The past couple of weeks have been a turbulent one for the medical profession in Nigeria as 788 doctors were issued queries and then sacked as a result of a strike act[sup][/sup]ion that resulted from futile dialogue with the Lagos state government over its failure to keep its side of an agreement signed by both parties more than a year ago.
We’ve heard the patients and concerned citizens air their views. Doctors have been largely misrepresented by the media according to Dr. Y who believes one of the medical association’s biggest problems is those we select to represent us (hence the losing PR battle). Doctors need to be heard and here’s what some doctors had to say:
Dr. D, an NMA spokesperson said; “Bola Ahmed Tinubu was part of the government team that signed an agreement with Lagos doctors last year, Fashola should honor the agreement. FYI, Lagos judicial workers earn more than Federal judicial workers. Fashola must be a Governor of all not a group”
Dr. IN, a Lagos state doctor has this to say: “The consolidated medical salary scale (CONMESS) was the salary structure designed by the Federal Government four years ago with the aim of providing a uniform salary scale for doctors irrespective of the state, kind of hospital and area of specialization with an annual increment denoting years of experience. Most states in the country immediately began paying CONMESS in full. Two years after this, the medical guild wrote several letters to the Lagos Government to remind them of CONMESS as they were yet to be paid. The governor then SIGNED an agreement that he would commence payment in 2011 with arrears being owed. The Federal Government made it clear that if CONMESS was paid, doctors would ignore the poor work conditions, work extended hours like they have been accustomed to (but this time they would be happy doing it) and they wouldn’t have to leave the country to work abroad. More people would be encouraged to train as doctors and the health of the people would be secured! Instead, tax was increased, CONMESS was not paid, work conditions were not improved, doctors’ lives were lost to stress related illnesses and medical hazards and call rooms were not provided for doctors on call. When Governor Fashola was reminded in January, he simply said the President couldn’t dictate how much he would pay doctors in his state and the tax increase was necessary so the doctors should get used to it! He said he couldn’t afford to pay CONMESS (but he could plan the most expensive birthday party in the World for Alhaji Tinubu). We then embarked on a legal 3-day warning strike with prior notice to sensitize the people and remind the government of the signed agreement. On resumption, all doctors were given individual query letters (for a joint action!), another one was issued, and then letters were issued for “call to panel / impending dismissal from duty”. A week later, armored tanks were brought to all Lagos General Hospitals and Teaching Hospital Lasuth, Ikeja with doctors walked out of their clinics while seeing patients. The Med guild immediately called for an indefinite strike and the Lagos state government was sued for breach of agreement and victimization of doctors. Fake pay slips were published in the papers some weeks ago claiming doctors were being paid as much as 900,000 whereas a medical professor of 20 years has never been paid as much as 500,000. A Neurosurgeon (brain surgeon) consultant still collects 171,000 as basic salary (excluding allowances). Be informed we have only about 20 in Nigeria (Two of them with Lagos state, they trained in America and they have both been sacked!) and these are doctors who work round the clock due to the number of head injuries daily as a result of road traffic accidents. 3 days ago, we were issued sack letters and 97 doctors (not 373 like you heard) were employed as Locum doctors (doctors paid per hour). These locum doctors need residents and consultants to put them through. It takes years of experience to perform a caesarian section on a woman or a brain surgery (especially bore hole to relieve increased brain pressure or blood in the brain) or an appendectomy or treat a sick child or even to help a mentally ill patient. The Nigerian Medical Association (NMA) has made it clear that the newly appointed doctors should not & would not accept the job offer and that all doctors across the nation would join in the strike against victimization on Friday after the ongoing professional exams. The issue is now beyond CONMESS struggle – the government is aiming to devour the medical and dental profession. Be informed that doctors are not slaves, our Hippocratic oath explains that we owe an obligation to our patients and they owe an obligation to us and our services must be paid for.”
This is the Hippocratic oath that binds doctors all over the world:
‘I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:
To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art; and that by my teaching, I will impart a knowledge of this art to my own sons, and to my teacher’s sons, and to disciples bound by an indenture and oath according to the medical laws, and no others. I will prescribe regimens for the good of my patients according to my ability and my judgement and never do harm to anyone. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and similarly I will not give a woman a pessary to cause an abortion. But I will preserve the purity of my life and my arts. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all humanity and in all times; but if I swerve from it or violate it, may the reverse be my life.’
The original text of the Hippocratic Oath is usually interpreted as one of the first statements of a moral of conduct to be used by doctors. Being a doctor from ages past has always been an honorable profession. The doctors were not usually the wealthiest citizens but they and their families did not suffer untold hardship and they were revered. Many doctors in Nigeria die unsung, unable to provide for their families in their death, from diseases mostly due to medical hazards. Those alive and working can barely make ends meet and cannot substitute financial aid for the time and attention their families are deprived of. So what is a doctor’s reward in Nigeria? Or should we also join the queue for 70 virgins in heaven?
Dr. OF, a doctor working outside Lagos says: “Where I work, I have not gone on leave for 5 years because of the patients. No time to see my parents or siblings, attend burial of friends and relatives and weddings of close friends. I have lost many friends who think that I’m only pretending to be busy meanwhile I see patients every other day that can only be equated to church sessions. Many people cannot sit near a HIV positive patient, but these are the people, whose blood I put hands in everyday during surgery, and their blood splashes into my eyes, mouth and face yet I endure because I won’t abandon them to die. I risk my own life and my family’s life every day to care for others. What I get as hazard allowance monthly is only N5000!!! If I ask my employer to keep an agreement to help me feed my family, is that too much to ask?”
Dr. B, a Nigerian medical doctor practicing in the US says; “Nigerians need to change their mindset, doctors have lost it all in Naija, from money to respect. The respect and pay of registered nurses (RN) in the US is unthinkable let alone doctors. In many instances you will have to downplay being a doctor because of the attention you get”
Dr. OO had this to say: “We live in a tribal society: ethnic tribes, religious tribes and in this case professional tribe, so I understand why non-doctors would find the fact that doctors should ever have a reason to go on strike repulsive and why doctors would find the lack of understanding from the general populace unbelievable. Like all polarized debates, people are leaning towards their gut instinct, which is hardly objective, but emotionally driven. The doctors’ association needs to get off the emotional debate because trust me statements such as “oh, I work too hard and earn so little” is never going to come out tops against sentiments like “my dad died yesterday because doctors were on strike.” Looking at it in this manner, it becomes easier to understand why we are losing what Dr. F calls the “PR war” and why we are likely to lose future ones. As a doctor, I know first-hand what it is like to treat patients without light, giving injection drugs in the dark, putting myself at the risk of needle stick injuries far from the watching eyes of the public. I do it because, like the public, I care about your dad not dying even though I know you would never ask if a needle pricked me last night. I remember a particular incidence. We had an emergency, an unconscious pregnant woman with a blood pressure 280/220mmhg (severe hypertension) who was almost at term. She was unbooked and my call was almost over but I was available. Her husband had just 200 Naira on him. We had to operate on her within the next hour with no blood, no money and no drugs. But guess what? We did! That was the first time I had a needle stick injury because NEPA/PHCN was at their norm. Minutes later the air was filled with the cry of a pretty baby girl in the arms of a doting grandmother and father. In the background were the moans of a slowly rousing mother and then there was me with a pensive look on my face while awaiting the results of my HIV test. I was okay. Even though, I had worked overtime and had to be up to make work in the morning which was now 2 hours away, there was no complain, no feeling of accomplishment because in my “tribe” I was not unique. It is the story of 788 and thousands of other people I share a proud profession with. I got a gracious thank you from the family, a thankful smile from the now recuperating mother and a smiling appreciation from my parents when I narrated it to them.
So to the “court of public opinion” we don’t just measure remunerations in cash only, we do in kind as well. I am sure I am a thousand “thank you” richer and a million “smiles” wealthier because of the job I do. Now all we are asking is that the LASG should match our generosity with trustworthiness and our patience with understanding.”Today the punch newspaper announced that doctors in Federal Government Hospitals in Lagos State have begun an indefinite strike.
Dr. K summarizes the doctor’s plight in these words: “Back in the days the next to a nation’s president was the surgeon General…what do we have now? Back in the days doctors used to get accommodation for free or for cheaper prices now doctors are being evicted from the shams they call quarters. Back then you would never want to travel to America after medical school because you were entitled to a car and good pay but now doctors go to even Ghana where circumstances are better for doctors. Back then we had functioning hospitals but now we cancel surgeries week-in week-out because there are no sterile materials, no dependable power supply…”
Dr. T warns: “A government not sensitive to the health of its citizenry is like a walking corpse. Worse of all is the senseless approach to employ rookie doctors to fill in for consultants. I sympathize with the poor people of Lagos state, I pray for the doctors who have always left their families to take care of us despite the harsh conditions, I would advise Governor Fashola to have a rethink and reinstate the sacked doctors.”
There’s no citizen who hasn’t benefitted from health aid provided by a doctor. Doctors have served you tirelessly, thanklessly and in all manner of conditions both safe and extremely dangerous but these doctors are human too and if it has gotten to a stage where a strike is the only way the Government will pay attention to their cry then be angry with an uncaring government, be mad at a government that would frustrate one of the most important sectors of the economy while they fly their families overseas. Be mad at a government that will put the lives of its people in jeopardy. Be mad at a government that callously breaches legal agreements made with its workforce but please do not be mad at the doctors, they are the victims here. When a doctor weeps, his patients weep too…Fashola harden not your heart!