I met Ikenna Obieze last year when I juststarted my horsemanship. A tall, brilliant chapwith a tired smile. He always wore that smile,he told me, to ward off the spirit of aggressionthat seemed to threaten his relationship withpeople especially, his patients. "Excessive workin a suffocating working environment have away of making people angry so, I have to smileaway the anger," he smiled. I had just startedmy obstetrics and gynecology posting when hewas about to Start his neurosurgery posting.And that same day, in the common room, hereceived a text from his girlfriend sayinggoodbye to him, breaking up with him.He showed me that text with hot tears runningdown his cheeks. But, he did not cry for long;he was just starting the second of three ninetydays, 24hours calls. And soon as he showedme the text, his phone started ringing; somenew accident victims had just been brought intothe hospital. There was no room for pettyemotions or his work would be compromised.He would have to toss his life away,immediately, in order to save the sick. Yet, hetoo, was sick, only that he could not notice. ButI saw it in his eyes.That was the day I swore never to become asurgeon. Or even to do residency in any clinicalfield at all. That singular encounter with DrIkenna completely discouraged me. I couldn'tjust imagine myself, after the hell of medicalschool, writing primaries - a hectic West Africanexam that qualifies one for the residencyprogram, that then leads into years of morehell, like Ikenna was experiencing.The program is designed to train would-bespecialist in the different areas of specializationin medical and surgical practices. It takes onthe average of six years to complete theprogram. But, in reality, it takes a lot longerbecause, it is designed in such a way thatninety percent fails the exams, each time it isconducted. "It's relatively, deliberate" anexaminer once told me. "It is to ensure that anywould be consultant is properly trained, takenthrough the furnace, so that he would be ableto handle a patient's life and the teachinghospital. It is a holistic training," he concluded.That same day, I made up my mind to go formaster in pharmacology instead of residency.And when I discussed it with my consultant, hegave me a stern warning. "You'll never becomea consultant," he warned. "You'll never be aCMD, and you will watch your mates leap frogyou in the practice." I just sat there, nodding ashe babbled. In the end I just said "no problem".My, mind was made up. I wasn't going to be aslave in the hospital, a prisoner for up to adecade like Ikenna had chosen. And I was right.Ikenna's life became more distorted as timewent by. Not because his fiancé had left himbecause, as she lamented, he wasn't giving herenough attention. Not because he was oftenseen dosing off at almost every corner of thehospital because he never had time to sleep atnight. Not because some people starteddoubting his sanity; lack of sleep actuallyaffects our mental health and Ikenna had notslept adequately for two years now owing toexcessive, overwhelming work load. It wasrather because of what happened in the middleof his neurosurgery posting. It was on a coldDecember monday.We were watching a premier League matchbetween Chelsea and liverpool when his phonerang for the millionth time. It was a patientcalling. A patient that had been previously incoma and had just recovered. Ikenna, as usual,ran off for the millionth time."It's that patient I told you about, let me go andempty his urine bag. The nurses won't go closeto him, you know. He is violent and HIVPositive; they are afraid of getting smeared byhis ever bleeding hand", he said to me in onebreath, as he ran off."But, you can't be doing your work and do thenurses work, too," I countered."Is that what you are considering; of what useis it to wait for the nurses? In this practice you,the doctor, is responsible for the patient's lifeand if you keep waiting for the non committedsupport staff, you'll lose a lot of patients." Hereplied in one breath, as usual, and ran off.The match was nearing the end, when he cameback, so sad and sullen. He had a slightdressing on his forehead. I noticed it as hequietly came and sat beside me, dropping hishead to cry."That bastered just gave me a needle prick", helamented.I was shocked. That was the first time I knewwhat risk faces me daily, in medical practice."How did it happen," I asked, a bit angry thathe didn't take precautions.He shook his head at me. " Of course I tookprecautions, Emeka, but as I bent to fix hiscatheter, he pulled out his Butterfly cannula andstuck it on my forehead."" You should go for Post exposure prophylaxis,you know," I proffered." I got it covered already" he feebly replied. But,he was shaken and really scared."Who knows.... Just pray for me so I wouldn'tjust become infected doing this job." Heresumed watching the match."We have to pray for one another," I said.I would later have my own encounter with thatkind of hazard three times but, luckily for me,the patients were not infected. Each hashappened owing to tiredness during my ownsurgery posting. After staying awake for threeweeks at a stretch, it was inevitable that Iwould injure myself in the process of caring formy patients. Lack of sleep makes people lesscareful and shaky. It stems from over workwhich stems from the fact that very few doctorsare left in the country because, majority haverun away from the stifling working conditions inthe country. And work has got heavier andheavier, as time went by. And again, morepatients are coming in as economic hardship hitthe populace harder and harder.And just like Ikenna, over sixteen thousandresident doctors sweat and bleed daily,spending every second of every day in thehospital, working to save patients' lives. Oftentimes you could see it in their faces, theexcessive suffering they go through. Tatteredand hungry, these brave doctors keep thehospitals ticking and without them, there wouldbe no teaching hospitals. They are bleeding tobecome capable consultants in the future, tocreate a better healthy future for the nation. TheHazzard allowance is five thousand naira.Greatly unfair. Even for hazards like the onesboth Ikenna and I suffered. Even ones biggerthan ours. But, that's not the major difficultythese days.Sadly, they too, are not immune to the difficultyfacing every serious minded intellectual in thecountry. The same leadership problems pushingintellectuals, daily, out of this country togreener pastures, real greener pastures.Problems like poor renumeration, not in any waycommiserate with the amount of effort investedin working for the government.Problems, like anarchy in work place, instigatedby the hydra-headed anti-doctor association ofevery other health workers, termed JOHESU,troubling the hospitals. And this is the one I'veexperience myself, just like Ikenna.I wouldn't have gotten really exposed to thesehazards had I had time to rest, and I would'verested relatively adequately, had I just done onlymy work and not that of other health workers inaddition. And I'm not lying, where I work, I dothe work of a doctor, a nurse, a cleaner, anorderly, etc. All in the bid to help the patienteffectively. These supporting staff wouldn't dotheir work, because the government isencouraging their demand to dethrone doctorsas the leaders of the health team. They nowfeel they are not answerable to anyone but,themselves.So, most times, the doctor is run ragged,covering every inch of ground in the hospitalbecause, literally, the patient is his and heanswers for the patient's life or death.

A masterpiece of pure fiction, composed deceive those who do not have first hand knowledge of the hospital setting! let me tackle you head on.


1) you work and school at the same time, you are sponsored by the government, and remunerated accordingly ( how much is your call duty allowances compared to that of other health workers?) when you become consultants, you earn well. do you expect all to come on a platter of gold?.

2) No nurse will refuse to empty the urine bag of a patient because of fear. (this was a lame attempt to disregard nurses) if it actually happened, then it becomes a disciplinary issue, you should have taken it up with the hospital management, and the nurse will be dealth with accordingly. nurses are accustomed to doing the "dirty job" in the hospital....it is actually unbelievable that a doctor Droped his pride and ego to touch a urine bag! any nurse in the house would understand what I'm saying.


3) on the issue of hazard, we are all exposed! but the most exposed of all are the nurses! at least you have time to sit in your ARD lounge to watch soccer. the nurse is inside the ward, by the patients bed side all through her shift. she inhales, touches, and contacts everything the patient brings out! take a look at the ebola mortality statistics, who is worst hit? it had been 3 nurses and 1 doctor. I remember 2years ago, after attending to a badly wounded victim, and having his blood all over my body, his test results came out, he was HIV positive! I emptied a full bottle of jik on myself that day, and did HIV tests monthly for a whole year! ask any nurse you know, they have a story to tell. 5k is small for all the hazard, if it should be increased, it should be done across board.


4) saying that the resident doctor is usually the first to make contact with a patient is a direct misinformation! what about the medical record officer that issues cards? or the OPD nurses that registers the client and take vital signs? when a patient is rushed to the a&e unit, who gets to the patient first? when a patient is admitted to the ward, who receives him? THE NURSE!


5) Registras do everybody's work? doctors are overwhelmed? well it is partly so because you made it so. when you prevent a midwife from examining a pregnant woman, delivering a baby, the gyneacologist is bound to overwork himself! when you refuse to allow a registered nurse do physical examination, or pass iv line, she ll wake you at 2 a.m to do it. when you refuse to allow the lab scientist to do his work, you are bound to outdo yourselves. when you reduced a pharmacist to a dispenser, you thought you were doing yourself a favour!


6) appointing other healthworkers as consultants in their own fields does not affect the chain of command in any way! A consultant pharmacist is restricted to "pharmacy" that's his specialty, he ll work within his scope of knowledge and experience. he has no right to alter a doctors prescription. if he does, then it is a disciplinary issue period! He should offer suggestion to the medical consultant, who makes the final decision. please get that right.


7) if you think a nurse is going to arrange instruments for you to do your wound dressing, then please go back to your private hospitals and order your auxiliaries around. if you were taught asepsis, then you should know how you ought to get your instruments.


refering to core members of the health team as "suport staff" and paramedics, is the height of your pride and ignorance. please Google the term "para medics" and "hospital suport staff "


9) other members of the health team are not jealous, they are just fed up with the oppression and prejudice in the system.

10) please identify any of the 24 demands of NMA that has anything to do with improving healthcare delivery in nigeria

When you ve got enough intelligence to study medicine even if to prove you can be a doctor; then you ll be taken seriously. Loser.

drmat02: When you ve got enough intelligence to study medicine even if to prove you can be a doctor; then you ll be taken seriously. Loser.

Very poor and unintelligent response to what the previous poster outlined.