The Incessant Doctors' Strike in Nigeria

by Bolaji Aregbeshola

It has now become a routine for doctors in both the State and Federal medical institutions and hospitals to down-tool. Not too long ago, doctors under the employ of Lagos State government embarked on a fresh round of strike to drive home their demand for the full implementation of the Consolidated Medical Salary Structure (CONMESS) as well as the reinstatement of their former colleague who was relieved of his job as result of the struggle. It would be recalled that Lagos State doctors went on strike for 14 weeks sometime last year before a truce was later broken between the government and the striking doctors but few months after, the doctors decided to call another strike. The Assembly of Healthcare Professionals had also on February 15 embarked on nationwide strike to protest the stoppage of their teaching allowance. In a related development, doctors in other states of the Federation were also reported to have commenced sympathy strikes.

The Guild of Medical doctors have threatened to continue the strike indefinitely until their demands are met. The issue of doctor’s strike is not peculiar to Nigeria alone. This difficulty facing the Nigerian health sector will continue for a long time to come if appropriate strategies and solutions are not adopted by healthcare leaders and policy makers because doctors go on strike for many reasons besides numerous studies have shown that health workers embark on strikes due to factors other than remuneration. The reasons why doctors strike incessantly is also responsible for the migration of doctors and nurses out of Nigeria to countries like United States of America, Canada, United Kingdom, France, Belgium and Australia. Though no country is immune to different migration streams. But some countries are attracting highly skilled professionals from poor countries because they offer a positive working environment and other incentives that these workers want. These high-income countries have better remuneration, support systems and safer working environment. They provide opportunities for career advancement, continuing education and promote team work. For instance, the USA which is one of the choice destination for Nigerian doctors and nurses have been recruiting workers from countries like Nigeria in order to reduce the workload on their domestic workers, health systems all over the world are faced with a lot of crises but it is left for the leaders of health systems of a country to manage these crises properly. Nigerian healthcare leaders and decision makers need to be proactive and innovative.

Unsatisfactory compensations are not the only grievances of medical doctors and nurses although it is quite important. Also inherent in Nigeria, the complaints of health workers are heavy workloads, burn outs, too many administrative duties, isolation from colleagues, insufficient team work, occupational hazards, lack of recognition, discouragement of new ideas, lack of career opportunities, poor management systems, wage freezes, lack of medicines and technology, decay of infrastructure, violence, threats and abuse etc. Therefore, the above complaints are what the Health Ministries and management of government hospitals need to address. The health system has suffered enough harm from shortage of health workers than be in a situation where there are no doctors to attend to the teeming population of Nigerians.

There is a colossal loss of lives even with doctors in attendance; one can only imagine the number of lives lost as a result of incessant doctor’s strike across the federation. This is the least the nation needs as it approaches another round of elections. Health workers are key to changing the health system away from its current state. Doctor’s strike is an issue health leaders need to grapple with in order to save Nigeria’s health system from imminent collapse. Nigeria is faced with a lot of public health challenges all of which require the design of specific programs to address them. Loss of health workers through migration, deficiency of health professionals and geographic maldistribution of health workers are all among health workforce issues that health leaders have to contend with. The earlier policy makers began to address these problems, the better for the nation’s health system. We cannot wait until the health system becomes paralyzed before something drastic is done hence there is a state of emergency in the health sector.

Obviously, the doctors like every human beings and members of a society have yearnings, aspirations and families they are responsible for besides they face many risk in the discharge of their duties. Though they have sworn to a Hippocratic Oath to save lives, their consistent demand for better remuneration and compensation shows that they are human after all. Incessant strikes by health workers across every state of the federation are not the best for our health system and can never be a solution to the complaint of health workers. Health workers and leaders as partners in the delivery of health services to the people should find a better means of addressing issues bothering on remuneration and working conditions.

A study of how countries of choice destinations for health workers are able to manage their workforce crisis could be useful in changing Nigerian health workers attitude and behavior. Governments through the Ministries of Health should be able to provide non-financial incentives to doctors, nurses and other health workers if they cannot afford to meet their demands. The calls for the striking doctors return to work while dialogue continues every time there is an issue of worker dissatisfaction has proved to be an ineffective approach. A more holistic approach such a continually reassessing health workers remuneration, creating a positive working environment and providing support system is needed to enhance the motivation of workers who many believe are critical to the survival of the human race.

I am convinced that the foregoing approach if adopted by governments and health leaders will go a long way in addressing the issues of health workers strike and it attendant consequences on the health of the citizens as well as the struggling health system. The current capacity of Nigeria’s health system to cope with the myriads of problems facing it is limited and the incidence of striking health workers if not stopped will lead to a catastrophe. This is far from prophesying doom for the nation’s health system but the truth is, strikes have devastating consequences. It is high time those responsible for the protection and improvement of the health of individuals and populations acted to avoid future occurrence. It would be of great benefit to the health system if the issue of striking health workers can be solved ones and for all so that other health issues can be focused upon with a view to addressing them. By so doing, Nigeria’s health problems would be tackled one after the other. We just have to confront these problems, watching them destroy our health system could be disastrous. Funding is still an issue and this is affecting the performance of the health system. The impact of donor funds on the health system has not been felt.

Doctor’s strike is the least the health sector needs at this point in time; it gives the sector a bad name. The Ministry of Health should be a model that other ministries follow.

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