₦airaland Forum

The Nigerian Health Sector has been in the news for some
time now, as a result of the lingering crisis that has bedeviled
the Sector. The HEALTH sector is expected to be a place of
total wellbeing but why is there so much hostility in the
Sector which has taken a hydra-headed form? Why is the
Sector matching towards Tophet; the Valley of Destruction?
There is so much misinformation, impunity, violation of
Established Rules and Codes of Conduct. Why is the Place
polarized with mistrust, and disharmony? Why has the
Government allowed herself to become a pawn in the hands
of Nigerian Medical Association (NMA) and Medical and
Dental Consultants Association(MDCAN) which are not
legally recognized Trade Unions ? Why does the Government
allow double Standards within the same Sector? The
government that was able to restrain a registered Trade
Union from going on strike has not stopped an unregistered
body posturing as a Trade Union. Why has the Government
allowed the Constitution of the Federal Republic, to be
violated by NMA who sees herself as the Imperial Majesty,
who must continue to subjugate other workers in the Health
Sector? Before we bring answers to these numerous WHYS,
let us x-ray the pathogenesis of the crisis in the Health
Sector.
SALARY STRUCTURES IN THE HEALTH SECTOR
Under the then President, His Excellency Alhaji Umaru Musa
Yar’Adua, the Nigerian Government in 2009 had approved
two different Salary Structures in the Health Sector. These
two Salary Scales were known as Consolidated Medical
Salary Scale (CONMESS) and Consolidated Health Salary
Scale (CONHESS).Medical Doctors in the Service of the
Nigerian Civil Service are on CONMESS, while every other
person working in the Health Sector was placed under the
CONHESS structure. Before the emergence of the late
President UMARU MUSA YAR’ ADUA, President Olusegun
Obasanjo, had placed all Nigerian Health Workers under a
unified Salary Scale.NMA had seriously kicked against this
unified Salary Scale. It was NMA that negotiated CONMESS
for her members while the Joint Health Sector Union
(JOHESU), a recognized Trade Union made up of all Unions
in the Health Sector outside Medical Doctors, negotiated
CONHESS for her members. Below is the two Salary Scales.
CONMESS SALARY SCALE
CONMESS 01----- HOUSE OFFICER/YOUTH CORPS DOCTOR
– Grade Level 10
CONMESS 02----- Registrar/Medical Officer - Grade Level 12
CONMESS 03----- Senior Registrar Grade 11/Senior Medical
Officer Grade 2 Grade Level 13
CONMESS 04---- - Senior Registrar Grade 1/Senior Medical
Officer Grade 1 Grade level 14
CONMESS 05------ Consultant/Principal Medical officer
Grade 2 Grade Level 15
CONMESS 06------ Consultant Special Grade 2/Principal
Medical Officer Grade 1 Grade Level 16
CONMESS 07-------Consultant Special Grade 1/Chief
Medical Officer Grade Level 17
CONHESS SALARY SCALE
CONHESS 7 INTERNS/NYSC ----------- Grade Level 8
CONHESS 8 X -Officer 1 ----------- Grade Level 9
CONHESS 9 Senior X-Officer ----------- Grade Level 10
CONHESS 11 Principal X- Officer ----------- Grade Level 12
CONHESS 12 Assistant Chief X-Officer ------------ Grade
Level 13
CONHESS 13 Chief X-Officer ------------- Grade Level 14
CONHESS 14 Assistant Director X-Officer ---------- Grade
Level 15
CONHESS 15 Deputy Director X-Officer ------------- Grade
Level 16
CONHESS 16 Director X-Officer ---------------------Grade
Level 17
THE FACE OF JANUS AND THE MATCH TOWARDS TOPHET!
In the late 2009, NMA, started a campaign of calumny,
against members of JOHESU , that they were Skipping, which
she alleged as a violation of Government policy. And they as
Medical Doctors are treated unjustly in the health sector .As
shown above, we have seen that NMA members were the
greatest beneficiary of the Government approved Salary
Scale, with higher entry point and jumbo pay.NMA was of the
opinion that any member of JOHESU, who had moved from
CONHESS 9 -to CONHESS 11, should be brought down by
one grade level. JOHESU members were unjustly accused of
skipping and the polity was heated up. The Public Service
Rule provides in 020205 and 020205 (e)- To be eligible for
appointment into the Federal Public Service (e) possess
requisite qualifications as provided for in the scheme of
service. The accusation was faulty because in the Scheme of
Service for JOHESU members, there was nothing like Grade
level 11.In fact it is a misnomer to term the movement from
Grade Level 10 to Grade Level 12 skipping. This is not
skipping, because there is no level 11 and what you have in
the Scheme of Service is movement from Grade level 10 to
12.The Ministry of Health was seeing through the prism and
binoculars of NMA. She supported the recommendation
subscribed by NMA that all JOHESU members who have
moved from Grade Level 10 to Grade level 12 should be
brought down by one Grade level. In a circular dated 11th of
January 2010 , with reference number HCSF /EPO/EIR/RR/
B.63755/T1/77 ,the office of the Head of Service of the
Federation stopped the movement of JOHESU members from
Grade 10 to Grade level 12. About a year later, the Head of
Service in a similar circular dated 10th of February, 2011
with reference number HCSF/EPO/EIR/63755/T1/149 called
the movement of Workers from Grade 10 to Grade Level 12
an unauthorized Skipping. By June 2011, the Health Sector
was already heated up with drum beats of war between the
Workers under the aegis of JOHESU and the Nigerian
Government represented by the Ministry of Health. It should
be recalled, that as at June 28th 2010, in a meeting held at
JUTH GUEST HOUSE in Abuja all Chief Medical Directors and
Medical Directors under the auspices of Committee of Chief
Executives, Federal Tertiary Aspect in Nigeria, unanimously
agreed and released a memo with the reference number
CCEHTH/SEC/V.1/86 on the 29th of June 2010 addressed to
all Chief Executives of Federal Health Institutions. Article 3 on
the topic was- implementation of circular on CONTISS
forbidding skipping of Grade Level 10 or any Grade level. The
decision taken was;-(1) Members decided that by July this
year (2010) all Federal Tertiary Hospital should have fully
implemented the circular with effect from 1st April 2010.All
officers who had skipped Grade level 10 should be brought
down by one grade level except those occupying the
appointive posts of Director of Administration.(2)To effect this
all CF.Os should simultaneously issue a circular to all
affected staff on the 12th July,2010 informing them of the
plan to implement the circular in July. This memo was signed
by M O. Adeoba for: Chairman CCEFTH. Immediately this
directive was later implemented, the Health Sector was
thrown into chaos, JOHESU gave the Government ultimatum
to change her decisions which was not workers friendly, but
the Government refused. Moreover the Government failed to
implement agreements signed with JOHESU since 2009. This
was now followed with a Strike action by JOHESU who
accused, the Government of not keeping with the principle of
Collective Bargaining. As a result of the crisis in the health
Sector on the 9th of August 2011, The Minister of Labour
waded into the matter, but the Ministry of Health was not
satistisfied by the resolution, and the matter was later taken
to the National Industrial Court for adjudication. After a legal
battle between the Ministry of Health and JOHESU, the Court
ruled in favour of JOHESU in 2013, that Government was
wrong to have denied JOHESU members her right. And that
JOHESU members appointed Consultants were wrongfully
stopped as consultants. After the judgment, from nowhere,
NMA/MDCAN who were not a party to the suit, cried foul that
the Court Judgment should not be implemented. They as
usual were the one that hoodwinked the Government, to have
taken the wrong decision that was upturned by the Court.
Suddenly they started accusing government of favouring
JOHESU members, and that they must skip, even though that
no JOHESU member was skipping. Now that the Government
is trying to muster the courage to do what is right, NMA/
MDCAN has chosen to fight the Nigerian patients, by denying
them services and declaring a strike action. Note that it is the
same patient they have told the world that they own and that
all their actions is for the best interest of the patient. Today
NMA/MDCAN who insisted that they must have a different
salary structure are the ones imposing on the Government
what other employees should earn .The same NMA/MDCAN
that wrongfully accused JOHESU members of skipping and
even lost this matter in court is the one, now championing
skipping for her members, even when doctors scheme of
service does not grant such. What a double standard!
NMA/MDCAN AND CALCULATED SABOTAGE.
Since July 1st 2014,NMA AND MDCAN have denied patients
the right to treatment even when the National Industrial Court
had ruled that all parties involved should maintain status quo
ante. Dr Obembe the leader of NMA, who also happens to be
a member of MDCAN has continued to defy Court orders
under the guise that it is MDCAN that went to Court. One is
forced to ask, “Is Dr Obembe not a member of MDCAN”?
Again, does NMA have the moral justification to call for strike
when she is not a Trade Union? Can NMA go on strike on an
issue that is already before a Court of competent jurisdiction?
How does NMA think that the Government will be negotiating
with her on an issue before the Court? MDCAN in a
calculated ploy to deceive the Nigerian populace came on air
to declare that they are not on strike and that they are not
joining NMA in the strike action. The truth of the matter is
that MDCAN is on strike they are not on ground, and they are
not working. MDCAN and her fellow consultants, who have
so designated themselves as the owner of the patients, have
abandoned the patient they say they own. On the so called
minimal achievable demand, NMA should be told in clear
terms that they are not achievable. In the immortal words of
the erudite Justice Niki Tobi, JCA ( as he then was) “when an
issue is before a Court of competent jurisdiction, even though
it takes time, the parties must wait ,they must not jump the
gun, they cannot go for self help” What NMA is doing now is
self help and transfer of aggression on the innocent patients
they have acclaimed to own. The issues raised by NMA/
MDCAN are before a court, so negotiations and decisions
cannot be taking on such matters.
NMA/MDCAN strike is a strike of Prejudice and Ego trip, and
Government should be firm to stop this hydra-headed
problem. The Members of the National Assembly and the
Government should not cave in to the blackmail by NMA/
MDCAN. They must be firm to make NMA/MDCAN see that
their actions are against the state. This is the only way to
make NMA/MDCAN amenable to the laws of the land and
eschew impunity. The Government should know that
Nigerians and indeed the world is watching! JOHESU
members account over 95% of the Healthcare work force, so
the Government must be careful not to be seen to show
favoritism. But must stand on the pedestal of equity and
justice to call a spade a spade. The agitation by NMA/MDCAN
that only they should be Directors, Hospital Chief Executives,
and Consultants should be jettisoned in a jiffy. This is
because such demands are not supported by any statute in
Nigeria. If one is to use the principle of balance of
convenience, how does appointing other healthcare experts
as Directors, Consultants in their specialized disciplines,
affect members of NMA/MDCAN? Even when the different
approved scheme of service, for all these professionals,
allows them to reach the zenith of their career and recognizes
such appointments. How does it affect NMA/MDCAN?. NMA/
MDCAN should know that the other Healthcare Workers are
not a conquered people and that the hospital is not their
capitalist empire. The hospital is a government parastatals
set by law and must operate within the confines of the law
setting it up.NMA/MDCAN should throw away the toga of
medical capitalism and imperialism by embracing medical
humanism. A Physician is expected to be compassionate,
and service oriented devoid of prejudice. NMA/MDCAN
should go and study the preamble to the declaration of
Independence of the United States of America, composed in
1776 which reads thus, “We hold these truth to be self-
evident that all men are created equal, that they are endowed
by their creator with certain inalienable rights; that among
these are life, liberty and the pursuit of happiness” So do all
medical personnel in the health sector who is not an
allopathic physician do affirm. NMA/MDCAN should know
that for a nation to excel, it must be build on equality of all
men, rights of life, liberty and pursuit of happiness.NMA/
MDCAN are not the employers of the Nigerian Health Workers,
so she cannot decide what Nigerian Health Workers get. The
issue of relativity is unfounded and has no basis on any
Nigerian Statute book even indeed world over. No
professional’s wage bill is determined by the wage bill of
another, but by Governments’ Terms of Appointment into the
Service.
On the floor of the Nigerian National Assembly, when, the
incumbent Minister of Health, Prof Onyebuchi Chukwu ,was
being screened to become a Minister, he was asked, “how
would he maintain peace in the health sector that has been
so laden with interprofessional disharmony?”. The Minister
answered that he would do all it takes to bring harmony into
the sector. Again, he was also asked, “what are his views that
only one professional group is the one virtually in control in
the health sector and that other healthcare professionals are
not so involved in leadership of the System?”. The Min. of
Health again answered; that “we will get there that it is a
gradual process that things are changing.” To the Most HIGH
be the glory that the Hon Minister told the world ,that his
action of stopping the consultancy status of other health
workers, was as a result of the complain made by NMA. It is
on the same issue, that the National Industrial Court has said
that, that action was in error, a violation of workers right to
collective bargain. Now that the Hon. Min. of Health has
started seeing that NMA/MDCANS’ actions, are in bad faith,
he must be firm to right the structural injustices in the Health
Sector. So that he would have lived up to his words, “that he
would do everything in his power to bring harmony in the
health sector.” The crisis in the health sector has gotten to
where it is today, because of the over bearing attitude of
some allopathic physicians, who have forgotten that medicine
is the art, act and science of healing, whose scope is beyond
allopathic medicine. It is highly unfortunate that NMA/
MDCAN leadership personified in the person of Dr Obembe
has suddenly forgotten that the word medical is an adjective
which means related to the art, act and science of healing. A
situation, where allopathic physicians in a false mindset sees
only themselves as being medical and other healthcare
experts as non medical breeds/creates a wrong image. The
future allopathic physicians must be nursed and nurtured to
have a mind set of medical humanism to give a good medical
image that does not thrive on rancor, falsehood and a
doctored ideology. The word medical is not a synonym for a
doctor, for if it were, it would not be seen placed in front of
the word doctor as in the term “medical doctor” for that will
be tautology. Every healthcare professional involved with the
act, art and science related to healing are all medical
personnel. So the word medical is not an exclusive term to
designate allopathic physicians but all that is involved with
healing and healthcare services.
Conclusion
Now that it is so glaring that NMA/MDCAN strike is sabotage
against the state, because they are causing untold hardship
to the citizens of Nigeria. This as a result of their ego driven
demands. And have failed to obey Government orders,
because most hospital Chief Executives being members of
MDCAN are in sympathy with them. They have failed to call
NMA/MDCAN to order to suspend the strike, even when there
is a court order. As a result of the death of Nigerians, based
on this sabotage, the Federal Government should invoke the
powers conferred on her in section 18(1) and 18(2) of
University Teaching Hospitals (Reconstruction of Boards, etc)
Act CAP 463 LFN which states 18(1) “The President may,
notwithstanding any provision of this Act, take such
measures as occasion may warrant in order to improve the
efficiency or due administration of the teaching hospitals
specified in the Schedule to this Act.”
18(2) “ For the purpose of section (1 )of this section, the
President may appoint or give such authority for the
appointment of Military Commandments to take charge of
administration of any of the teaching hospitals specified in
this Act for such period as may be stipulated in the authority.
Again, section 19 of the act, on the definition of hospital
states “Hospital includes all institutions (however called)
controlled by the board.” Government should as a matter of
urgency bring sanity into the system by making sure; that
this sabotage by allopathic doctors is stopped. The
Government should declare their actions illegal. As the Health
Sector moves towards TOPHET a symbol of collapse, we
must do all it takes to salvage her, by doing what is right!
AJUFO,BENJAMIN CHUKWUNONSO. WRITES FROM ASABA IS
the Secretary Association of Medical laboratory Scientists
Delta State Branch.
16/7/14

drcakes: Firedup na only you waka come?
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NMA President Ignorant of Standard Infection Control Precautions - Nigerian Nurses

As the Health sector crises continues, Nigerian Nurses have taken to social media on Medicalworld Nigeria to express their utter bewildment at the ignorance displayed on national television by the NMA President Dr. Obembe on Standard Infection control precautions.

The Nurses were reacting to comments credited to the NMA President where he stated "I gave an example before when i was demonstrating, i finished operating in an hospital in scotland and when i removed my glove the nurse who was asisting me in the theatre told me that gloove should come from my hand to her hand. that was her job. Your gloove cannot just go to the floor or to the DUSTBIN. thats what i am paid for. she said if you start droping it in the DUSTBIN the NHS would sack me and they would say am no longer useful for that job"

In a torrent of messages sent to Medicalworld Nigeria, The nurses termed his comments as derogatory and wondered how he lacked basic knowledge on how to dispose a gloove wondering if he intended droping his gloove on the floor before the nurse offered to show his how to discard a used gloove.

According to the NHS Professionals: Standard Infection Control Precautions Scope of Guidance Page 11: "Used gloves should never be placed on environmental surfaces, but disposed of safely and IMMEDIATELY following use, as clinical waste, into appropriate receptacles" Thus the nurses wondered how a colleagues hands has become an "appropriate Receptacle" for his glooves.

Majority of the nurses comments were also related to his continued reference to "DUST BIN" as a dust bin had no place in a sterile theatre where Dr obembe claimed to have done an operation.

In a swift reaction, the Forum for Local Government Nurses and Midwives Chairman Lateef-Yusuf has Reacted to the NMA Presidents Derogatory Comments describing it as obnoxious. In a statement issued to Medicalworld Nigeria he remarked that:

These are some of the issues on ground wherein an abusive, offensive, undisciplined and uncouth individual, of the stone age will imply that Nurses are mere servants to Doctors and get away with it.

It is sad that a group of highly intelligent persons will have a moronic,over-fed, pot-bellied fool as it's leader. Nurses know their worth and roles and thus cannot be intimidated by an indecent, ego- driven and pampered nonentity seeking attention.

Nurses will not accept or tolerate such abusive behavior from any quarter as demonstrated by Dr. Obembe.
Imagine a man from whom people expect a well behaved and disciplined leader belittling, and insulting Nurses, aired live on television with the intention of making Nurses feel like the bottom of the food chain.

This must be challenged by our parent body and a retraction obtained from him.
Be that as it may, It will take more than a prejudiced and unprincipled bigot to get to us. We are still in charge of our clients, standing resolute and unmoved.

In the interest of industrial harmony in the health sector, the government should call Dr. Obembe and his likes to order.
Change is dynamic, and a time is coming in the nearest future when doctors will work on their own and Nurses too will do their work without dancing to the tune of silly individuals who see themselves as God just because they bear the title of GP.
He concluded by saying :it is a thousand times better to have common sense without education than to have education without common sense.

Look at this document and the strategic plans of the NMA thereafter
The House of representatives , house committee on health invites all health stakeholders, civil society groups and the general public to a ONE DAY PUBLIC HEARING ON
a) A bill for an act to provide free integrated maternal newborn and child health care programs for women and children in all government controlled medical facilities and for related matters, 2012 (HB.199)
B) A bill for an act to provide medical professional indemnity to establish the medical negligence complaints committee, repeal section 45 of the national health insurance scheme decree No 35 of 1999 and Matters connected thereto, 2012 (HB 248)
C) A bill for an act to enact the tobacco smoking control bill to among other things provide for the regulation of the production, importation, advertising, promoting, sponsorship, distributio, sale and designation of areas where tobacco products may and may not be somoked and for matters connected therewith 2013 (HB 455)
D) A bill for an act to provide for compensation of victims of road accident and to establish the road accident victims compensation commission and for related matters (HB 294)
E) A bill for an act to enact the nigerian mental health bill to make elaborate provisions for the management of mental health in nigeria and for other purposes connected therewith, 2013 (HB 465)
F) A bill for an act to amned the national agency for food and drugs administration and control act, cap N1, laws of the federation of nigeria, 2004 and for other matters connected therewith, 2013 (HB 445)
G) A bill for an act to amend the counterfeit and fake drugs and unwholesome processed foods (miscellaneous provisions) act, cap c34, laws of the federation 2004 to increase the penalties for offences under the act, to make comprehensive provisions for assess forteiture, compensation and for other matters connected therewith , 2013 (hb 446)
h) A bill for an act to establish the federal college of Medical labaoratory science jos and to provide for courses leading to the award of degrees, fellowship, diploma and certificate in medical laboratory science, biometrical science, other related courses and for other matters conncected therewith 2013 (HB 489)
I) A bill for an act to establish the national post graduate college of medical laboratory science and for matters connected therewith, 2013 (hb.463)
j) A bill for an act to promote voluntary blood www.medicalworldnigeria.comdonation providing for an adequate supply of safe blood, regulating blood banks and for other matters connnected therewith, 2013 (HB 159)
THE PUBLIC HEARING IS SCHEDULED AS FOLLOWS
DATE: Wednesday 16th july 2014
TIME: 10am prompt
VENUE: House conference hall 0.28 (zero floor)
House of representatives (new wing)
National assembly complex, abuja
In view of the foregoing the commmitte requests 31 copies of written memoranda and one soft copy (flash drive) on the proposed bills to be submitted to the committee's secretariat at room 4, (HG 19) Zero floor, white house, house of representative, nationa assembly complex, three arms zone, abuja on or before tuesday 15th july 2014.
For further enquiries, you can contact the committee clerk on 08037000725

NMA SECRET REACTION TO ITS MEMBERS
I JUST HOPE WE WILL TAKE THIS SERIOUS NOW AND NOT START REACTING AFTER THE SHOW IS OVER!
DR LC IMOH
CONSULTANT CHEMICAL PATHOLOGIST
JUTH
Dear All,
For our information please
Item A - Attention SOGON
Item B - Attention NMA Secretariat
Item C - Attention Nigerian Cardiac Society
Item D - Attention The Orthopedic Surgeons
Item E - Attention our brothers in Psychiatry
Items H I - Attention ASSOPON - Behold the short cut to becoming consultants. We should not be surprised if Ghana must go have been processed
Item J - Attention Nigerian Society for Haematology and Blood Transfusion
The desperation of these people knows no bound
Tunji Omotayo
NMA Ekiti
Dear All,
This is an opportunity for both the Nigerian Society for Haematology and ASSOPON to properly brief the leadership of the NMA national on the DANGERS of establishing Postgrad College for laboratory scientist. This is because in a few years they will be brandishing fellowship which they will claim is equal to both the West African and National Postgraduate Fellowships and thus they should be appointed consultants. This will be followed by National Postgrad college of Pharmacy, Physiotherapy, Nursing, Optometry e.tc.our arguments against this should include
1. They are technical cadre staff and they do not need any Postgraduate qualification
2. Even if they do they can go for MSc and PhD which are already exiting in Nigerian Universities
3. The Cost implication to government will be unbearable as they will request that their trainees be employed and paid Just like resident doctors
I beleive Dr. Iregbu and his team will represent us well
God save Nigerian Health sector
Dr. Abdul-Aziz Hassan MBBS (ABU) FMCPath
Department of Haematology
Ahmadu Bello University Teaching Hospital
Zaria, Nigeria
Here are the bills for public hearing on the 16th of July 2014 at the House of Representatives. Please pass on your concrete suggestions on what should be our defence at the HOR. All suggestions should be sent directly to keniregbu@yahoo.co.uk, ibekwets@yahoo.com, tunebg@yahoo.com, and NOT to any groupmail (whether ASSOPON or NMA or MDCAN). In addition SOGON, PAN, Psychiatrists Association, Family Physicians, MDCAN, an all other affiliates of NMA and all other professionals associations should make submissions so that they can speak at the public hearing. We should all be prepared for a MASS movement to the National Assembly.
Please contact NMA Sec Gen, VP-1 or the undersigned for further enquiries
Dr Kenneth C. Iregbu
MBBS, MSc, MPH, FMCPath, FWACP (Lab Med)
Consultant Clinical Microbiologist/Parasitologist &
Infectious Diseases Physician
National Hospital Abuja, Nigeria
234- 805 493 2992

WHAT, ANOTHER DOCTORS’ STRIKE?

With due respect to my teachers, senior colleagues and colleagues, the call for downing of tool by the doctors is needless having read the ratio in which the strike was called upon.

Over the years, having worked within and outside Nigeria both in clinical and public health domains, I am strongly obliged to state that the nation’s health drawbacks are essentially caused by doctors who ordinary are meant to be the leaders of the health team. It suffices to state that, while it is true that the leadership of the health team is like a birth right, their roles and responsibility are equally a birth right, only when these are aligned that we can claim the leadership of the heath team. Come to think of the request placed before the federal government, It is sad to note that the issues are quite petty and trivial to culminate to such a decision that will result to irreversible consequences and loss of lives.

As a medical doctor with over fourteen years experience, I have never had a course to question if I am the head of any health team where I found myself as the most senior doctor or the only doctor in a collection of health practitioners in a health mission, for the simple reason that, I know my bound and appreciated that even the weakest link in my team count. I will also not pursue vanity to a disreputable feat. The posture and activities of my colleagues both at the public and private sectors is appalling, such that it has left some of us who have seen our shortfalls and have made or shown some resentment to it are seen as deviance. We must note that what we think and promote is what can endear us or otherwise to the good books of the government, other health workers and the general public.

For me, I am not surprised at the backlash we receive from other supposedly team mates in the hospital. Looking critically at their opposition to us, you will naturally find out that something is wrong with us as doctors, if not, how could we have lose the confidence of all our team mates including non medic such as the ward attendance, administration staff etc? The truth of the matter is that, if we change our corrupt and indiscipline posture, we will naturally occupy our rightful place. Take for instance, the Heads of Hospitals and many health agencies are being led by the doctors, most of which their hall mark is characterized by kickbacks, high contract inflation even to outright thieving of public funds. Our colleagues will promise heaven and earth to be appointed as heads of organizations, but as soon as they get there, their best friends and new found colleagues are the finance and admin managers and the procurement practitioners.

I have survived several heartbreaks from my colleagues (very senior) in the past and have vowed never to listen to their germane-less advocacy for headship of the health team. From national assignments to international and so many other clinical/public health engagement I have found myself, one of the most recent once was in a supposed tertiary institution headed by a doctor anyway, where doctors no matter your rank should go to the record office and queue up for prescription paper being issued by an officer below the rank of a record officer. I have also been to an organization where patients are dying in troops for simple reason of lack of machine to run tests for a certain class of patients visiting a specialty clinic. Another one was a jamboree organization where names are submitted arbitrarily for ad-hoc jobs that needs some level of expertise, yet competency was dropped into the bin and meritocracy upheld.

The peak of my heartbreak was when I worked in one of a supposed tertiary institution where in a bid to save patient life, a doctor rushed to the theatre to get an oxygen as a last point where such equipment are unarguably handy, could not find one, and we watch the man die. Here, I am not saying the man couldn’t have died, but could have died gracefully, and with some human effort. One can count on and on the rots in organizations headed by doctors.

Now my question is:
1. Of what value is the appointment of a DCMAC adds to the already CMD and CMAC that has been exclusively for doctors?
2. How does the work of a doctor be affected by the appointment of the most senior health practitioner to direct the activities of his other colleagues as a director or
3. How is your work being affected if a health practitioner has reached a level of expertise in his field and he is refered to as a consultant”.

It is quite worrisome to hear my colleagues have downed tools for the simple reason that the post of a Surgeon General is yet to be filled, even when the two ministerial slots are occupied by them. I believe that the hazards’ allowance be reviewed, but doctors especially our Consultants most justify the little that has been paid by actively and routinely availing themselves in the daily routines of the hospital instead of turning attainment of Consultant in the hospital as a gateway to truancy ; my colleagues certainly know what I mean.

We are already fast losing our respect from the government and the general public, and in recent time even from our colleagues whose disposition is for the good of man.

Let me also use this opportunity to congratulate our President who has just assumed office and to urge him to be steadfast in his decision where reasoning should take over precedent than mere emotions and sentiment. Accept my unalloyed loyalty.

This piece is a wakeup call to my colleagues to look up within us and appreciate the rots and imbroglio our actions and in-actions has brought to this noble profession and the health sector in general; as the only way to solve the problem of a leopard wanting to be called a lion can only be addressed by a change of behaviour of the supposed “LION”.

About the author:
Dr Abdul is former UN medical personnel in Trinidad and Tobago.

LIKE IF YOU ARE NOT BIASED.

When not on strike they cream all the monies in the guise of sundry allowances. When on strike they make even more by diverting the patients to their private clinics. Little wonder it is more attractive for them to go on strike on flimsy excuses than to remain on their duty posts....mtcheeewww

NMA's 24 demand has gone down to 2 viz; relativity and skipping. Do u think nma is in their right senses? they are killing Nigerians because of relativity and skipping yet they are the highest paid in the hospitals, better remunerated than other health workers. Why then go on strike? , May the single soul that may have died due to this unwarranted ,lawless strike embarked by NMA rest upon their head.

by Oladayo Afolabi

Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.

- Martin Luther King, Jr.

Historically, the first documented envy-ridden feud between Nurses and Doctors was during the Crimean War (1853-1856), when Florence Nightingale was commissioned to go to Scutari barracks in order to join military doctors to combat the high mortality rate in the military hospitals. The doctors, feeling threatened, resisted the help of Nightingale and her Nurses until they became overwhelmed with casualties and succumbed to reality. This pattern of doctors being threatened by the educated and empowered Nurse has continued to plague the working relationship in the healthcare system till today.

I am therefore not surprised as the current situation is not peculiar to Nigeria. The war between Nurse Practitioners and Doctors is still on even in the country with the supposedly most advanced nursing practice in the world, USA. However, it is being done using tact, legislative lobbying and empirical evidence. In Nigeria, professional civility and self respect has been thrown to the winds as some Nigerian doctors handle this situation in an appalling manner, using a combination of verbal brawl, comical assertions and frustrated rants. This betrays their characteristic ego-servicing claims of being the most knowledgeable member of the healthcare team.

I have been silent about the ongoing row between Doctors and other health professionals since its beginning. While my colleagues and friends from other health professions have continued to spit fire and brimstone deriding the doctors, my social media walls have been squeaky clean, devoid of such tirades. This is not because of lack of professional patriotism or inability to lay the bricks of words to construct a towering harangue about the issue. But, due to many reasons – personal, interpersonal and professional, I have kept my cool and refused to give in to cheap ineffective social media rants. However, when someone like the author of this article publicly displays crass ignorance of the nursing profession through a charisma-laden, highly bombastic but grossly information-deficient and intellectually-flawed article like this; I feel forced to talk, better still, write.

READ: Ayokunle Ayk Fowosire: NMA Strike: Consultant, My Foot!

The incessant strikes in the health sector have rendered the system moribund over the years. The ongoing feud has further grounded the ailing system. This article is not meant to expatiate and justify the (absolutely justifiable!) position of nurses and other health professionals (that is reserved for another day), but to answer Mr Fowosire’s beautifully-written article, an A-rated effort in sincere ignorance and conscientious stupidity. As much as I am highly disconcerted and extremely irritated reading Mr Fowosire’s article, I will try not to walk the dishonourable path of name calling. Therefore, in order to answer his pathetic rants, I do not intend to join issues with him or stoop low to trade banters, but this article will address the misrepresentation of facts presented by the previous writer.

On this background I can begin to address Mr Fowosire’s points. Firstly, the author’s effrontery to undermine the knowledge base of graduate nurses in basic medical science courses is a display of nescience. I still remembered that when I was in second year in the university, we attended the same lectures and wrote same exams for Reproductive and Digestive physiology and Neuroanatomy courses with third year physiology and Biochemistry students. Are doctors not being taught physiology and Biochemistry by graduate physiologists and Biochemists? Maybe a graduate nurse can now boast that s/he was taught in the same class with your teacher. Also in our third year, we were taught pathology with the same note used for part four Medical student. My transcript still says I scored 77% on the same Histo and chemical pathology MCQ given to part four Medical students. How did I know this? We used part four medical students’ past MCQ questions to prepare for exams.

I will not forget to let you know that as a part 4 undergrad, I led Nursing department team to victory over senior part 6 medical students’ team in an interdepartmental debate on bothering national and international health issues; not to talk of the fact that we attended the same lectures with medical student colleagues during first year in the university and some of us clearly surpassed most of them in first year academic performance. And this is not as a result of ‘la cram la pour’ as you said, because the consistency I, specifically and many of my colleagues have shown in academic and intellectual performance over the years could not have come by that. In addition, this ironing of facts should not be misconstrued for vain ego aggrandisement but to let Mr Fowosire, many other doctors like him and the general public know that many Nurses (especially degree holders) did not do nursing because they are academically-impaired but because of their love for the profession and some because of the socio-political environment of securing admissions into University in Nigeria.

The question of who should lead the healthcare team has also been a long-standing one. While many developed countries have undergone the health management structure-shift from vertically structured systems to a matrix structure, Mr Fowosire and many Nigerian doctors like him still live in the dark ages clamouring for ‘oga- omo ise’ relationship within the healthcare team. They want the Medical doctor to be even the director of Hospital security. This is inane absurdity. The National Health Service UK has been named as the best performing national health system in the world many times. The NHS and Hospitals in the UK are being managed by managers who are recruited through the NHS management trainee scheme. These trainees come from myriads of field, from geography to history, what matters in their recruitment is intelligence and ability to provide creative solutions to health system problems. These are recruited into the management cadre and grow through the ranks mastering the dynamics of the health system until reaching the highest managerial post of the hospitals and NHS trusts. Space will fail me to talk about the US, Canada, Sweden and so on. However, a six hours flight down south to Nigeria, we have the best medical professors and consultants wasting human resource by sitting down romanticising administration as CMDs, instead of taking care of the patients they claim to own. A predilection fuelled by the position-consciousness, power-hungry-proclivity, greed and corruption eating the fabrics of our society.

It is on ‘debatable‘ record that the best ever Minister for Health in Nigeria in performance was an economist not a Medical Doctor, Prof Eyitayo Lambo. The reason for that is not surprising, it is just common sense. A simple google-oracle consultation will show all his achievements as the longest serving Minister for Health in Nigeria. I will like to highlight that majority of my colleagues in graduating class 2012, Master in Health Planning and Management, University of Maiduguri, were seasoned consultants in different medical and surgical speciality from all over Northern Nigeria. However, I finished in top three out of the over forty six members of the class. Therefore, if the CMD position is filled based on performance and best management knowledge, skill and expertise, why should I not be lined up for consideration for such alongside my classmate medical consultants? Nevertheless, going by the meaning of CMD (Chief Medical Director), the inherent nominalistic connotation in this position is the reason why the doctors have made the position their exclusive preserve; a domain they plan to extend to commissioner for health and Minister for health positions too. As a responsible professional, in my personal opinion (which many of my colleagues may differ with) it will be clearly unreasonable to make a nurse the chief medical director. Notwithstanding, my proposition has always been, ‘why do we need a CMD if we have a CMAC?’ Therefore, I think the name CMD should be ditched and changed to favour international best practices. I think something like Chief Executive Officer or Chief Operating Officer as used in developed world should be adopted. This de-clutters the name and removes any exclusive preserve that medical doctors may lay hold on.

In trying to disparage and clarify Mr Fowosire’s embellished bombastic views of the superiority of the doctor over other health professionals, I mentioned my previous consultant classmates who I respect for their professional achievements in their field. I do not in any way use this to mean that I know what the consultants know about medicine, but I bet the consultants do not know what I know about nursing too. You do not compare grapes to mango. There is no basis for such. They are two different fruits. However, in your five-a-day dietary plan, you need to have both; one cannot replace another. On this premise, if the dictionary meaning of the term consultant, which has been selfishly usurped by doctors, is ‘a specialist’; then, why should a nurse, pharmacist or Laboratory Scientist not be called a consultant in their field if they have gathered enough knowledge, skill and competency to attain such specialised level. An expert who gives advice on business even if he has never managed one single start-up is called a business consultant. This is the case in many other professions and vocations. Why will doctors refuse to face their own effectiveness in their profession? Why are they trying so hard to bar other professions from progressing?

The ludicrous height of Mr Fowosire’s display of crassitude was the un-informed assertion that there are no male midwives in Nigeria. There is nothing like tradition in an Evidence-driven age and there is nothing like Midwifery being the exclusive domains of female nurses. I am a male midwife registered and licensed to practice by the Nursing and Midwifery Council of Nigeria. Male midwives have been produced and registered in Nigeria since 2007 and I was one of the early set of male midwives to be registered in the country in 2009. I am proud to be who I am and I am striving to be the best at what I do. I only wonder where Mr Fowosire is undergoing his medical education if he is boldly casting such un-informed aspersion about Nigerian Nursing in 2014. Your stereotyped labelling of all male nurses as wanting to become a doctor can be forgiven as another symptom of your ‘hypo-exposure-induced myopia’.

Furthermore, Mr Fowosire tried to lark about, tinkering with words. He used a comparison of ‘doctored’ and ‘nursed’ as a contextual basis to make an assertion that we live in a society clouded by vanity. What a comedy? What a good understanding of English language? Nevertheless, I will ask, ‘why do we nurse children and not doctor them?’ ‘Why do we nurse ambitions…?’ ‘Why do we nurse wounds and pain…?’ I guess ‘nurse’ is not a bad verb after all; but why does the verb- ‘doctor’ sound like someone falsified claims, adulterated the original and committed fraud. This is exactly what the doctors in Nigeria are currently doing raising unfounded propaganda and spreading intentional half-truths and falsified claims about the essence of the ambitions of the other health professionals, an archetype of fraud.

Mr Fowosire, your fear and concern for the society and posterity in this issue is highly unnecessary and totally misplaced. Empirical evidence has it that Nurse-Led Units are making the difference in patient’s life in the developed world. In the UK, a Nurse led unit, Barking Community Hospital (Yes a nurse-led hospital) close by my apartment has MRI machine. How many Professor of Medicine-Led teaching hospitals in Nigeria have that? That is what you should be concerned about, the fact that our hospitals are ill-equipped for 21st century medical practice. What you should be getting concerned about is the fact that Community Health Extension Workers (CHEWs) are consulting at Paediatric Out-patient departments in State Owned supposed Specialist Hospitals in Nigeria. The fact that after government spend lots of money to train a doctor (common in Northern Nigeria) till he becomes a consultant in a rare speciality then he goes to sit in the office as a CMD while all the money spent and specialist knowledge gained wastes. What you should be concerned about is the jungle medicine still being practiced in Nigerian teaching hospitals and many other cases of malpractice and negligence (documented by Olatunji Ololade in the Nation of 5th April, 2008), where doctors spent one month diagnosing a brain tumour as a sinusitis problem. And, most of all you should be very concerned about the fact that, after spending nine years for a six years course, you still have your part six MBBS exams to write. Until you become a fully certified medical doctor, your contributions in this debate are rather unwelcomed.

- Oladayo Afolabi is a trained Nurse-Midwife Researcher, Health Management Consultant and Idea Driver for MACHE initiative Nigeria. He is currently studying M.Sc. at London Metropolitan University on Dr. Muritala Muhammed Postgraduate Scholarship. Twitter handle @deeone6603

Source:http://www.thescoopng.com/oladayo-afolabi-rejoinder-nma-strike-nurses-point-view-stepped-toes/

wtf

[quote author=TheDoc]Another strike coming up from 1st October, by the association of resident doctors.
give GEJ a breaak

meanwhile,nard -are they not post garduate students? how come they are paid? is it not them that should pay fg school fees for using the hospital and patients as a practising tool(lab animals)?
now why are they complaining when ippis have exposed that they work as residents(pg students) in one Fg hospital and also m.o(medical officer) in another fg hospital and also working inalary private hospitals thereby collecting salary triple which is against the law.
u guys should just leave Gej alone

no comment

the truth is that whether their is a political udertone or not,the teachers were dispersed and the said L.G is still under the siege of police men therefore going against a court order...lawlessness by the mbu led rivers npf

FOR the umpteenth time, the nation was again, told that Nigeria holds the dismal record of having the highest paid legislators globally.

Had this report not emanated from The Economist of London Magazine, it would have been dismissed as a none issue since the matter has been in the public domain and Nigerians seemed helpless about the situation.

The report said that federal legislators with a basic salary of $189,500 per annum (N30.6m) were the highest paid lawmakers in the world.

Quoting data from the International Monetary Fund (IMF) and The Economist of London, the study looked at the law makers’ basic salary as a ratio of the Gross Domestic Product per person across countries of the world.

It further suggested that the lowest paid legislator in Nigeria earns N30.6 million ($189.5,000) per annum which was put at 116 times the Gross Domestic Product, GDP, per person. As a ratio to GDP per person, Kenya was second with 76 times, Ghana 30 times and Indonesia 18 times.

While the report did not add anything new to the debate on the take home of our lawmakers, it however, reactivated public consciousness about the issue.

The actual take home of the federal legislators has continued to remain in the dark, for reasons best known to the Revenue Mobilisation Allocation and Fiscal Commission, (RMAFC).

However, the RMAFC report of 2007, said the subsisting approved packages for National Assembly (NASS) members include accommodation: (Senator N4m, Rep N3.97m), vehicle loan (Senator N8m, Rep N6.948m), furniture (Senator N6m, Rep N5.956m) and severance gratuity (Senator N6m, Rep N5.956m), which are due once in four years.

Other allowances, payable annually, are car maintenance (Senator N1.52m, Rep N595,563), constituency (Senator N5m, Rep N1.687m), domestic staff (Senator N1.5m, Rep N1.488m), personal assistant (Senator N506,600; Rep N496,303), entertainment (Senator N202,640, Rep N198,521), recess (Senator N202,640; Rep N198,521), utilities (Senator N607,920; Rep N397,042), newspaper/periodicals (Senator N303,960; Rep N297,781), house maintenance (Senator N101,320; Rep N99,260) and wardrobe (Senator N405,280; Rep N397,4020).

The Senate and the House of Representatives, through their spokesmen, have alleged mischief in the report, saying it was a figment of imagination of the authors.

Civil society activists have denounced the legislators, saying they could bankrupt the economy, a sentiment that Central Bank Governor, Mallam Sanusi Lamido Sanusi, once voiced.

Against this backdrop, we call on the RMAFC to make public the actual take home of our law makers. There is need for adjustment of the wages of the legislators to reflect the pay structure in a country where the minimum wage is N18,000

The Nigerian public also has the right to know the actual earnings of those elected to represent them in the legislature.

We frown on any act of impunity whereby legislators, simply because they are in charge of the public purse, help themselves to jumbo packages without resort to constitutional checks and balances.

mtcheeew.

MANY PEOPLE WILL WALK AND OUT OF YOUR LIFE

BUT ONLY TRUE FRIENDS WILL LEAVE FOOTPRINTS IN YOUR HEART.

HE,WHO LOSES MONEY,LOSES MUCH.

HE WHO LOSES A FRIEND,LOSES MUCH MORE AND HE WHO LOSES FAITH,LOSES ALL.

IF SOMEONE BETRAYS YOU ONCE,IT IS HIS FAULT,

IF HE BETRAYS YOU TWICE,IT IS YOUR FAULT.

TO HANDLE OTHERS USE YOUR HEART.ANGER IS ONLY ONE LETTER SHORT OF DANGER.

GREAT MINDS DISCUSS IDEAS,AVERAGE MINDS DISCUSS EVENTS AND SMALL MINDS DISCUSS PEOPLE.

BEAUTIFUL YOUNG PEOPLE ARE ACCIDENTS OF NATURE BUT BEAUTIFUL OLD PEOPLE ARE WORKS OF ARTS.

LEARN FROM THE MISTAKES OF OTHERS.YOU CAN'T LIVE LONG ENOUGH TO MAKE THEM YOURSELF.

lord have mercy