STRIKE OF DEATHS AND TEARS
JULY 10, 2014 BY FOLASHADE ADEBAYO AND ARUKAINO
UMUKORO


Families of victims of the ongoing strike in the health sector take on doctors,
Folashade Adebayo and Arukaino Umukoro report

Mr. Sahr Kaingbanja, a Nigerian based in the United States, had always
known that life is fleeting, a beautiful rose that could wither at noon. But never
in his wildest imagination did he think that the events of Tuesday, July 1 could
have a place in reality.

On that day, his nephew, a newborn, died after he was reportedly removed from
an incubator by doctors bent on going on strike at a public hospital in Rivers
State.
The loss of the baby boy was particularly painful for Kaingbanja. Just a few
days old, the baby was born with some complications and needed a life-saving
surgery. His parents were told to make the initial N400,000 deposit before the
surgery could commence — which they did; and the baby survived that episode.
He was then transferred into an incubator where he remained until July 1 when
his parents alleged that he was removed from the life-saving equipment.
Kaingbanja is irked that doctors could remove a baby from an incubator just to
press home the demand for pay rise. On July 1, the first day of the latest strike,
Kaingbanja alleged, doctors demanded that the pending N89,000 balance be
paid. The new parents rushed to comply but that reportedly did not stop the
doctors from removing the baby from the incubator.
“Less than 30 minutes after the baby was taken out of the incubator, he died.
He was buried that evening. You can imagine how the parents felt and how they
are feeling even now. The parents lost money and also lost their son. Is that
behaviour on the part of the doctors not inhuman?
“It is nothing less than manslaughter and robbery. I believe these doctors should
be banned from practice anywhere in the world. This kind of medical
malpractice should be stopped in Nigeria. In the West, a doctor can kiss his/her
medical practice goodbye for such callousness and outright inhuman treatment
because he/she wants increase in pay,” lamented Kaingbanja in an email to one
of our correspondents.
Kaingbanja is not alone in his grief. He shares that lonely space with a
journalist, Mr. Kehinde Akinpelu, who lost his wife, Olayemi, on Thursday,
July 4, the third day of the indefinite nationwide strike embarked upon by the
Nigerian Medical Association.

Olayemi, 43, had complained of a persistent headache which no self-medication
could abate. From a private hospital, the couple headed for the General
Hospital, Ogbomoso, Oyo State, where doctors reportedly shooed them out
alongside other patients.
Unfortunately for Akinpelu, time is the most important factor in any medical
emergency. His wife had lost time and medical attention at the most crucial
period. Spirited efforts by doctors at Bowen Hospital, a private medical facility
in Ogbomoso, could not save the mother of five. She died with many unfulfilled
dreams, one of which was to see her grandchildren.
Akinpelu is hurt that the action of the doctors cost him his wife. He plans to sue
the doctors once the mourning period is over. “If it was not for the strike, my
wife would still be here with me. We have five children; the youngest is nine
years old. I don’t know how to cope. I am so bitter right now. People are dying
every day. I am definitely going to sue the doctors,” he said.

Where there is no doctor
Aside from the mortalities recorded around the nation, the strike has left many
Nigerians bedridden and in pain. While some resorted to private hospitals or
herbal practitioners for quick relief, others simply accepted their fate, hoping to
be alive when the strike is eventually called off. These Nigerians shared their
experiences with our correspondents.

The octogenarian
Pa Benjamin, in his seventies, has difficulty in walking. Since then, he has been
undergoing regular tests at the Lagos University Teaching Hospital, Idi-Araba.
He was given another appointment to see the doctor last Thursday for a scan.
However, due to the NMA strike, Benjamin, who was brought to the hospital
by his daughter, was kept waiting for hours as there was no doctor to attend to
him.
After waiting for so long, Benjamin, who walks with the aid of a walking frame,
got tired and his daughter had to carry him on her back into the hospital ward.
They went to check if any of the doctors was around, but they found the X-ray
room locked.
“We were told earlier by a doctor that he might need surgery, but that a scan
and further tests would ascertain if he would need one or not,” the daughter told
one of our correspondents but declined to give further information.

Cancer patient who needs blood
In another ward, three relatives of critically ill Ms. Nkechi Oka had been
waiting for over five hours when one of our correspondents met them on
Thursday at LUTH. One of the relatives said Oka, who was lying down
heavily sedated in one of the wards, needed urgent medical attention but there
was no doctor available to see her because of the strike.
“She has cancer and needs two pints of blood urgently. We have been here at
the hospital since 6am. She took a heavy dose of sedative and needs to be
transfused with blood as soon as possible,” said one of them, who gave his name
as Ifeanyi Oka.

Another relation of hers who did not give his name lamented that his sister
would have been transfused with the needed blood since his blood group
matched hers if the doctors were available.
“I had to leave my workplace to come here. But we have no choice but to find a
way to get the pints of blood. We may have to go to a private hospital to get it
for her. But the problem is, even when we succeed in getting the blood, where
is the doctor to do the transfusion?” he asked, worried. Oka and her relatives
refused to allow their pictures to be taken.
Later, one of the few nurses around was seen making calls in a bid to convince a
doctor to come around to attend to the sick lady. An hour later, the calls had
yielded no fruit. “We are still waiting,” Ifeanyi said.
When our correspondents visited the other wards, they were almost empty,
except for a few nurses and other staff members. At the time, no patient was
seen at the accidents, surgery and emergency wards. “All of them were
discharged and sent home last week because of the strike,” one of the nurses
said.

No new patient
In the children’s ward, nurses offered skeletal services to a few patients. On
enquiry, the nurses said only critical cases were being attended to.
“We are not admitting new patients now because of the strike. Only cases that
involve severe convulsion and difficulty in breathing are being attended to. The
advice I would give to anyone who is sick or wants to bring a patient is to go to
a private hospital for now,” said the nurse; adding that they could only help
resuscitate a patient if it’s an emergency.
Stories of regret about the strike action abound across the length and breadth of
the country. Many Nigerians like Ifeanyi are already worried sick about the
episode. “This strike is becoming a hydra-headed problem. Not everyone can
afford private hospitals or go abroad whenever they fall sick,” he lamented,
while hoping that his sister would be lucky to get the treatment she urgently
needed then.

The doctors’ shopping list
At a news conference in Abuja in June, the NMA President, Dr. Kayode
Obembe, had said the association had to go on a nationwide strike after the
expiration of a two-week ultimatum it gave the Federal Government to meet its
24-point demand.

The doctors want government to honour its agreement on certain issues which
they claim are vital to the growth of the health sector. A scrutiny of the doctors’
demands shows an admixture of an improved welfare package, a supremacy
battle with other medical workers, as well as other matters relating to
administration in the health sector.
For instance, they demand that the Federal Government should immediately
appoint a Surgeon-General of the Federation and the extension of the National
Health Insurance Act to cover all Nigerians, as against the present 30 per cent
coverage. The NMA also wants government to set up a health trust fund for the
upgrading of all hospitals in Nigeria. It is also opposed to the appointment of
directors in hospitals but wants the retention of the post of the deputy chairman,
Medical Advisory Committee.

But a chunk of the 24-point demand of the NMA leans heavily on welfare
package. Among other things, the doctors want government to scrap Grade
Level 12 for medical and dental practitioners. The implication is that while other
civil servants move from grade 10 to 12, medical and dental practitioners would
move from grade 10 to 13.
Aside from wanting a hazard allowance of at least N100,000 per month for
medical doctors, they also insist on the immediate adjustment of doctors’ salaries
to maintain relativity and “the immediate payment of the arrears of the corrected
relativity for 22 years during which her members were short changed.’’
Furthermore, the NMA requests that clinical duty allowance for honorary
consultants be increased by 90 per cent of the Consolidated Medical Salary
Scale.

“Additionally, all doctors on CONMESS 3 and above must be paid specialist
allowance or its equivalent that is not less than 50 per cent higher than what is
paid to other health workers,” they added.
Now in its 11th day, the strike has defied negotiations, despite many meetings
with agents of the Federal Government. Arbitration led by the Secretary to the
Government of the Federation, Mr. Anyim Pius Anyim; the Minister for Health,
Prof. Onyebuchi Chukwu; and the Delta State Governor, Dr. Emmanuel
Uduaghan, has failed as the NMA maintained its hard stance.

Discordant tunes
A few days into the strike action, however, affiliates of the NMA are developing
cold feet. On Saturday, the Medical and Dental Consultant Association of
Nigeria opted out of the strike. Citing a National Industrial Court judgment
which stopped the Federal Government from the implementation of its agreement
with the Joint Health Sector Union, the MDCAN National President, Dr.
Steven Oluwole, urged its members to return to work.
“We note without reservations the unnecessary rivalry that has thrown the
health sector into endless cycles of strikes and threat of strikes. The MDCAN
complies fully with the restraining order on all parties, which is contained in the
ruling.

“In the same vein, MDCAN expects the other parties to the above suit to
comply fully with the terms of the restraining order. Branches of the MDCAN
and individual consultants should continue to provide services to patients but
should exercise their professional judgment as to the best care feasible and
practicable in the current situation,” Oluwole said.
The JOHESU, a coalition of health workers, also has an axe to grind with the
NMA. In a statement jointly signed by its chairman, Mr. Ayuba Wabba;
secretary, Mr. Yusuf Badmus; and the chairperson, AHPA, Mr. Godswill
Okara, the JOHESU described the latest strike action as ‘absurd,’ asking its
workers to shun the strike.

The JOHESU urged health professionals in its fold in both the public and
private sectors to “continue to render services within their competence and skills
to ameliorate the conditions of patients who seek care in the weeks ahead.”
But the NMA has kicked against the stand of the MDCAN and the JOHESU.
The NMA President, Dr. Kayode Obembe, maintained that every medical
doctor in Nigeria is bound to comply. “Every doctor is a member of NMA; other
affiliates are allowed to operate also. We sought legal advice on the court
injunction; our legal opinion is that the court order did not mention any reference
to NMA and since it did not mention NMA, we don’t want to dwell on it,” he
stated.

An unending cycle
Since 2009 when the circular of the CONMESS was released by the Federal
Government, the nation has witnessed different types of strike actions by medical
doctors. From warning strike, sympathy strike to full blown strike, patients have
been paying with their lives.

The CONMESS has proved to be the beginning of the battle for the doctors
who are agitating for improved welfare packages. Since 2009, the battle ground
has shifted to the states, where governments engage doctors on their payroll in
negotiation.
Perhaps the bloodiest of the bouts happened in April 2012 between the Lagos
State Government and its doctors who were angry at the reluctance of the state
government to implement the CONMESS. The 14-week strike, which led to the
sacking of 788 doctors, crippled the 26 general hospitals owned by the state and
attracted a sympathy strike from the Federal Government doctors working in
Lagos.

The NMA had planned an earlier showdown with the Federal Government on
January 6, but the association later shelved its plans after a five-day warning
strike last December.
In the last one year, affiliates of the NMA have also had to go on strike to push
for peculiar demands. Last month, a three-day warning strike was declared by
the National Association of Resident Doctors. The NARD was pushing for the
Federal Government to fund residency programmes in teaching hospitals.
As the doctors’ strike enters its 11th day today, the nation is still counting the
cost. However, for the Publicity Secretary, NMA, Lagos State, Dr. Peter
Ogunnubi, the action, although regrettable, would benefit Nigerians in many
areas in the long run.

In a telephone interview, Ogunnubi said the NMA strike would also ensure that
patients are protected. He said, “It would also correct the anomaly which has
seen doctors leaving this country en masse, and you know the implication of that
to the public. Then, we are asking for a total health insurance for all Nigerians
so that a person can go to hospital with his or her identification card and be
managed freely on that insurance.”
Ogunnubi further said, “In addition, there is the National Health Bill that we are
clamouring for. Nigeria is one of the few countries that have no law regulating
health delivery. So, a patient is not protected under any law, and if one’s right
is violated as a patient, there is no law to protect that person. We are asking for
the passage of the National Health Bill so that the health care rights of citizens
can be protected.
“Also, concerning the rural allowance, today, doctors are concentrated in the
cities because there is no out-of-station allowance that is on offer in any
organisation. That is why we don’t have doctors in our primary health care
system.
“Our primary health care system has turned to ordinary offices. But with the
rural allowance in place, doctors would then be able to leave the city if they
know that they have an additional stipend. As a result, there would be wider
distribution of doctors and medical personnel across our villages and towns
instead of them concentrating in the cities.”
Ogunnubi called on the government to be decisive in tackling the issues raised
by the NMA in its 24-point demand. “The present situation now is that the
Federal Government is not decisive enough. And confusion would always set
into any government which does not want to do what is required in line with
international best practices,” he noted.
‘Doctors have the right to go on strike’
However, the Chairman, Nigerian Bar Association, Ikeja branch, Mr. Monday
Ubani, said it would be difficult for any aggrieved patient to sue doctors for
ongoing strike.


He said, “Strike is recognised as one of the legitimate instruments for
negotiation and agitation under modern labour law. So, I doubt if a patient can
succeed in that action because the doctors are also pursuing their legitimate
aspiration in embarking on the strike.
“The doctors are also fighting for their rights. So, it’s not a matter of whether
patients cannot sue, but whether they can succeed in convincing any court that
they have been wronged and that there has been a breach of contract between
the patient and the medical practitioner.
“But then, it is important that doctors also remember that there is an oath they
usually take when they are being sworn in as doctors to ensure that they save
lives. Would it be in the interest of the medical profession to continue the strike
and then see lives being lost or wasted? I think there must be a balance in this
regard,” Ubani said.

The 1st story is probably a lie for the ff reasons.
1. Doctors in public hospitals are not responsible for asking patients to pay up their bills, rather the nurses with the account dept staff are.
2. It is not likely that a doctor will remove a baby from an incubator. Don't forget that nurses are not on strike and will be present to nurse the baby if need be. In d worst case scenario, they would have been advised to move d baby to another hospital, and probably went to source money to settle outstanding bill. However, it is not the duty of the doctor to move a patient on admission after discharge,but that of the nurse. If the nurse on duty deemed it fit to remove the baby out of the incubator eventhough the baby was not stable, then the relatives should sort it out with the nurse. The doctor has no business in the matter.