I certainly believe the NMA/ JOHESU fight's inhuman contribution to the unwarranted loss of precious Nigerian lives is a tragedy. That it has as main actors the very people who have sworn to help others live healthy lives is also a sad irony. However, in looking carefully at the unfolding events, it is quite clear that there are only three options and only one of those options is able to bring about the change we need. But, I will outline those options later. Instead of only searching for one-size-fits all solution, we need to become… the very people who bring change. The emphasis of this article however is to highlight the beautiful opportunity this current impasse presents to all healthcare stakeholders; a turnaround. The current situation can only be described as a cul-de-sac- a destination reached. If we do not want to live in this house that we have reached, the only sane option is to turn around, retrace our steps and go back to the cross roads where we missed it.

On social media forums and on-line news sites, the arguments have been loud and jarring; while the patients who are presumably the reasons why we gather are wallowing in their miseries. Questions have been thrown back and forth and allegations slung in every imaginable direction. However, rather than clearing up the air, it appears to be breeding new vendettas among people (particularly in the younger generation who studied and played together while in the College of Medicine) who are ordinarily supposed to work together as a team. A possible explanation for some of the problems has been touted as our “Africanness”.

I beg to differ, at the very least my Yoruba values taught me that the wisdom of the child together with the elderly sages’ own store was vital for building the cradle of civilization Ile-ife. Another worthy aphorism is “the child’s hands cannot reach the mantel neither would the adult’s fit inside a gourd”; both must assist each other depending on the task at hand. It is even odious to refer to the relationship between healthcare professionals as elder and child; but for the fact that worse descriptions of master-slave, boss-servant are currently flying in the air and thus necessitating this reminder that not even the child is to be done away with when progress is the goal.

The conversations are ongoing on social media and it is hoped the Ahmed Yayale committee will be a reference point for resolving the healthcare sector crisis.

However, while we wait, counting all gains from this present mess is very essential and possible if we are able to rise above the petty issues that divide us and realize some fundamental facts:

•The patient is the most important person in the hospital.

We get paid because they come and customers/clients deserve the very best service that is on offer. This is why I do not blame anybody who travels out for medical checks including the current Health Minister who is reported to be abroad as at the time of writing this for his routine checks. Angela Adeboye recently dealt with how we can curb this practice in her brilliant report (Nigeria: The Paradox of Nigerian Healthcare).

•United we stand, divided we fall is the aphorism we all need to stick on our dashboards to remind us of our only alternative.

A joint health sector union - JOHESU is a big plus and is capable of ensuring the government sits up and performs her responsibilities to the Nigerian people. That the NMA is not yet part of it is a big shame.

• There are many different models of team work in healthcare and the best model gives some form of equality to all team members. (Compare and contrast the UK health system versus the US health system and identify obvious differences in team structure with correlating healthcare outcomes- the hospital readmission rates in the US is very high and quality care is very expensive).

An analysis of their health system suggests a focus on advanced specialist healthcare which is the very opposite of some other systems which favour hands- on primary healthcare – GP (General Practitioner) and AHPs (Allied Health Professionals) based. With the regular troubleshooting of the US system though, it is hoped that better results are obtained post-ACA (Affordable Care Act). The clichéd “snap on a band aid and send out the door Medicaid” is surely not our wish for the Nigerian populace. This I say in response to some calls for 100% government funded health insurance. A more workable alternative for Nigeria is Capped Access by Category payments (this will be addressed in another article).

•When a service is crucial to diagnosis, such a service can/should only be treated as core and never ancillary otherwise the patients suffer and misdiagnosis becomes the order of the day.

By the way, the word on the street is that “Nigerian healthcare professionals are wicked, and only went to school for the money and prestige that medical school would give them and that they are intentionally doing things to make more people sicker so they can get more patronage!” . Can this be the truth? Redeeming our collective image by changing our ways is the next best thing to do. Start requesting minimum laboratory investigations for all patients especially considering our environment, endemic diseases and known penchant of the general populace for herbals and herbal supplements. Thus, Urine microscopy/Urine analysis, Full Blood count with microscopic- examined slides or at the very least the Haematocrit (we have enough manpower wasting away) must be requested as baseline investigations even for private hospital practitioners. The alarming rates of Kidney disease and failures is worrying and making use of simple laboratory tests before prescription of potentially nephro-toxic drugs must become sine qua non standard in the Nigerian healthcare sector. Health care access is not only about being able to get to the hospital. It includes but is not limited to getting the best care possible for every individual.

We can choose at this junction to do one of three things:

Continue with the in-house wrangling till the house collapses on all.



This will be very easy to do, just keep passing the baton of strikes back and forth till the people rise up to say Enough! It is instructive to note that the people who really need our services often do not have the ability to pay what is right for those services. It is time to begin to call our altruistic selves back to life from the dungeon of an early death. The vulnerable poor, above 60% of the populace cannot afford quality healthcare. How do we help them get the needed attention from our “always travelling out for medical attention” government and elite class?

2.Convene a round table of ALL stakeholders chaired by an invited expert in mediation and conflict resolution because I have no doubt tempers will still fly at such a forum.

The objectives of the stakeholders forum should be firstly, the identification of health policy experts; formation of think-tanks who will for a start work on solutions to the current crisis and in the long-term work at formulating home-grown policies tailored to Nigeria’s peculiar health challenges and who would always be ready to provide modifications for communities that do not quite fit the box models. A definition of home-grown models will suffice- “When we say home-grown, it is not a proud claim to being an entirely original idea of ours but, one formulated with recognition of our peculiar challenges and environment as well as one having enough room for modifications per community in our multi-dynamic country.

3. Complicate issues further by continually importing ideas and solutions for the health sector without due consideration for the peculiarities of our nation and the people.

I know the option I would prefer, what is your own option or perhaps you have a better one? Please do share, Nigeria needs all the help it can get now.

As a blessing in disguise, identifying our mistakes can be the very catalyst we need for the change we all should be working towards- a functional and responsive, culturally competent healthcare system; one that meets the needs of our people firstly in a humane and timely fashion. I am already on board that ship and I hope you will join by sharing this article until every stakeholder has gotten the message. Thank you for reading, sharing and taking necessary action/s.
https://www.linkedin.com/today/post/article/20140710010449-126258749-the-nma-joshesu-face-off-is-a-blessing-in-disguise-for-nigeria?fb_action_ids=10152292485773719&fb_action_types=og%2Elikes

This NMA/JOHESU issue keeps giving me migraines. Same old shi.t.

They should call off the damn strike make we hear word jare. People are dying out there.....haba!

Enuff already..This issue has been too damn overflogged