise the no-work-no-pay policy against doctors.

In the court’s ruling on August 23, Justice Alkali said he based his order on the prevailing health crisis in Nigeria and the need for the doctors to resume duties as essential workers, to curtail the wave of COVID-19.

It could be recalled that in 2020, medical practitioners went on industrial actions thrice over demands for allowances for treating COVID-19 patients and increment in basic salary.

NARD is also demanding the payment of COVID-19 treatment allowances in the absence of death-in-service insurance, having lost at least 19 of its members to the pandemic, while also protesting the shortage of manpower in public hospitals.

Unfortunately, while the federal government and the striking doctors continue to bicker, patients who throng public health facilities get little or no care. Medical residents, doctors practising to become specialists, make up the larger number of the medical workforce across federal and state tertiary hospitals. There is more.

To-date, many hospitals have long halted the admission of new patients. Those on admission are forcibly discharged or directed to private hospitals.

More unthinkably, the health sector might completely shut down as the Nigerian Medical Association (NMA), with over 44,000 practising/registered members and other affiliates, including the Medical and Dental Consultants Association of Nigeria (MDCAN), may join the ongoing strike.

NMA President, Prof. Innocent Ujah, about three weeks ago after the association’s National Executive Council meeting in Benin City, Edo State, told journalists that in the event that the government failed to implement the agreements after the expiration of its 21-day notice, they would be forced to declare a nationwide strike and join the resident doctors.

The emerging consensus is that the federal and state governments must of necessity show courtesy to the nation’s doctors and other medical personnel. Even as the industrial action lingers, many of NARD members are leaving the country in droves for greener pastures as evidenced by the recruitment drive of medical personnel by Saudi Arabian Ministry of Health and other foreign entities that appear to appreciate their skill sets much better.

NARD’s industrial action is the fourth within the past two years over the same issues. And unfortunately, at the core of their angst is government’s constant failure to meet the agreement voluntarily reached with NARD over its demands.

When medical insecurity is added to the current activities of terrorists, so-called bandits and rampaging rogue herdsmen, then its goodbye to the Nigerian project.