On August 2nd, 2021, members of the National Association of Resident Doctors (NARD) commenced an indefinite strike. 22 days later, the strike is still ongoing as resident doctors continue to seek compensation for issues related to accumulated unpaid salaries, owed Covid-19 inducement hazard allowance, and the general lack of care of the government towards essential health professionals risking their lives in hospitals and COVID-19 treatment centres during the most significant public health crisis of this century.
This is not the first-time resident doctors are striking since the first confirmed COVID-19 case was reported in Nigeria on February 27th last year. According to The Associated Press, the current strike is “the fourth work stoppage by medical residents since the pandemic began.” Before this, the longest strike during the pandemic had lasted a total of 10 days before being called off, making the current extended strike even more dangerous and disruptive.
Given the government’s failed attempt on August 18th to obtain a court order, compelling resident doctors to return to work and no current offer to meet doctors’ demands, it is still unclear when the issue will be resolved. The absence of resident doctors is deeply troubling to any Nigerian reliant on public healthcare and extremely damaging to Nigeria’s already fragile healthcare system because these resident doctors make up a large percentage of public hospital staff.
In the wake of the strike and a new wave of Covid infections, news outlets have reported that short-staffed hospitals have been forced to turn away patients showing COVID-19 symptoms. Already admitted patients have also receiving inadequate care with many left undiagnosed or discharged pre-emptively.
It would be easy to blame resident doctors for not simply getting on with it and returning to work to serve needing patients. After all, essential workers all over the world have been under undue pressure and faced multiple unforeseeable challenges during the pandemic. Lack of deserved pay and shortages in personal protective equipment (PPE) have been key focal points of healthcare workers and their representatives in everywhere from the Paraguay to the US as governments are forced to confront their demands for better working conditions.
But truly, how can one continue to serve others when their own physical and mental wellbeing is at risk?
Without owed salaries, resident doctors are unable to provide basic amenities like food, clothing, and housing for themselves and their families. Yet they are asked to compromise their bodies which are put on the front lines in COVID infected wards every day based on duty and patriotism. What about the country’s duty of care to them? Man cannot survive on promises and good faith alone, particularly in Nigeria when government promises to everyone from the general electorate to select groups such as teachers and civil servants remain largely unfulfilled.
Moreover, the problems Nigeria’s resident doctors and healthcare professionals face might have been amplified by the pandemic but certainly did not start at its commencement. Our healthcare system has long been in crisis due to what Dr Francis Adedayo Faduyile, President of the Nigerian Medical Association described in 2019 to the BBC as “chronic underfunding”. This underfunding has prompted mass migration of medical professionals and a brain drain in the nation’s health sector.
When we look at the numbers, one can understand why Dr Faduyile would use such dire terms to describe the status quo in the health sector. Only 4.52% of Nigeria’s overall 2021 budget (N592.166 billion) was allocated to the healthcare sector despite the pandemic. In a budget breakdown, The Guardian revealed that this figure means that a shocking N246.715 is allocated monthly for the healthcare of every Nigerian.
Moreover, WHO statistics place the doctor-patient ratio in Nigeria at 4 physicians to 10,000 patients, a figure which hardly improves when other sources are cited. Whilst the country’s elite, including current President Muhammudu Buhari are fortunate enough to be able to access private healthcare or in the President’s case take medical leave abroad, the same cannot be said for the majority of ordinary Nigerians.
Nigeria and Africa’s private medical technology start-ups and innovators in telemedicine have tried their best to alleviate problems in their local health sectors, particularly those which have come to the forefront during the pandemic. However, even their resources, dedication, and goodwill to help underserved communities and improve patient care can only do so much when faced with deep-rooted, structural health issues.
Nothing can replace the feeling of being heard, attended to, and cared for by another human being. This experience is even more critical to segments of the population who may not understand, access, or simply feel comfortable with technology-enabled solutions. We need doctors to come back to work. We need the resident doctor strike to end, with the deserved pay and protection for doctors and government concessions that ensure that this 4th strike isn’t followed up with a 5th one anytime soon. The question is are our leaders willing to make the compromises and sacrifices needed to ensure this?
