Rethinking The Doctors’ Sack ,By Issa Aremu

Observers of the events in the ever crisis ridden country’s health sector desperately wait to hear about something new. Certainly Nigeria and Nigerians want to read that governments at all levels of responses have successfully sacked the dreaded Ebola disease, halt the spread of the new monster or getting closer to a cure drug. Certainly the news anybody wants to hear is the mass sack of 16,000 resident doctors in Nigeria and worse still abolition of residency or trainee doctors altogether.
Precisely because this latest panicky decision of the Federal government was borne out of .frustration rather than an informed sobering policy for health service delivery, the government must urgently rethink the action. According to the Permanent Secretary in the Ministry of Health, L.N. Awute, the sack directive was based on an order by President Goodluck Jonathan adding the “letters of termination of residency training” would be served on the resident doctors. Mr. Yusuf, a director/spokesman for the Federal Ministry of Health said that the sack came after successive attempts by the Federal Government to reach a consensus with striking doctors under the Nigeria Medical Association, NMA. He noted that despite successive intervention meetings, the NMA had gone ahead with its protracted strike action with attendant pains to Nigerians in dire need of medical attention. The point cannot be overstated; the NMA has over used the strike weapon over dispute of interests as distinct from dispute of rights. Assuming practicing medicine is a popularity test, very few Nigerians would vote for a Nigerian doctor given the ease with which they abandon work on account of issues not dealing with pay or core work right agenda but with sector governance issues.
One of the demands of the NMA was that the Federal Government through the Ministry of Health should formalize and implement the report of the inter-agency committee on residency training. Another was that the FG must release a uniform template on the appointment of resident doctors and a funding framework for residency training established while overseas clinical attachment be fully restored and properly funded. Of course these are legitimate demands but the method of pursuing this struggle through indefinite strikes is unacceptable. How earth can you abandon a cancer or accident victim in the name of strike just to get an inter-agency report implemented? As a trade unionist myself, the point must be made that labour market issues should be knowledge driven. Increasingly labour market is becoming an all comers territory and the latest comers are the doctors who engage on endless works stoppages in a country in which many are looking for work. Dispute of rights dealing with pay and employment requires different approaches to resolve as distinct from dispute of interests that requires sustained campaigns and lobby in a democracy. Doctors are not denied pay, so they cannot deny their patients the services they are being paid under any pretext. Dictatorship of strikes by doctors is as bad and unacceptable as dictatorship of sack letters by the government. All said government mass sack approach is an unacceptable over kill that will further worsen the crisis in the sector. Coming on the heal of Ebola outbreak begging for more hands, it is self -defeatist . It’s time government engaged the doctors further providing them the necessary insurance covers to deal with the latest menace of Ebola. Let’s sack Ebola not the doctors. Above all both the doctors and the government must be tempered by the miserable Nigeria’s health numbers.They include the following;
Life expectancy at birth was estimated at 43.3 years for Nigeria compared to 56.7 years for Ghana and 49 years for South Africa. Infant mortality rate was estimated at 98 per 1000 live births for Nigeria. In Ghana and South Africa, the comparative figures were 59 and 53. Under five mortality rate per 1000 live births stood at 265 in Nigeria compared to 186 for Ghana in 2003. The probability at birth of surviving to age 55 for females in Ghana (52.9 percent) was almost twice that of Nigeria (33.2 percent). The maternal mortality ratio (adjusted) per 100,000 live births in Nigeria was 800. The corresponding figures for Ghana and South Africa were 540 and 240. By 2003, the maternal mortality ratio in Nigeria had risen to 948/100,000. Indeed, with a range of 339/100,000 to 1.716/100,000) Nigeria’s maternal mortality rate is considered to be ‘one of the highest in the world’ (FMoH Health Sector Reform Program,. Please by all means let’s sack these miserable statistics and not the doctors. But the doctors must also re look at their strategy for welfare improvement beyond the most predictable and increasingly unhelpful endless work stoppages.
Issa Aremu mni