In Nigeria, a mother draws her last breath as her baby, bloodied and warm-blooded, draws its first, her breast milk congealing in the arctic rigors of death. In South Sudan, amidst the internecine intrigues of a nascent nation crippled by internal sabotage and strangled by external aggression , a baby‘s first breath is extinguished for the last time as its mother takes yet another breath punctuated by gunshots and wonders if her husband and son will return to a razed home.
In a 250,000-strong refugee camp in Dadaab, Kenya, a colony of flies buzz around a brittle-as-sticks cluster of children, in an elegiac annunciation of cholera‘s latest visitation. As on previous occasions, water polluted by poorly disposed waste and just too many people crammed into little, tortured spaces are the unashamed bringers of diarrhea and death. In a town of 1.2 million long -suffering DR Congolese, a sickness darker than death armed with a lightening ability to spread and kill is causing the World Health Organisation, with its staggering funds, extravagantly trained experts and volunteers and groundbreaking pieces of research to run in panicked shoes. Ebola.
These imageries of infirmity and mortality show that our world is sick and sore in so many places where heartbreaking suffering meets very little solutions. In America, a country where the world is supposedly content at the enormity of its resources, continent within its own borders and possessing the presence of mind to relieve the suffering of others, twenty-two school shootings in 2018 alone betray the mind as a plaything of myriad personal demons. The Texas school shooting painfully reaffirmed this.
Amidst the chaos of an ailing world, the dilemma of the Nigerian worker is a dire one. In most spaces where employment is private, the statutory minimum wage is an illusion. So is the intrinsic and inalienable occupational security that is the invaluable progenitor of the primacy of productivity and the dignity of labour – the twin bedrocks of work. Nigerians cannot completely sidestep accusations of a desperately poor work ethic just as the monkey dey work baboon dey chop syndrome, the prominent brainchild of institutional corruption cannot shirk culpability as a major purveyor of work-place lethargy.
In public employment which is tellingly and rather dismissively described as “government work”, Nigerian workers who have refused or simply have no means of exporting their expertise to the West for more money, better recognition(as a prophet is not recognized in his own country ), and more human dignity have remained to straddle Nigeria`s many sectors and contribute to growth. Some have also been willing exponents of its culture of corruption. They easily find a thousand reasons to down tools and ground public services fingering the millennial culprit that is government`s dereliction which breaches existing salary structures, starves labour of work-force strength and lowers the retirement age in a country where the mechanics of pension is a exemplar of everything pensive.
The Joint Health Sectors Union, JOHESU, is the latest Nigerian labour player to suspect that the grass is greener on the other side. With governments at different levels looking askance at the Unions‘ bucket list of prescriptions for the health sector, which include a review of the retirement age, conformity with existing and reviewed salary structures and more recruitments to bolster the health sector work-force , it has continued to brandish an age-long labour bayonet – strike. It is no rocket science to guess the victims of its severest blows.
It would include the Nigerian man whose months-long anticipation of fatherhood is now a life-long grief at the loss of a wife and unborn child to a sealed hospital; it is that Nigerian family whose tentative tranquility and sanity have finally caved in to the death of a child at the door of an abandoned hospital.
If it is simplistic to blame the many unfortunate loss of lives at the recent JOHESU strike, it is because Nigeria‘s health system, broken for years has remained a steep precipice from which salvation has remained a mirage.
By this strike action, JOHESU is also the latest labour union to take on the Nigerian government in an elephantine collision of politics and work. The grass that suffers is, undoubtedly, Nigerians of the tiniest means .In spite of the feverish and suspect efforts of the Nigerian Medical Association to cushion the effects of the strike, they have been denied use of public hospitals to patients who are too poor to visit private hospitals.
The NMA, openly suspicious of JOHESU, has abstained and even criticized its actions. They have kept hospitals open and provided the services that they can. Yet, in a country where a “complete” health sector work-force is desperately short of what Nigerians need, this strike action has again ensured that the historically reluctant victims of industrial actions are again holding the sharp end of the knife and blood is trickling down; fast and fatally.
The struggle to provide quality and affordable health care to its poorest has always been frustrated by institutional corruption, poorly trained health personnel and the mocking spectacle of medical tourism. Nigeria‘s rich and corruptly enriched stampeding hospitals in India and Germany is a painful accent on the failure of its domestic health care system. It is egregious not only because it confirms a systemic failure of health care but also because it is only the rich and corruptly enriched that can afford the expensive attention of Indian and German doctors for an itch or headache. It is a bridge too far for many Nigerians. Without the stethoscopes of foreign doctors, death and interminable suffering are lower hanging fruits for poorer Nigerians with life-threatening health complications. As if Nigerians cannot afford to train world-class doctors or equip world-class hospitals
Poor health care is one of the many realities making poverty an unwritten capital offence in Nigeria. When you do not have money or know a big man or when you live in the villages in Nigeria, death is easy. If armed robbers or Boko Haram and Fulani terrorists do not invade your poorly secured house to kill you, you may yet perish at the hand of overzealous security personnel. You could also live out your days in an overcrowded Nigerian prison crawling with squalor, crime and corruption, for a minor offence. An anxious trip, across miles and broken roads and bridges, to the nearest facility to attend to a childbirth-related complication can also end, many times, in the death of mother and child.
One of the starkest realities of inequality is that wealth, which is by not being evenly distributed, means bumps health care down the list of public priorities. It provides some explanation for the insidious culture of corruption and the fact that young, desperate Nigerians will engage in everything, including the darkest of enterprises, to make money.
One of the greatest markers of developing countries is the gradual erosion of human dignity. When poverty makes survival a daily grind for people, education and health care always suffer a costly displacement. The dark immediacy of survival then rules and inflicts a forgetfulness of the transformation a healthy and educated mind and body can bring.
JOHESU‘s strike highlights what staying back in Nigeria means for health workers and what leaving the country to more productive and profitable shores means to those who have left : that we are not healthy and that work does not always bestow dignity in Nigeria, especially when you are working for the broken in a system that is itself broken.
Nigeria‘s health care system provides some justification for the thousands of Nigerian health workers who barter their scalpels and syringes to other countries for remuneration reflective of the services they offer. Nigeria‘s health sector and the poorest Nigerians remain worse for this.
Government at all its three levels in Nigeria has eminently qualified health workers and experts in its ranks and service. In the global village of today‘s world, it is also not difficult to know what international health best practices are or what the latest groundbreaking vaccine or treatment is. What is especially difficult in Nigeria and across developing countries is the political will to make families, especially children, disease-free.
Children from developing countries should not be dying of wholly preventable diseases. Grants and internal budgetary allocations meant to insulate children and women against killer but preventable diseases should never be diverted into the purchase of weapons or corrupt politics. Health care should be strengthened by the injection of health infrastructure and all attempts should be made to keep our health personnel home. When they stay, we are better for it.
- Obiezu writes from Abuja.
