As members of the Nigerian Medical Association commence another round of strike, patients across the nation have no compliments but condemnation for what they describe as doctors’ insensitivity. Folashade Adebayo, Femi Makinde, (Oshogbo); Success Nwogu (Ilorin); Emmanuel Obe (Asaba); Etim Ekpimah (Uyo); Oluwole Josiah (Akure); Olaleye Aluko and Emeka Obi (Lagos) report.

Ronke Adegborioye held her stomach in agony inside the premises of the Ifako-Ijaiye General Hospital, Lagos, Tuesday, as the persistent pains the pregnant woman had been experiencing for some time now warranted an early visit to the hospital.

But there was no doctor in sight as at 10:30am! As her husband waited at the car park, Adegborioye told one of our correspondents that her only option was a private hospital.

“Actually, I knew the strike would begin today, but I thought I would be lucky. There is no doctor to attend to patients. My case is not life-threatening and I have decided to go to a private hospital,’’ she said.

Adegborioye was not alone. Services at the tertiary hospitals in Lagos State and across the country yesterday were skeletal, though there was considerable patient traffic. While nurses got busy checking the vital signs of the patients, the general experience was that doctors stayed away.

At the General Hospitals in Somolu, Orile Agege and Alimosho, the ubiquitous crowd was present with few or no doctors to attend to them.

The conditions were not different at the Lagos State University Teaching Hospital. While other nurses and other support staff were seen at duty posts, it was different for doctors who had already downed tools. Except for the absence of doctors, though, the pace of activities at LASUTH did not falter.

Attempts to speak with the Chief Medical Director, Prof. David Oke were not successful, as he was said to be attending a programme. However, patients decried the latest development and the implications on their individual finances.

Patients bear the brunt

An insurance broker, Mrs. Dunsin Akinpelu, expressed disappointment at the latest development in the health sector and lamented the unnecessary fatalities that would be recorded.

“Each time doctors go on strike, it is the patients who suffer. Many people will be forced to seek treatment either at private hospitals or herbal practitioners. Many people will die as a result. I find it baffling that patients are not reckoned with in Nigeria. Why must the crisis get to this level?” she asked.

Meanwhile, the Minister for Health, Prof. Onyebuchi Chukwu, has described the strike action as “unfortunate.” In a text message to one of our correspondents, Chukwu, who is currently attending a meeting overseas, said he would cut short his itinerary and return to the country immediately.

“I understand NMA plans to embark on the threatened strike despite an apparent understanding reached with government last week. The (health) ministry has requested an immediate meeting with them. The minister of state for health is on ground and is handling the situation. I’m cutting short my participation at the meeting to return tomorrow (today).”

However, efforts to get the Minister of State for Health, Dr. Haliru Alhassan, on Tuesday were abortive, as he was said to be engaged with the NMA officials and the Minister of Labour, Emeka Wogu. His public relations officer, Mr. Clement Egbeama, said a statement would be issued at the end of the meeting. The meeting has not ended as at press time on Tuesday.

In Asaba, Ilorin, Osogbo, Ado-Ekiti, Akure and other parts of the country, doctors shunned hospitals as the strike got underway. However, at the Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, one of our correspondents observed that patients already on admission have yet to be discharged.

Other categories of health workers were seen in the hospital attending to patients, though.

‘We love our patients, but…’

The Chairman of Medical and Dental Consultants Association of Nigeria at LAUTECH, Dr. Kazeem Adebayo, in an interview, said the strike was very effective.

He said, “The strike is 100 per cent effective. But the ethics of our profession is to save lives, no matter the situation. You are expected to make patients under your care who are in critical condition stable. That is why some are still around, but there are no new admissions.

“In case of any emergency, you are expected to work to save lives, irrespective of where you are working. We love our patients and we don’t want them to die.”

He said patients were no longer admitted into the hospital due to the strike.

Visits to the Federal Medical Centre, Owo; and the State Specialists Hospital showed that with doctors’ absence, nurses were only able to perform skeletal clinical services among patients whose cases were not critical.

The Chief Medical Director, Dr. Adeniran Ikumola, said the hospital’s management decided to discharge patients in critical condition in order to reduce the suffering.

The nationwide strike also negatively affected medical services at the University of Ilorin Teaching Hospital, Kwara State; and the Federal Medical Centre, Lokoja, the Kogi State capital.

At the UITH on Tuesday, some patients complained bitterly about their ordeal. They said the strike could worsen their condition, as the doctors were not on ground to attend to them. As in other states, other categories of health workers at UITH were attending to some patients.

‘The strike is total’

In a telephone interview with one of our correspondents on Tuesday, the NMA Chairman, Kwara State chapter, Prof. Olayinka Buhari, said the strike was “total.” He added that all the doctors in the chapter complied with the directive.

Buhari had, on Monday, ordered all the members of the association to comply with the directive.

Efforts to get the response of the Chief Medical Officer, UITH, Prof. Abdulwaheed Olatinwo, proved abortive; as he did not pick his calls.

The strike grounded medical services at the FMC, Lokoja; where many of the doctors complied fully. The situation made patients to plead with the doctors and the Federal Government to resolve their differences in the interest of the nation.

The Kogi State chapter chairman of the NMA, Dr. Kassim Davidson, on Monday, ordered members to join in the national strike.

FG reneged on its promise

Davidson, at a media briefing in Lokoja, had said the chapter would join the strike following the expiration of the 14-day ultimatum given to Federal Government by the union. The NMA had appealed to the government to honour the 2009 agreement it entered into with the association.

He noted that the government had refused to review the issues raised by the NMA.

He added that the inability of the Federal Government to resolve the issues forced the NMA to embark on the latest round of indefinite strike.

The Federal Medical Centre, Asaba, Delta State, also stopped admitting new patients following the commencement of the strike.

The Public Relations Officer of the hospital, Mr. Nnamdi Ogbogu, said the strike notwithstanding, the hospital has been able to cope with the situation.

“All other workers, along with consultants, are on duty. But we are not taking new admissions. Very serious matters will be referred to other places.

“But for now, the effect of the strike is minimal. We are only in the first day and we are coping very well,” Ogbogu said.

The doctors’ grouse

A press statement signed by the Lagos State Chairman, Dr. Babatunde Bamigboye, says the NMA raised 24 issues for resolution. The demands border on salary increment, establishment of a health trust fund for the upgrade of every public hospital facilities, swift passage of the National Health Bill, and a universal coverage for all Nigerians — as against the 30 per cent coverage advocated by the National Health Insurance Scheme. Another grievance of the NMA has to do with the retention of the post of the Deputy Chairman, Medical Advisory Committee; and the opposition to the appointment of directors in the hospitals.

But other aspects of the demands have already pitted the association with other professionals like the Pharmaceutical Society of Nigeria. The age-long rivalry with PSN and other groups in the medical field is, perhaps, the biggest highlight of the statement. Again, the NMA stoutly opposed the extension of the consultant title to any other professional.

“The title, ‘consultant,’ in a hospital setting describes the relationship between the specialist medical doctor and his patient. It will be a source of confusion if the title is applied to any other health worker who statutorily does not own a patient.

“The NMA therefore declares with unmitigated emphasis that if ‘non-doctor’ consultants are appointed, it will lead to chaos in the health sector. This should not happen,” the association insists.

The NMA also disapproves of the appointment of any other professionals to the position of the Chief Medical Director, as provided for by the Act establishing tertiary hospitals.

“Why did they not ask that the post of vice chancellor be open to everyone in the university, since ASUU and SANU members are made up of graduates?

“Can you be a judge of the High Court or Court of Appeal if you are not a lawyer? Why do they think the hospitals, where lives are saved everyday, should sacrifice the established leadership — that is the Chief Medical Director?” asked Bamigboye.

The Ekiti State NMA chairman, Dr. Obitade Obimakinde, also toes this line. As far as he is concerned, pharmacists and nurses must be confined to supportive roles and continue to take directives from doctors.

NMA is selfish!

However the NMA has been knocked for its “selfishness.” In a phone interview, the Chairman, Association of Community Pharmacists of Nigeria, Mr. Olufemi Ismail, says the NMA is not “broadminded” or “accommodating.”

“The NMA is just being selfish. The CMD is an administrative position. In other countries, we have individuals who are ministers for health and they are not even from the medical line. The NMA should be more broadminded and accommodate other professionals,” Ismail submits.

Meanwhile the President of the National Association of Resident Doctors, University of Uyo Teaching Hospital chapter, Dr. Dolapo Shittu, says the union has exempted doctors in private practice as well as those in non-governmental organisations from joining the strike for two weeks.