₦airaland Forum

I wnt to sey dat









































mek I book space sha

I'll comment Wen d news hits fp. For now mek I get space

kettykin: oga it is like you trek a lot , the shoe's ruggedness has seen better days please this is on a lighter note

Wareva. It's made in Nigeria 4 Nigerians. use ur italo trek 4 6mnts, den post d pics mey we see

A shoemaker in Aba produced dis pair of shoe 4me since May last yr. It has nva visited another shoemaker since den. I wear it frm Monday to Friday every wk. I dnt bother buying another cos it shows no signs of spoiling. Guess wat? It cost me only #1500 to get it. Aba's ingenuity

I have an "Italian" suit in my wardrobe nw, Tnx to my tailor in #100 mkt rd, Aba.

k

GEJ till APC bow to PDP

I watched d match in my dream. It was Arsenal winning 3nil

shadelek: Why is Eboue not making the list?

Eboue kwa? U no get eyes o

Wia is Sahko of liverpool?

Aston Villa 0-3 Arsenal. my prediction

May Amadioha bless their union and may sango visit Nigerians dat go abroad to do theirs. Iseeee

My son, neva U 4get God. Alwz pray cos dats d key

Hmmmm open eye no good oh, na so person
take chop
snake 2day
the woman ask me if i need shot or long meat,
i think say
long mean big meat......na after i chop finish
the woman
say my money na 500 hmmm i get to ask "how
manage"
# WOMAN: snake meat hard to get this time
oh.
My people Na vomitin i dey since oh

Hmmmm open eye no good oh, na so person
take chop
snake 2day
the woman ask me if i need shot or long meat,
i think say
long mean big meat......na after i chop finish
the woman
say my money na 500 hmmm i get to ask "how
manage"
# WOMAN: snake meat hard to get this time
oh.
My people Na vomitin i dey since oh

Watch Gov T A at d okija shrine
https://www.youtube.com/watch?v=2_eHbzBZPnA&feature=youtube_gdata_player

RochASS deceiving himself

Its no fraud. They only take 10% of ur total winning. OP pls Save ppl d stress of visiting ur blog b4 u give dem d Info. Rmb, freely thou received....
U can watch d medical student on the hotseat here
https://www.youtube.com/watch?v=C2su3eUvuiE.

Every time the Minister of health is asked about the
strike
he'll say that 90% of NMA demands have been
met. No one
ever asks him to explain what 90% meant; some
circulars and
MoU. These are documents they offer you and turn
round to
contravene and debase. In January they offered
circulars
and MoU, we took them and called off threat of
strike, 7
months later the circulars were never implemented
and the
MoU have been desecrated by this same
government. Now
MoU and Circulars are no longer sacred
government
documents. We want commencement of
implementation. This
government lies a lot. Today they said they don't
have money
to implement but 6 months earlier when granting
the
circular we urged them to send supplementary
budget for it's
implementation. The government agents said our
business
was to do our work as they will pay from SERVICE
WIDE
VOTE. Who is fooling who? Isreal despite being in a
constant
war zone did not sack her doctors after 5 months
of strike.
All through this strike, doctors under NMA directive
have
always scrambled to take care of bomb blasts
victims in the
North. Several NGOs commended this gesture, did
your
government comment on these? People are
bamboozled into
thinking that all doctors are actually needed to
contain
ebola (which by the way this government stood by
and watch
fly into Nigeria). That’s cheap propaganda.All they
need are
infectious disease specialists and the public health
physicians.Ebola will also not be managed in
Teaching
Hospitals, we need quarantine centres. Not that
pako (raw
wood) mama-put structure at Mainland hospital
Lagos. After
N1.9b release all we have are wooden structures
no airflow
controlled tents. No citizen have asked government
questions on these. NMA have volunteered to send
necessary
specialists to the quarantine centres. Where are the
quarantine centres in your state? We don't need
Surgeons,
Gynaecologists, Dermatologist, etc for ebola
containment.
It's all cheap propaganda. Note that in this strike
NMA is
going for broke. We don’t care what Nigerians think
because
they are weak. People that worship those that
acquired
riches by stealing from them (Nigerians). We want
the health
sector privatised or order restored. People that set
up
Yayale Ahmed committee to study international
best
practices in health sector and make suggestions on
way
forward then turn around and undermine the same
committee, rendering their recommendations
useless before
they started (after spending so much to fund
it).Nigerians'
capacity for selective amnesia amazes me.Well, I
am always
consoled by the fact that every population only
gets the
leadership they deserve.

Wat happens to d £16.7m? They for allow am enter UK, den nab am if na true

Cheating ON a test? snoop I gakwara school?

dnt blame d poor guy, dat might b his 1st tym on a plane

JOHESU is synonymous wit inferiority complex.
Their problem is like the story of a monkey who
shaved his beards, rubbed Powder & carried his
oga car to go and look for a gal, cos he wnts to
be lyk his master

JOHESU is synonymous wit inferiority complex.
Their problem is like the story of a monkey who
shaved his beards, rubbed Powder & carried his
oga car to go and look for a gal, cos he wnts to
be lyk his master

THE TROUBLE WITH THE NIGERIAN HEALTH
SECTOR
For a longtime now I have come across so
many articles
and reports in the national dailies and in online
social
media on the rife in the health sector which
centers
mainly on the row between doctors and non-
doctors
working in the healthcare system. Most of these
reports
and articles, mostly lopsided, have one common
denominator, presenting the Doctor as an
enemy of the
people and the manner of their submissions is
such as to
draw undue sympathy from the unsuspecting
public. But
for the neutral members of the society who
have had
cause to have sufficient contact with the
hospital
environment, I’m not talking of some quasi
journalists,
they need not be told, if there are, who the
Angels and
Demons are.
This article is not aimed at indicting or
exonerating any of
the two combatant parties as both have had a
fair share of
the blame, and honestly, the deplorable state of
our
healthcare system is not as a result of the
performance of
the health workers, but it is a component of an
overall
failed system called Nigeria which the current
government
is still trying to salvage amongst other difficult
challenges. Considering the lines along which
the divide
has been made, I shall delve into an inquest of
some of
the key issues at stake, mostly those that affect
the
general public, and this I will do by placing the
Nigerian
Doctor on one side to be reviewed alongside a
few of the
numerous “health professionals” working in the
healthcare system with due consideration to the
most
important person in the system, the Patient. I
shall
concentrate mostly on the tertiary healthcare
institutions
where the bulk of the rivalry is most felt.
The Patient and the Hospital:
Let us begin from the beginning. A healthy
person falls
sick and needs to regain his health and function
properly.
He says to himself, “I don’t feel well enough, I
need to see
a Doctor. May be I should go to the hospital
tomorrow”.
He sets out of his house with this principal aim.
On
getting to the hospital, he first gets to the
reception,
obtains a card at the Out Patient Department
and then
proceeds to see a Doctor (usually a Medical
Officer) if his
condition is one that necessitates a Specialists
attention,
he is then Referred to another Doctor, the
Specialist
(Consultant) for further treatment. On getting to
the point
of referral, the Record staff assist him in
opening a folder
containing case notes, and in the process of
this, a Doctor
(Consultant) is assigned to him. The entire
process of
obtaining a card and folder have no direct effect
on the
patient’s condition but help ensure proper
documentation
and recording within the hospital. He is then
directed to
the designated Specialist or Consultant Clinic
where he is
received by a Nurse who does further
documentation and
records his vital signs which may or may not
be repeated
by the Doctor. Then the patient enters the clinic
to see the
Doctor, his primary aim for coming to the
hospital ab
initio.
The Patient, the Doctor and Other Health
Workers:
The Doctor begins by taking a complete history
of the
patient which includes his current complaints,
previous
health challenges, living condition, social habits,
family
history, drug history, financial capacity, religious
and
cultural beliefs, and then proceeds to do a
complete
physical examination of his entire body system,
at the end
of which the Doctor would have verified the
patients
complaints and identified any other problems
unknown to
the patient, before arriving at a Provisional
Diagnosis. He
then counsels the patient, draws up a treatment
plan,
which is to be strictly adhered to provided the
patient is
within the hospital environment, and
automatically takes
full responsibility for any problems encountered
along the
line. He finally schedules him for a follow-up
visit to
ascertain his response to treatment. This
process of
history taking creates a personal relationship
between the
Patient and the Doctor and this is where the
confidence of
a patient on the Healthcare system of a Nation
is built; the
Doctor-Patient Relationship.
The treatment plan of the Patient, drawn by the
Doctor,
may or may not include; the investigations (or
tests) both
laboratory or radiological to be carried out, the
drugs to
be dispensed and the appropriate prescription,
the
additional care to be rendered outside the basic
nursing
care and the treatment orders to be followed,
some of
which he does himself (or via his subordinate
Doctors)
and others by the Nurses. There is no
stereotyped outline
of what must be done for every patient;
investigations to
be carried out, treatment to be administered or
drugs to be
prescribed lies solely at the discretion of the
Patient and
his Doctor.
Apart from the Nurses, all other “Health
Professionals”
come into patient care when the Doctor’s plan
involves
them. Clearly, a patient has no business with
the
Radiographer if the Doctor’s plan does not
involve
radiography, neither does he have any business
with the
Pharmacist if the patient does not require any
drugs, of
course, not every patients require drugs.
Therefore, it is
safe to assert that if Patient Care is the sole
interest of
everybody in the Health sector, then the Doctor
takes the
Central stage in this service to Patients and
must carry
the Nurses along at every point in time, and
together they
look out for any other “Health Professional” that
should be
roped into patient care. Why then should the
Doctor take
the Central stage? Very simple. He has been
trained
thoroughly to do so. Invariably, the Doctor is
naturally the
undisputed leader of the Health team and only
two classes
of people can challenge this standing; the
criminal minded
ones pursing their selfish interests and the dim-
wits
incapable of any logical reasoning.
On the Headship of the Hospital:
Over time, the functional head of the tertiary
hospital
setting has been the office of the Chief Medical
Director,
CMD, and part of the Act establishing the
hospitals
specified that this position be held by a Medical
Doctor.
However, there has recently been a loud cry
from other
“Health Professionals” under the auspices of the
Joint
Health Workers Union (JOHESU) for the chance
to also
partake in the “enjoyment” of this office, as if to
say it is a
political office, a “National Cake” which should
be shared
equally to everyone in the scene, whereas, it is
the most
sensitive of all positions in the hospital setting,
one with
huge implications on the health of patients. The
Medical
Doctors on the other hand, insist that the office
of the
Chief Medical Director and the headship in
general, of the
Hospitals is their exclusive reserve.
How true is this claim by the Doctors? Again, it
is very
simple. Healthcare is all about patient care, and
in
rendering care to the patient who is the main
focus of
everyone, the Doctor is the arrow head. He
brings together
the activities of all in the health care delivery
system to
bear fruit on the health of the patient. He has a
broad-
based and yet in-depth medical knowledge that
enables
him to function as a leader in patient
management and
take responsibility for the outcome. It is then
indeed a
funny ideology to expect the Doctor to maintain
leadership of Patient Management and then
cede the
leadership of the Hospital Management to a
Non-Doctor.
Right thinking people would agree that whoever
takes the
blame should take the lead. Leadership is about
responsibility, and Doctors embrace such
responsibility
mainly as it involves lives which they have
sworn an oath
to protect.
Furthermore, JOHESU, a body comprising of
other “health
professionals”, support staffs and in fact all in
the Hospital
setting except Doctors, claim to be equal and
allied to
Medicine. But my question is, how is the
clerical staff
allied to Medicine? How can a support staff
head the core
members of the organization? Also, why should
a
“profession” that is “allied” to Medicine
surmount
Medicine? Can a Non-Lawyer become the
Attorney
General of the Federation? Why isn’t the office
of the Vice-
Chancellor made open to every staff in the
University
system since ASUU and NASUU both consist of
“professionals”? How would ceding hospital
leadership to
JOHESU improve the health indices of our
country? These
are people that do not deal directly with
patients, people
that do not really understand the agony of
patients which
Doctors do. The saddest part is the extent they
can go to
press home their irrational demands. We have a
documented occurrence of how they turned off
power
supply to the Intensive Care Unit during a
JOHESU
orchestrated strike action in a southeastern
Teaching
Hospital leading to death of patients on life
support. This
was an attempt to frustrate the Doctors’ effort
to keep
hospital services running while they were
“striking”. How
can people who have displayed this level of
irresponsibility be allowed to head the Health
sector?
Again, God forbid!
It is a common saying that Doctors are “proud”,
and I
insist, they have very just reasons to be, and
when it
comes to arrogance, the patients can tell who
amongst
Doctors and Nurses are more approachable.
Doctors are a
select class of elite and comprise the best
brains of the
society. Yes, the entry requirements into the
profession
and the medical training ensure that only the
best emerge
as Doctors. As such, the government has to
understand
that any arrangement that sees a Non-Doctor in
a
sensitive position to head Doctors in any Health
related
issue would be met with fierce resistance and
the never
ending tussle it will ensue will have detrimental
effects on
our nation’s healthcare delivery. In the interest
of peace
and decorum, the Federal Government has to
dig in and
ensure that the status quo is been maintained.
The ear
that will hear needs not be the size of a raffia
palm.
On conferment of Consultancy on other “Health
Professionals”:
A Consultant (Medical) is the title for a senior
hospital-
based physician or surgeon who has completed
all of his/
her specialist (Residency) training and has been
placed
on the specialist register (Fellow) in their
chosen
specialty. This level of Doctor joins the Civil
service as a
Consultant and automatically leads a team of
Doctors
comprising Residents, Medical Officers and
House Officers
who train under him.
Currently, there has been an outcry by JOHESU
to also be
awarded Honorary Consultancy based on the
fact that
Doctors are been appointed as Consultants,
why not they
too. The concession of the government to this
particular
demand has led to the entire hospital going
berserk in
some centers. This was done against the
warning of the
Nigerian Medical Association that the
introduction of such
“alien” practices would be detrimental to the
lives of
patients and the results are showing.
At the Nnamdi Azikiwe University Teaching
Hospitals, it is
been said that a “Consultant Pharmacist”
invaded the
wards with his team, cancelling patients
prescriptions and
also demanded that a Consultant Cardiologist
remove a
key drug in an inpatient prescription, on grounds
that the
drug has some known adverse effects. Another
report has
it that in Abuja University Teaching Hospital,
the Ante-
Natal Clinic was invaded by Nurses who
decided to
consult patients and make prescriptions, of
which the
Doctors left the clinic and the Patients were
confused.
Patients who sought to see their Doctors were
told that
there was a “Consultant Nurse” who does
whatever a
Consultant does. Also, in University College
Hospital,
Ibadan, stories had it that a Consultant Plastic
Surgeon
was barred from reviewing the surgical wound
he created
post-operatively because a “Consultant Nurse”
had
reviewed the wound earlier and was satisfied
with her
findings.
Let us address one of these occurrences. It is
grave
ignorance for a Pharmacist to tamper with a
drug
prescription simply because he has looked
through his
drug formulary and has identified a known
adverse effect
of the drug when he/she has no knowledge of
the
processes involved in the making of diagnosis
and
prescriptions. Patient management is highly
individualized. To make a prescription, the
Doctors put
many things into consideration viz; patient’s
history and
examination, financial cost of the drug, benefits
against
the risk of using the drug, other drugs to be
administered
etc. Sometimes the side effect of a drug is the
desired
effect needed in one patient but would remain a
serious
adverse effect in another patient. But no, the
Pharmacist
didn’t think in that line before cancelling
prescriptions. I
am not saying every doctor’s prescription is
infallible.
No. But if a pharmacist wishes to express
concern over a
patient’s prescription, he should discuss with
the Doctor
to sort out their concerns.
This whole consultancy for non-doctors arose
as a result
of their quest to have better remuneration. I am
not
opposed to better remuneration for other health
workers,
but looking for cheap means to it at the
expense of the
lives of patients is grossly unacceptable. Why
would you
want to be a Specialist (Consultant) when you
have no
specialty, or you have a specialty in an area
whose
service is not needed? Even if a non-doctor
must be a
consultant that does not automatically make
him/her a
Doctor. We all know how to become a Doctor
and age is
no barrier.
If non-doctors must immutably be made
consultants, their
duties and jurisdictions must be clearly spelt
out and
understood by all involved. A Consultant Nurse
should be
confined to Nursing Practice and she will be
expected to
enhance it, not to invade Medical Practice. She
must
ensure that the management plan of a Doctor is
properly
carried out, even if he is a House Officer.
Unfortunately,
the idea of non-doctor consultant emanates
from the
desire of these other “health Professionals” for
position
and better pay than the desire to meet any
specific needs.
For instance, a ward Nurse that does her duties
properly
becomes a Consultant, what extra services and
improvement does that bring to nursing care?
The fact that
there exist non-doctor consultants in a few
foreign
countries does not explain why the government
should
channel huge sums of money into the payment
of
honorarium to consultants that add nothing to
the existing
system but chaos. The NMA have identified
these
unhealthy health policies and should do all it
can to
prevent it from killing Nigerians.
On relativity of Wages:
Another very important object of discord is the
demand by
JOHESU for a unified salary scheme for
everyone in the
health sector and that will see a close
approximation of
the eventual earnings of all in the sector. What
else can be
sillier? Need I remind us that in every
organization there
is usually an established strata. Even in heaven,
there are
Angels and Arch angels, and the angels are
content with
their positions and would not want to usurp the
duties of
the Arch angels either. People cannot obtain
different
qualifications, different expertise, subserve
different needs
and end up earning similar pay. No. That
cannot happen.
Why would a non-specialist insist on being paid
specialists allowance? Why would a Non-doctor
terrorize
the government because he wants to be paid
like Doctors?
Where in the world is that obtainable? Relativity
is
sacrosanct and must be reflected both on the
basic
salaries and all allowances.
Granted. Doctors are few. Very very few. The
World Health
Organisiation recommends that a Doctor should
consult
not more than seven patients in a clinic session
and
should pay maximum attention to their needs,
but our
environment see us in a situation where a
Doctor consults
over 40 patients in one clinic session, yet, he is
underpaid
compared to his colleagues even in nearby
Ghana. There
are less than 30,000 Doctors currently
practicing in
Nigeria subserving over 170 million Nigerians,
and there
is a dire need for more, but that will not push
the Medical
schools to take in everybody and churn out
unqualified
people as Doctors, neither will the Nigerian
Doctor allow a
Non-Doctor to tamper with the lives of patients.
Doctors
swore an oath to preserve lives and the NMA
must see to
it that the lives of Nigerians are safeguarded. If
the
Hippocratic Oath is to be taken serious, then
the NMA
must win this battle.
More often than not, we are clear on the
knowledge that it
is injustice to treat equal people unequally, but
it fails to
come to our minds that, it is graver injustice to
treat
unequal people equally. This is not pride, it is a
statement
of fact. Doctors and Non-doctors in the Health
sector are
not equal and they cannot be treated as equal.
There is a
reason why some students work harder than
others to
become Doctors. Some sat for JAMB several
times to
achieve that, although many fail to do so and
even some
do fail out of medical school and end up as
“other Health
Professionals”. To eventually anticipate to be
rewarded
equally with those who triumphed where you
failed is
simply madness. The government must see to it
that
relativity is maintained. For if a Nurse or
Pharmacist
consults patient, not regarding quality of the
consult,
earns equally with a Doctor and even get a
chance to
head the Doctor, why then would one need to
work harder
to become a Doctor when he can easily become
a
Pharmacist? Tampering with relativity is a
conscious
attempt at breeding mediocrity, again at the
expense of
lives. If the Nurses and Pharmacists accept to
be paid
equally with the Lab “Scientist” and Janitors,
it’s their
own cup of tea, but paying Doctors and Non-
doctors
equally? God forbid!
On the Physiotherapists’ demand to make first
contact
with Patients:
According to Prof. K. E. Obidike, there are three
reasons
why patients go to see Doctors. Firstly, is to
ascertain the
causes of their complaints and resolve them.
Secondly, is
to identify any other health problems unknown
to the
patient, and again, resolve them timely, and
finally, to
have a baseline documentation of the patient as
a
reference for subsequent health issues. The
second
reason especially, answers the question as to
why a
Physiotherapist cannot make first contact with
patients.
Medicine is holistic, and the initial assessment
of a
patient takes the entire body system into
account not just
the presenting complaints. Therefore,
Physiotherapists
should remain Physiotherapists and should
come into
action when consulted. Simple.

THE TROUBLE WITH THE NIGERIAN HEALTH
SECTOR
For a longtime now I have come across so
many articles
and reports in the national dailies and in online
social
media on the rife in the health sector which
centers
mainly on the row between doctors and non-
doctors
working in the healthcare system. Most of these
reports
and articles, mostly lopsided, have one common
denominator, presenting the Doctor as an
enemy of the
people and the manner of their submissions is
such as to
draw undue sympathy from the unsuspecting
public. But
for the neutral members of the society who
have had
cause to have sufficient contact with the
hospital
environment, I’m not talking of some quasi
journalists,
they need not be told, if there are, who the
Angels and
Demons are.
This article is not aimed at indicting or
exonerating any of
the two combatant parties as both have had a
fair share of
the blame, and honestly, the deplorable state of
our
healthcare system is not as a result of the
performance of
the health workers, but it is a component of an
overall
failed system called Nigeria which the current
government
is still trying to salvage amongst other difficult
challenges. Considering the lines along which
the divide
has been made, I shall delve into an inquest of
some of
the key issues at stake, mostly those that affect
the
general public, and this I will do by placing the
Nigerian
Doctor on one side to be reviewed alongside a
few of the
numerous “health professionals” working in the
healthcare system with due consideration to the
most
important person in the system, the Patient. I
shall
concentrate mostly on the tertiary healthcare
institutions
where the bulk of the rivalry is most felt.
The Patient and the Hospital:
Let us begin from the beginning. A healthy
person falls
sick and needs to regain his health and function
properly.
He says to himself, “I don’t feel well enough, I
need to see
a Doctor. May be I should go to the hospital
tomorrow”.
He sets out of his house with this principal aim.
On
getting to the hospital, he first gets to the
reception,
obtains a card at the Out Patient Department
and then
proceeds to see a Doctor (usually a Medical
Officer) if his
condition is one that necessitates a Specialists
attention,
he is then Referred to another Doctor, the
Specialist
(Consultant) for further treatment. On getting to
the point
of referral, the Record staff assist him in
opening a folder
containing case notes, and in the process of
this, a Doctor
(Consultant) is assigned to him. The entire
process of
obtaining a card and folder have no direct effect
on the
patient’s condition but help ensure proper
documentation
and recording within the hospital. He is then
directed to
the designated Specialist or Consultant Clinic
where he is
received by a Nurse who does further
documentation and
records his vital signs which may or may not
be repeated
by the Doctor. Then the patient enters the clinic
to see the
Doctor, his primary aim for coming to the
hospital ab
initio.
The Patient, the Doctor and Other Health
Workers:
The Doctor begins by taking a complete history
of the
patient which includes his current complaints,
previous
health challenges, living condition, social habits,
family
history, drug history, financial capacity, religious
and
cultural beliefs, and then proceeds to do a
complete
physical examination of his entire body system,
at the end
of which the Doctor would have verified the
patients
complaints and identified any other problems
unknown to
the patient, before arriving at a Provisional
Diagnosis. He
then counsels the patient, draws up a treatment
plan,
which is to be strictly adhered to provided the
patient is
within the hospital environment, and
automatically takes
full responsibility for any problems encountered
along the
line. He finally schedules him for a follow-up
visit to
ascertain his response to treatment. This
process of
history taking creates a personal relationship
between the
Patient and the Doctor and this is where the
confidence of
a patient on the Healthcare system of a Nation
is built; the
Doctor-Patient Relationship.
The treatment plan of the Patient, drawn by the
Doctor,
may or may not include; the investigations (or
tests) both
laboratory or radiological to be carried out, the
drugs to
be dispensed and the appropriate prescription,
the
additional care to be rendered outside the basic
nursing
care and the treatment orders to be followed,
some of
which he does himself (or via his subordinate
Doctors)
and others by the Nurses. There is no
stereotyped outline
of what must be done for every patient;
investigations to
be carried out, treatment to be administered or
drugs to be
prescribed lies solely at the discretion of the
Patient and
his Doctor.
Apart from the Nurses, all other “Health
Professionals”
come into patient care when the Doctor’s plan
involves
them. Clearly, a patient has no business with
the
Radiographer if the Doctor’s plan does not
involve
radiography, neither does he have any business
with the
Pharmacist if the patient does not require any
drugs, of
course, not every patients require drugs.
Therefore, it is
safe to assert that if Patient Care is the sole
interest of
everybody in the Health sector, then the Doctor
takes the
Central stage in this service to Patients and
must carry
the Nurses along at every point in time, and
together they
look out for any other “Health Professional” that
should be
roped into patient care. Why then should the
Doctor take
the Central stage? Very simple. He has been
trained
thoroughly to do so. Invariably, the Doctor is
naturally the
undisputed leader of the Health team and only
two classes
of people can challenge this standing; the
criminal minded
ones pursing their selfish interests and the dim-
wits
incapable of any logical reasoning.
On the Headship of the Hospital:
Over time, the functional head of the tertiary
hospital
setting has been the office of the Chief Medical
Director,
CMD, and part of the Act establishing the
hospitals
specified that this position be held by a Medical
Doctor.
However, there has recently been a loud cry
from other
“Health Professionals” under the auspices of the
Joint
Health Workers Union (JOHESU) for the chance
to also
partake in the “enjoyment” of this office, as if to
say it is a
political office, a “National Cake” which should
be shared
equally to everyone in the scene, whereas, it is
the most
sensitive of all positions in the hospital setting,
one with
huge implications on the health of patients. The
Medical
Doctors on the other hand, insist that the office
of the
Chief Medical Director and the headship in
general, of the
Hospitals is their exclusive reserve.
How true is this claim by the Doctors? Again, it
is very
simple. Healthcare is all about patient care, and
in
rendering care to the patient who is the main
focus of
everyone, the Doctor is the arrow head. He
brings together
the activities of all in the health care delivery
system to
bear fruit on the health of the patient. He has a
broad-
based and yet in-depth medical knowledge that
enables
him to function as a leader in patient
management and
take responsibility for the outcome. It is then
indeed a
funny ideology to expect the Doctor to maintain
leadership of Patient Management and then
cede the
leadership of the Hospital Management to a
Non-Doctor.
Right thinking people would agree that whoever
takes the
blame should take the lead. Leadership is about
responsibility, and Doctors embrace such
responsibility
mainly as it involves lives which they have
sworn an oath
to protect.
Furthermore, JOHESU, a body comprising of
other “health
professionals”, support staffs and in fact all in
the Hospital
setting except Doctors, claim to be equal and
allied to
Medicine. But my question is, how is the
clerical staff
allied to Medicine? How can a support staff
head the core
members of the organization? Also, why should
a
“profession” that is “allied” to Medicine
surmount
Medicine? Can a Non-Lawyer become the
Attorney
General of the Federation? Why isn’t the office
of the Vice-
Chancellor made open to every staff in the
University
system since ASUU and NASUU both consist of
“professionals”? How would ceding hospital
leadership to
JOHESU improve the health indices of our
country? These
are people that do not deal directly with
patients, people
that do not really understand the agony of
patients which
Doctors do. The saddest part is the extent they
can go to
press home their irrational demands. We have a
documented occurrence of how they turned off
power
supply to the Intensive Care Unit during a
JOHESU
orchestrated strike action in a southeastern
Teaching
Hospital leading to death of patients on life
support. This
was an attempt to frustrate the Doctors’ effort
to keep
hospital services running while they were
“striking”. How
can people who have displayed this level of
irresponsibility be allowed to head the Health
sector?
Again, God forbid!
It is a common saying that Doctors are “proud”,
and I
insist, they have very just reasons to be, and
when it
comes to arrogance, the patients can tell who
amongst
Doctors and Nurses are more approachable.
Doctors are a
select class of elite and comprise the best
brains of the
society. Yes, the entry requirements into the
profession
and the medical training ensure that only the
best emerge
as Doctors. As such, the government has to
understand
that any arrangement that sees a Non-Doctor in
a
sensitive position to head Doctors in any Health
related
issue would be met with fierce resistance and
the never
ending tussle it will ensue will have detrimental
effects on
our nation’s healthcare delivery. In the interest
of peace
and decorum, the Federal Government has to
dig in and
ensure that the status quo is been maintained.
The ear
that will hear needs not be the size of a raffia
palm.
On conferment of Consultancy on other “Health
Professionals”:
A Consultant (Medical) is the title for a senior
hospital-
based physician or surgeon who has completed
all of his/
her specialist (Residency) training and has been
placed
on the specialist register (Fellow) in their
chosen
specialty. This level of Doctor joins the Civil
service as a
Consultant and automatically leads a team of
Doctors
comprising Residents, Medical Officers and
House Officers
who train under him.
Currently, there has been an outcry by JOHESU
to also be
awarded Honorary Consultancy based on the
fact that
Doctors are been appointed as Consultants,
why not they
too. The concession of the government to this
particular
demand has led to the entire hospital going
berserk in
some centers. This was done against the
warning of the
Nigerian Medical Association that the
introduction of such
“alien” practices would be detrimental to the
lives of
patients and the results are showing.
At the Nnamdi Azikiwe University Teaching
Hospitals, it is
been said that a “Consultant Pharmacist”
invaded the
wards with his team, cancelling patients
prescriptions and
also demanded that a Consultant Cardiologist
remove a
key drug in an inpatient prescription, on grounds
that the
drug has some known adverse effects. Another
report has
it that in Abuja University Teaching Hospital,
the Ante-
Natal Clinic was invaded by Nurses who
decided to
consult patients and make prescriptions, of
which the
Doctors left the clinic and the Patients were
confused.
Patients who sought to see their Doctors were
told that
there was a “Consultant Nurse” who does
whatever a
Consultant does. Also, in University College
Hospital,
Ibadan, stories had it that a Consultant Plastic
Surgeon
was barred from reviewing the surgical wound
he created
post-operatively because a “Consultant Nurse”
had
reviewed the wound earlier and was satisfied
with her
findings.
Let us address one of these occurrences. It is
grave
ignorance for a Pharmacist to tamper with a
drug
prescription simply because he has looked
through his
drug formulary and has identified a known
adverse effect
of the drug when he/she has no knowledge of
the
processes involved in the making of diagnosis
and
prescriptions. Patient management is highly
individualized. To make a prescription, the
Doctors put
many things into consideration viz; patient’s
history and
examination, financial cost of the drug, benefits
against
the risk of using the drug, other drugs to be
administered
etc. Sometimes the side effect of a drug is the
desired
effect needed in one patient but would remain a
serious
adverse effect in another patient. But no, the
Pharmacist
didn’t think in that line before cancelling
prescriptions. I
am not saying every doctor’s prescription is
infallible.
No. But if a pharmacist wishes to express
concern over a
patient’s prescription, he should discuss with
the Doctor
to sort out their concerns.
This whole consultancy for non-doctors arose
as a result
of their quest to have better remuneration. I am
not
opposed to better remuneration for other health
workers,
but looking for cheap means to it at the
expense of the
lives of patients is grossly unacceptable. Why
would you
want to be a Specialist (Consultant) when you
have no
specialty, or you have a specialty in an area
whose
service is not needed? Even if a non-doctor
must be a
consultant that does not automatically make
him/her a
Doctor. We all know how to become a Doctor
and age is
no barrier.
If non-doctors must immutably be made
consultants, their
duties and jurisdictions must be clearly spelt
out and
understood by all involved. A Consultant Nurse
should be
confined to Nursing Practice and she will be
expected to
enhance it, not to invade Medical Practice. She
must
ensure that the management plan of a Doctor is
properly
carried out, even if he is a House Officer.
Unfortunately,
the idea of non-doctor consultant emanates
from the
desire of these other “health Professionals” for
position
and better pay than the desire to meet any
specific needs.
For instance, a ward Nurse that does her duties
properly
becomes a Consultant, what extra services and
improvement does that bring to nursing care?
The fact that
there exist non-doctor consultants in a few
foreign
countries does not explain why the government
should
channel huge sums of money into the payment
of
honorarium to consultants that add nothing to
the existing
system but chaos. The NMA have identified
these
unhealthy health policies and should do all it
can to
prevent it from killing Nigerians.
On relativity of Wages:
Another very important object of discord is the
demand by
JOHESU for a unified salary scheme for
everyone in the
health sector and that will see a close
approximation of
the eventual earnings of all in the sector. What
else can be
sillier? Need I remind us that in every
organization there
is usually an established strata. Even in heaven,
there are
Angels and Arch angels, and the angels are
content with
their positions and would not want to usurp the
duties of
the Arch angels either. People cannot obtain
different
qualifications, different expertise, subserve
different needs
and end up earning similar pay. No. That
cannot happen.
Why would a non-specialist insist on being paid
specialists allowance? Why would a Non-doctor
terrorize
the government because he wants to be paid
like Doctors?
Where in the world is that obtainable? Relativity
is
sacrosanct and must be reflected both on the
basic
salaries and all allowances.
Granted. Doctors are few. Very very few. The
World Health
Organisiation recommends that a Doctor should
consult
not more than seven patients in a clinic session
and
should pay maximum attention to their needs,
but our
environment see us in a situation where a
Doctor consults
over 40 patients in one clinic session, yet, he is
underpaid
compared to his colleagues even in nearby
Ghana. There
are less than 30,000 Doctors currently
practicing in
Nigeria subserving over 170 million Nigerians,
and there
is a dire need for more, but that will not push
the Medical
schools to take in everybody and churn out
unqualified
people as Doctors, neither will the Nigerian
Doctor allow a
Non-Doctor to tamper with the lives of patients.
Doctors
swore an oath to preserve lives and the NMA
must see to
it that the lives of Nigerians are safeguarded. If
the
Hippocratic Oath is to be taken serious, then
the NMA
must win this battle.
More often than not, we are clear on the
knowledge that it
is injustice to treat equal people unequally, but
it fails to
come to our minds that, it is graver injustice to
treat
unequal people equally. This is not pride, it is a
statement
of fact. Doctors and Non-doctors in the Health
sector are
not equal and they cannot be treated as equal.
There is a
reason why some students work harder than
others to
become Doctors. Some sat for JAMB several
times to
achieve that, although many fail to do so and
even some
do fail out of medical school and end up as
“other Health
Professionals”. To eventually anticipate to be
rewarded
equally with those who triumphed where you
failed is
simply madness. The government must see to it
that
relativity is maintained. For if a Nurse or
Pharmacist
consults patient, not regarding quality of the
consult,
earns equally with a Doctor and even get a
chance to
head the Doctor, why then would one need to
work harder
to become a Doctor when he can easily become
a
Pharmacist? Tampering with relativity is a
conscious
attempt at breeding mediocrity, again at the
expense of
lives. If the Nurses and Pharmacists accept to
be paid
equally with the Lab “Scientist” and Janitors,
it’s their
own cup of tea, but paying Doctors and Non-
doctors
equally? God forbid!
On the Physiotherapists’ demand to make first
contact
with Patients:
According to Prof. K. E. Obidike, there are three
reasons
why patients go to see Doctors. Firstly, is to
ascertain the
causes of their complaints and resolve them.
Secondly, is
to identify any other health problems unknown
to the
patient, and again, resolve them timely, and
finally, to
have a baseline documentation of the patient as
a
reference for subsequent health issues. The
second
reason especially, answers the question as to
why a
Physiotherapist cannot make first contact with
patients.
Medicine is holistic, and the initial assessment
of a
patient takes the entire body system into
account not just
the presenting complaints. Therefore,
Physiotherapists
should remain Physiotherapists and should
come into
action when consulted. Simple.

JOHESU is synonymous wit inferiority complex.
Their problem is like the story of a monkey who
shaved his beards, rubbed Powder & carried his
oga car to go and look for a gal, cos he wnts to
be lyk his master

The rd is beta & traffic lighter dan wat we have at Osisioma, here in Enugu-Aba-PH express rd

The damage has been done.

kokoA: Hostel dey burn you dey browse nairaland, dey send pix instead of to follow quench fire. Ode!

The tyms house of reps members fight, y dnt journalists drop dere cameras & separate dem?

Dnt come wit water cos d damage ia already done. Jst bring relief materials for those affected. U can buy pants & bras cos I m sure some gals will hav only d 1 dey re wearin nw. But if d prsn wasnt wearin any b4 d inferno, na trouble b dat