The decision to suspend or cancel the medical residency programme in Nigeria was announced a few days ago by a government that has once again proven that it clearly lacks the ability to think before acting. I was not surprised by the decision of the President and his team because this is just one in a very long list of many ridiculous decisions he and his team has made. It was however quite unfortunate seeing and listening to the reaction of many health professionals ranging from Physiotherapists, Medical Laboratory scientists, radiographers, the nurses and other members of Joint Health Sector Union (JOHESU). For many of them it sounded like a victory. How wrong they are.
It is common knowledge that the health sector is in shambles. It has even been made worse by the fact that the doctors see the other health professionals as the enemy while the other health workers under the aegis of JOHESU sees the doctors as their sole problem. In the middle of all these chaos, we forget to ask the real question. Are other members of the health team really the enemy? Why do we not have equipments and the right facilities to work with? Why do many teaching hospitals not have functional equipments for Computed Tomography Scans, MRI and hence have to refer patients to private laboratories? Why is the government always unwilling to meet some of the reasonable demands of both the NMA and JOHESU which always results in incessant strike actions? It is a known fact that patients suffer during the industrial actions instituted by any of the unions of the health sector.
I have always maintained the view that successive governments have deliberately not improved the health sector because they always knew they were one flight away from a hospital in Europe, Asia or North America. In 2012, Senate President David Mark travelled to Israel for what was referred to as a “minor” medical treatment. How “minor” was this “minor ailments” that he did not trust the Nigerian health care system to handle it and instead chose to travel with public funds to seek treatment outside the shores of this country. Umaru Yar’adua left the country in order to receive treatment for an extended period of time with taxpayers’ money before his unfortunate demise. How else can we defend this government when the First lady always flies to Germany when she falls sick? I will not even be surprised if one of such visits had cough as the only presenting complaint. The National Hospital, Abuja is meant to be a model hospital in this country and is located at the nation’s seat of power making it very accessible to these public office holders. Yet they constantly choose to travel abroad because they are fully aware that they have failed the Nigerian health care system by deliberately ignoring the challenges facing the system or by embezzling funds meant for the health system.
It is of great significance to note that even when Nelson Mandela’s health condition got critical and deteriorated, he was never flown abroad. He spent those days in health facilities located in South Africa. When the late Israeli Prime Minister, Ariel Sharon, suffered a stroke in 2006, he was cared for in Jerusalem and Tel Aviv. Never for one moment was he taken out of the country to receive “expert” medical management. There was never any consideration to take them outside their countries. This was because over the years they had worked hard to improve the health sector in their respective countries. If they were Nigerian politicians, you could bet your life that they would have been on the first available air ambulance and then taken to a foreign country.
Estimates show that, Nigeria accounts for about 13 percent of the global maternal death rates. But we all know it is much higher than that. Many cases are never reported since a good number of those that occur in the rural areas end up at the homes of traditional birth attendants and the so called faith clinics. The high rate of maternal deaths can be linked to the absence of adequate qualified health workers and facilities. How then does the government intend to solve this problem when one of their plans is to terminate a problem that ensures we have qualified professionals taking care of these areas? Hospitals are understaffed and underfunded. Patients spend up to 6 to 7 hours in general hospitals, medical centres and teaching hospitals before they are attended to. How can you justify the decision to sack 16000 doctors across the federation who are few years away from becoming qualified specialists in their chosen area of specialization? By choosing the end the programme, young medical students and new graduates may have to leave the country in order to get the desired training. This will further reduce the amount of qualified health workers available. There are also some areas in the field of medicine which are so important. An area like Neurosurgery requires experts. There is already an acceptance that that particular field is understaffed. With the increase in road traffic accidents, individuals may be at the mercy of doctors who were not trained in such area. The decision is even more perplexing when you realize that the minister of health is a Consultant Orthopedic Surgeon who was produced by the same programme he is trying to cancel.
Therefore, before anyone goes on to rejoice, there must be an acceptance that we all are vulnerable because many of us are not in government and will not benefit from free trips abroad for medical treatment. Before anyone begins to make statements like it serves the doctors right, we must realise that our relatives and ourselves may never get the best care they deserve simply because we are in support of a senseless policy which only serves to worsen the situation of an already decaying health care sector. Can a nurse treat his or her relatives with a severe head injury following a road traffic accident? We must all realise that the doctors are not the victims here. Those who will be worst hit by this policy are the 170 million Nigerians, especially the poor ones who visit the tertiary hospitals and are attended to even without having millions of naira in their bank accounts. If you have not visited any of the primary health care facilities in the country, you probably know nothing. Many of such centres do not have gloves or mask. These items are luxurious items in many of such places. Many do not even have running water and the very poor masses have no choice but to visit them. Thousands of health centres do not even have any qualified personnel. Those in the rural areas are in grave danger because many of them are poor and uneducated.
We must begin to tell ourselves the truth. This is not a triumph for anyone. JOHESU may see this as a victory but the importance of having well trained doctors cannot be overemphasized. A doctor will like his family to get the best possible care at all times. So will a nurse, a physiotherapist, a medical lab scientist, a porter or a cleaner. The various unions must begin to realize that the real enemies are those men and women skilfully looting public funds without remorse at Abuja. The health sector is in a sorry state.
Finally, this decision confirms that the government has lost the plot and are short of ideas. Welcome to Nigeria; the country with many health challenges, where the country’s response is to sack 16,000 doctors rather than get them back to work.