Three months into the health workers’ strike, BISI OLADELE and TAYO JOHNSON visited two public hospitals in Ibadan, the Oyo State capital. They were confronted by the pains of people seeking health care services in government hospitals.
Mrs Aina Basiru sat on a bench, looking helpless as she endured a long wait to see a physician at the State Hospital, Yemetu, Ibadan, the Oyo State Capital. Her countenance expressed disappointment at a system that is failing in some ways, including healthcare delivery.
“Hello ma,” this reporter greeted. “Hello, my brother,” she replied in faint voice.
Mrs. Basiru reluctanctly granted a two-minute-chat with the reporter, expressing disappointment with the system. For her, it is incomprehensible that public hospitals in an entire nation can be paralyzed by mere labour disputes. To her, it is unkind and a sign of leadership failure.
The weak patient appealed to the health workers to resume work in order to save lives of hundreds of thousands of ailing citizens.
Basiru is not happy with the development as she needs to be admitted in a public hospital. She does not have money for a private hospital.
“I am appealing to the government to meet the demands of the workers and prevent further delay of medical treatment of patients,’’ she said.
Alhaji Ganiyu Orelope went to the hospital to obtain a medical report but the strike made it impossible for him.
He said: “I need my medical report for another important event, only to come to the hospital and be turned back. I wonder when all these strikes will be resolved once and for all. We need stability in our health institutions and the government should ensure that.”
The encounters with these patients explained the frustration of many Nigerians with ill health seeking medical attention in public hospitals.
Once a beehive of activities with patients troopping in and out, the University College Hospital (UCH), Ibadan and state hospitals across Oyo State are now deserted by patients and others seeking medical services, leaving them as ghost centres of a sort.
The hospitals have been practically paralyzed by a strike action embarked upon by health workers over remuneration and job condition disputes.
The workers across all government hospitals nationwide, under the aegis of the Nigerian Unions of Allied Health Professionals embarked on the strike on October 15, 2014 to press home their demands. Their colleagues under the platform of the Joint Health Sector Unions (JOHESU) joined them on November 9, 2014 totally paralyzing the hospital system across the country.
The unions under JOHESU include the Medical and Health Workers Union; Nigeria Union of Allied Health Professionals; National Association of Nigeria Nurses and Midwives and the Senior Staff Association of Universities Teaching Hospitals and Research Institutes.
The health workers said their evaluation showed that the composition of the boards of federal health institutions was skewed in favour of medical practitioners. They explained that there are eight to nine medical practitioners on the 13-member board whereas only one health worker represents other health professionals who constitute over 90 per cent of the workforce in the hospital system.
They are demanding that boards of federal health institutions be reconstituted in line with the enabling statute and the agreements.
The striking workers also want government to increase the retirement age of health workers from 60 to 65 years in line with the May 10, 2012 agreement it reached with JOHESU.
They are also soliciting an urgent implementation of the ‘2008 Job Evaluation Report’ to sustain the tenets of relativity within the ranks of healthcare professionals in Nigeria.
Other demands include application of sanctions on chief executive officers (CEOs) of federal health institutions who failed to promote deserving healthcare professionals before the end of the first quarter of 2014 in line with existing circulars duly approved by government and issuing of the enabling circular placing intern medical laboratory scientists on CONHESS 8 Step 2 and CONHESS 9 after completing their National Youth service scheme by the Head of Civil Service of the federation.
The workers also want government to check impunity of chief medical directors (CMDs) and medical directors who have continually refused to implement circulars with respect to skipping of CONHESS 10 and payment of the accrued arrears.
As the strike entered the third month last week, patients and others seeking medical services were left groaning while facilities in the hospitals also languish away.
Members of Management of the hospitals are helpless because they cannot do anything to force workers back to work. So are patients who are burdened with heavy bills at private hospitals.
When The Nation visited the UCH last week, wards and offices were locked while beds and other furniture in the wards have gathered dust due to lack of use.
Doctors were, however, offering skeletal services where possible but they were largely hindered by the supporting services rendered by the striking workers who usually prepare patients for consultation right from card administration to admission into the ward.
At the General Out-Patient Department, which is the first port of call for most patients, the offices, consulting rooms and waiting rooms were all empty. Patients were no longer coming to try their luck because of the longevity of the strike.
The Morgue section, which usually hosts a lot of people coming to pick corpses, was deserted and the facility locked. So were the Pharmacy sections and administrative offices. The entire hospital was practically on a forced holiday.
Speaking with The Nation on the development, the Chief Medical Director (CMD) of the hospital, Prof. Temitope Alonge lamented the effect of the strike on the hospital. He was particularly pained that the management of the hospital could not do anything to bring the striking workers back to their duty posts because the strike is nationwide.
He said: “As with every national strike, we have no control over the workers. As an institution, we have not been able to work as we love to. Only our Public Private Partnership (PPP) services are running for now. One of such services is the digital Xray machine. These few services are still on because they are not fully owned by the hospital. Besides, we are able to offer emergency services and counseling. The General Out-Patient is running and the Eye Clinic is also running.
“I still reviewed patient myself in the Surgical Out-Patient this morning.”
Alonge opined that the PPP arrangement would rescue the Nigerian healthcare system from the funding challenges confronting it. He anchored his suggestion on the belief that government alone cannot fully fund healthcare in the country.
But he explained that involvement of the private sector would be so defined that they would be unable to exploit patients.
His words: “I have seen PPP as an answer to the many challenges in the health sector. It has been understood all over the world that government alone is not able to handle all sections of the economy except the Arabian governments. But the bottom line is that economies that survive embark on the PPP. I don’t see government funding the 55 tertiary health institutions in Nigeria optimally.”
Expanding on the involvement of the private sector, Alonge said government can leverage on the tariff system – charging fixed amounts for classified medical treatments. Calculations, he said, would be done based on all equipment and services involved. “So it becomes very easy to calculate the tariff, especially routine treatments.” He said.
The CMD also canvassed that the National Health Insurance Scheme (NHIS) should be made compulsory for all citizens including those in the informal sector.
“If we have 90 per cent of Nigerians on the scheme, healthcare delivery will be better for Nigerians,” he posited.
The situation was the same at the State Hospital, Yemetu, Ibadan where the strike was total. Only few doctors were around to render skeletal services which were made difficult due to inaccessibility of support services from nurses, pharmacists, physiotherapists and laboratory scientists, among others.
Although the doctors went the extra mile to care for patients, they could not book patients for admission. Patients were advised to seek care in private hospitals pending the end of the strike.
A doctor, who spoke to our reporter in confidence, said doctors were attending to some patients with critical health conditions.
“Patients are coming, and doctors are on duty. But we cannot admit patients or conduct any surgical operations. We come here 8:00 am daily and close by 4:00 pm. The turnout of patients has drastically reduced but we attend to emergencies. On a normal day I do attend to over 200 patients but since the health workers’ strike commenced, it’s even hard to attend to 50,” he said
All the departments such as Pharmacy, Physiotherapy, Nursing, Laboratory were locked, leaving only the Account and Administration departments open.
Speaking on the development, the Chairman of Medical and Health Workers Union of Nigeria in Oyo State, Comrade Ayobami Ajayi, said there had been full compliance by members of the union in the state.
But he raised the hope for a resolution soon.
“We have been directed by our national body to embark on strike but we believe that the solution will come in earnest because the minister and our leaders have started having meetings. They have earlier met with the Minister of Health but the outcome of the meeting is yet to reach the president. That is what we are waiting for.” Ajayi said
Highlighting the effect of the strike, the unionist said the situation is getting worse daily with patients dying day-by-day.
“At least, I have heard of three emergency cases whereby two of them died when they couldn’t be attended to. Some private hospitals have also increased their charges, which makes it difficult for the less-privileged and downtrodden to patronizethem. We are not happy with the situation. But it seems strike is the only language that the Federal Government understands. We have been on this our demands since January last year and till date they have not yielded to our demands.
“We have been going around the hospitals to make sure our members are comply with the directives. It is the government that forced us and allowed the situation to get to this point. Since we have started we are not going back and there is no way patients will be attended to in this situation,’’ Ajayi said.
According to him, the strike would be called off immediately the Federal Government accedes to their demands.
The Chairman of Nigeria Union of Allied Health Professionals, University College Hospital (UCH) branch, Comrade Segun Sotiloye who led some members of the union in an awareness protest at the hospital last week, said the protest served as a reminder to the Federal Government and to sensitize the public on the on-going strike.
The peaceful protest started in front of hospital around 10: 00 am and ended 12:00 noon.
The workers carried placards with different inscriptions including: “ President, accede to our demands: “People are dying on daily basis. “Please answer health workers; medical practitioners are not the only ones in the health sector.” “Save Nigeria’s health sector from collapsing,” among others.
Also addressing reporters at the end of a meeting with leaders of the striking workers last Friday, the CMD disclosed that the strike had cost the hospital N600 million in internally generated revenue.
