The President of the Nigerian Association of Resident Doctors, Dr. Dare Ishaya, explains in this interview with LARA ADEJORO why the association’s demands to the state and federal governments require immediate attention
You have issued two ultimatums to the government regarding your demands in one month. Before the ultimatum, had you any engagements with the government and the stakeholders involved?
Yes, we have had engagements, and that is why the National Executive Council of the Nigerian Association of Resident Doctors looked at the engagements and felt that even though the engagements had not yielded the desired results, at least there are some responses in some quarters, and with that, we felt it was only right that we should extend the ultimatum and see the genuineness as to solving the issues, and that’s the reason the ultimatum was extended.
Just as I said, following our communiqué issued in July, we mentioned that an ultimatum did not automatically translate into a strike but that it depended on the response from the government, and since we have seen that there is little response towards resolving the issues, we felt it was only proper and logical that we extend the ultimatum and see the genuineness of the government’s response to our issues.
Can you categorically state the efforts that have been made so far by the government regarding your demands?
The issues ranged from the federal to the state governments. On the federal government, recall that in our communiqué released at the end of our July NEC, we complained that our new hazard allowance rate, which was circularised on December 22, 2021, was almost eight years old, as at that time, we concluded at the meeting that there was no visible commitment from the government towards ensuring that the circular had been implemented.
Following the ultimatum, the Ministry of Health officially requested in a letter to the Ministry of Finance that the funds be released so that we could be paid, as well as the same for our Medical Residency Training Funds.
So the communication has gone out, so it’s the work of the Ministry of Finance to act. We hope that the Ministry of Finance will expedite action to release the money to the health workers, including our members, to benefit from it.
Regarding the state government issues, you will recall that Abia State owes our members about 24 months of salary arrears, and we got a communication from the government that they have started the payment, but our members have yet to confirm that they have received the alert of the money. It’s only logical that we give them more time, and whatever delay there may be, by the end of these two weeks, the issues will have been sorted. We have also received information that the issue of acute manpower shortages is being worked on. It is also our belief that whoever may be working on it, by the end of the two-week ultimatum, we should have seen palpable results. We should be able to say that the government has demonstrated enough commitment for us to drop our ultimatum or go on with an industrial action, which may ultimately be determined by the NEC of NARD.
So, these are the signals we are seeing from the government, and we felt that since these signals are emanating, can we now shelve or extend the ultimatum so that we will give room to the government to follow through with the process that they have put in place in ensuring that our issues are sorted out.
You said the funds have been budgeted, but the Ministry of Finance is withholding them. How are you sure of this?
The money was budgeted, and we have confirmation of the 2022 budget. The MRTF allowance is there in the National Postgraduate Medical College budget for 2022; likewise, the reviewed hazard allowance is also captured under service-wide voting. It was an anomaly as it was supposed to be captured under the personnel budget of the various institutions, but it was captured under the service-wide vote.
The only thing we are asking is for our supervisory ministry to write to the Ministry of Finance since it was budgeted under the service-wide vote. Someone has to write for the release of that fund to be paid for what it was intended for, but there was no communication whatsoever at the time we issued the ultimatum.
Following the ultimatum, when we met with the Ministry of Health, communication was sent to the Minister of Finance to release those funds so that they can be paid to the deserving members. The fear of our association has been that it was there in last year’s budget under the service-wide vote but because nobody applied for it, it wasn’t spent, and we are afraid that the same thing may befall this year’s new hazard allowance. So we have to push.
What are the things at stake if your demands are not met; if the government fails to pay the funds?
My NEC members are wise enough to always take appropriate decisions, and I still believe that they will still be able to make decisions if the government fails to do what it is supposed to do regarding the welfare of our members. I wouldn’t want to preempt what they will decide, but they have already said that industrial harmony may not be guaranteed if our demands are not given the necessary attention.
Your demands now are almost the same as the demands you had last year before you suspended the strike. So, why did you suspend the strike when your demands were not met?
Strikes are not meant to last forever. What we want to see is a genuine commitment to attending to our issues. We suspended the strike last year even though things were prolonging the strike regarding our withheld salary and the MRTF.
When we came on board, we met with the relevant stakeholders and extracted commitments that were visible to us, and we had to call for a NEC meeting to suspend the strike because it wasn’t actually our wish to go on strike and allow the patients to suffer unnecessarily, but because some of our welfare demands are not looked into, and when we saw that they had started receiving the necessary attention, we felt we owed the teeming Nigerian population the duty to resume and attend to them while the other officers responsible for looking after our welfare also carried through.
So, we are always very reasonable when it comes to welfare and balancing it with the duties we deliver. When we saw that those issues were receiving attention, we shelved the strike. We were able to get the 2021 MRTF allowance after the suspension of the strike, and we were able to continue on the negotiating table until the President, Major General Muhammadu Buhari (retd.), said that our withheld salary be paid to us.
Recently, you said the Abia, Imo, Ondo, and Ekiti state governments owed your members ranging from 24 months. How are the doctors in these states coping?
For the Abia state government, aside from our members being owed salary, the lingering industrial disharmony in that centre led to a situation whereby the institution lost accreditation and could not train our members to continue on their residency training programme. Even when we suspended the strike last year, I directed them to continue the strike because the only thing they will be rendering is their services, and if they are not being paid, where will they get the money to transport themselves to render their services? So we directed them to remain at home until their salary arrears are paid. We were hopeful that there would be a light at the end of the tunnel when the government promised to pay seven months’ salary arrears, but as I’m talking to you, the Abia State government has not lived up to the promises they made.
The issue of Ondo State—our members there are on the negotiating table—and their arrears is receiving attention. The government has told them that they are going to work out how they will be paid, and the same with Ekiti State.
So, since there is still discussion ongoing, we hope they will pay. The problem is when we discover that the issues are not being given attention, and that is when we feel those issues will not receive the needed attention. We also call on all well-meaning Nigerians to intervene and expedite action so that we will continue to enjoy peace in the health sector. It’s our collective desire that peace is maintained in the health sector.
The number of doctors in the UK alone has swollen to over 9,000. Are there still moves by some doctors to leave the country despite having fewer hands in the country, and what is the way forward?
You expect that more doctors will leave the country. As we speak, I’m aware of a lot of my colleagues who are working towards leaving the country, and there are lots of factors that push them. The push factor is largely the economy.
Of course, you will agree with me that we are having inflation in the country and that our naira is being devalued. If you compare our pay with the pay where most of these health workers go, you will discover that what we earn here is not up to one-tenth of what they get practising there.
Also, the educational system and the security situation in the country are not in good shape. So, it’s not only that they will have good pay, but they will have good schools to train their children, and their family will have security to train their children.
As long as these factors exist, our members and other health workers will continue to seek greener pastures, except if things are done to reverse them. Some of the things that can be done to reverse this are the reason we have to issue the ultimatum. If they implement the new hazard rate, possibly some of them will change their minds and ensure that the MRTF is spent when due, which will enable our members to train here. If the government can work on insecurity and other basic necessities, then the brain drain in the country can be reduced.
At this period, how does it feel to be a medical doctor in Nigeria?
It’s always frustrating in the sense that your welfare is not taken care of and we don’t have enough equipment to practice, and then you have to contend with the volume of patients, which is far above what you are supposed to attend to as recommended by the World Health Organisation.
Also, we are doing so in a very harsh environment, and most times, the patients and their relatives have high expectations when they come to see you and when you try your best.
Of course, this level of frustration is one of the reasons some of our doctors travel out of the country. There was a time my friend and I were in a particular hospital in the country; the patient came with a head injury, but because there was no facility to take care of him, he eventually died. When my friend saw the situation, he said if he suffered that kind of injury within that environment, it meant he was going to die, so he decided to leave this country, and since then he’s been in Australia.