Striking Doctors in Nigeria and The Effects on Our Healthcare System

It is easy to be indifferent, after all, there are a myriad of issues demanding our attention. Recurring strikes within our labor unions – ASUU, NASUU, NUT, NUPENG, PENGASSAN, NMA, NARD, and others – are nothing new. Yet, when the tiny thread on which the tattered pieces of our healthcare system dangles goes on strike, everyone should be worried. Nigeria Association of Resident Doctors (NARD), the body that forms a major part of Doctors in the country, recently suspended a two-week-long strike action. It is the second time they will embark on an industrial action this year, and unless something changes it won’t be the last. In the following paragraphs, we will talk about the effects of striking doctors in Nigeria.

The reasons for the strike weren’t new;
● A cry out for better wages to reflect the current harsh economic realities,
● An increase in hazard allowance from the meager twenty-five thousand naira
● One-on-one replacement of health workers to reduce the burden of care
● The payment of the annual medical residency training fund (MRTF), and domestication of the MRTF Act to include the state tertiary health institutions
● A Reversal in the downgrading of medical postgraduate certificates
● Government to fulfill their end of an agreement reached a while back at Abuja – health budgets, and allowances.

striking doctors in Nigeria
Photo credit: Premium Times

We could go down the same road and try to explore the remote causes of this crisis. I’d rather dwell on the direct fallout from these strike actions, the vulnerable group who happen to be the most affected by it – I mean the patients. Who cares? Who speaks for them? Many had to die this time around, many were denied the affordable and quality care that our Government hospitals provide.

We may never know the exact figure, but we can guess why it keeps happening – our people are at the mercy of a system that feeds the leaders at the detriment of starving essential health workers. It will be easy to push aside the thoughts and conversations, especially when neither you nor your relatives are affected. Well, Nigeria can happen to anyone, indifference is a luxury we cannot afford.

One minute you are having dinner with family, happy and hopeful for the seasons. Then the next, you’re driving through flooded roads, hoping to reach the nearest hospital for a family member’s emergency. Well, upon arriving at the closest medical facility, a Government hospital, your hopes are dashed as they turn you away due to their doctors being on strike. Yes, it is quite painful, and sadly it is happening. Critically ill patients get rejected in front of the Accident and Emergency units of our government hospitals.

Many in this predicament often have to leave the hospital without proper referral or stabilization. They are lucky if they make it
to a private health facility, although it would mean paying through their nose to get the quality health care they desire. Does it get worse than this?

Science has shown us certain conditions must be before healing can occur;
•The proper treatment (drugs, surgery, therapy).
•The right treatment facility.
•The right time.

Any form of disruption – like an industrial action by our health workers – can affect the healing process and cause further health deterioration. This is the exact situation observed in our Government hospitals over the past few weeks; early patient discharge, abandonment, deferment of, and even cancellations of surgical procedures. Also, the partial or complete closure of functional care units (like the ICU, radiology departments, dialysis units, and laboratories) happened.

An example involved Mr. X during the just-suspended strike (name withheld for the sake of confidentiality) who came in for a dialysis session. Imagine enduring an entire day in the hospital unattended to, because your consultants are overwhelmed with patients. This is what he suffered, like many other patients during this period.

One of the primary healthcare challenges we face as a society is poor ‘health-seeking behavior.’ A large percentage of the population delays until the medical condition gets worse. One reason might be the low public perception and trust in our hospitals; complaints about poor services, high cost, bureaucracy and chronic time wastage, worker burnout, demotivation, and frustrations. Sad to say, incessant industrial actions only make it worse by eroding the little confidence left. This situation can further lead to incidents of doctors and other health workers assault, damage to health facilities, and an increased rate of patients discharged against medical advice.

Although there are private hospitals that serve as alternatives, not a lot of people can afford to pay for them. Vulnerable populations, such as the poor and marginalized, often rely heavily on public healthcare services. Strikes can disproportionately affect these groups, worsening the already existing healthcare inequities.

There is no doubt that industrial action is the only language those in Authority seem to understand. Except for the fact that those in Authority seem to only listen to industrial actions, there are no silver linings. Loss of lives, health deterioration, and health institutions suffer human and financial losses. Once again, meetings and negotiations have taken place, and promises have been made. The Nigeria Association of Resident Doctors (NARD) suspends its strike in the hope that things change for good. Well, we the populace can only hope for this too.

Great Erhazele

Great Erhazele is a health writer, poet, and physician-in-training from southern Nigeria. An introverted type, he started his writing journey at a tender age, writing short stories for school plays, and has now graduated to compelling articles for the wellness industry. He has written several pieces of content for different publications and aims to write more. Besides writing, he is also a medical volunteer for various humanitarian organizations, and a part-time photographer.