Rising from its Emergency Delegates Meeting (EDM) at Minna, Niger State capital on Saturday December 14, 2013, the Nigerian Medical Association (NMA) direcall Medical and Dental Practitioners in Nigeria's Public health sector to embark on a 5-day warning strike action beginning from Wednesday 18th December to Sunday 22nd December, 2013.
This short duration of the warning strike action which was adopted in deference to the yuletide season, is to precede a total strike action in the first month of the new year (2014).
It is worthy to note that the NMA had on 2nd September, 2013 issued a 21day ultimatum to the Federal Government of Nigeria in which the Association highlighted several issues bordering on some health sector challenges, absence of a regulatory environment for practice in the healthcare sector, workplace conditions/conditions of service and funding of healthcare in Nigeria.
It is most distressing to note that aside from the reconstitution and inauguration of the Medical and Dental Council of Nigeria (MDCN) and other Health Regulatory Councils, none of the other issues contained in the ultimatum were given the deserved attention.
In appreciation of the possible impact of withdrawal of services by medical and dental practitioners in Nigeria, the NMA shifted her ultimatum three times (3) with 4 weeks apart, hoping and praying hard for Government to reciprocally respond and address the issues brought before her with a note of finality.
WHAT ARE THESE ISSUES?
A) Serial injustices done to doctors, particularly during the harmonization of salary structures in 1998/99 by the Federal Government and failure to correct fundamental errors in the existing salary structure for doctors.
The gross failure of government to address the serial injustices done to doctors, has led to the unacceptable reduction in the income and allowances of doctors with each level of promotion gained by doctors. This strange phenomenon unknown to labour laws has over time contributed significantly to the high level of brain drain of highly qualified Nigerian trained medical and dental practitioners to other countries where their services are better appreciated.
More disheartening is the fact that as we try to get government to redress the previous injustices, further attempts are made to create more injustices and escalate the crisis.
Painfully, we can report that there are over 3500 Nigerian trained physicians actively practicing in the United Kingdom. Many more are in the United States of America and other nations of the world, and several are still leaving on a daily basis. This is partly due to this defect as well as the unavailability of functional equipment/tools in the workplace, unhealthy competition in the health sector and a conducive work environment.
It is for this reason that one Nigerian doctor attends to over 5000 patients, a doctor:patient ratio that is very far away from the real World Health Organization (WHO) prescription of one doctor to 600 patients. It is the resolve of the Association therefore to awaken government at all levels to address this demand.
Restating our understanding of the economic realities, we insist that Nigeria has all it takes to attract and retain the best medical work force in Nigeria rather than allowing our country to be drained of this very useful human resource.
B) Funding of the healthcare sector and the health of Nigerians
Improvement in Nigeria's budgetary allocation to the health sector.
NMA advocates an improvement in the budgetary allocation to the health sector to meet up with the required minimum of 15% of Nigerias national budget. This is in line with the recommendation of the World Health Organization and the 2001 Abuja declaration of African Heads of Government.
In the event that the Nigerian government finds it difficult to move up from her average yearly budgetary allocation of 5-6% to health, the NMA advocates an irreducible minimum of 10% of Nigerias annual budget for the health sector.
Without this bold attempt at resuscitating an anaemic public health care financing system, our countrys hospitals would continue to groan in pains with over 70% of our citizens unable to have physical and financial access to them. Indeed, healthcare delivery will remain a scarce social service to more than 70% of our citizens.
Expansion of the Universal Health Coverage for all Nigerians by the provision of a minimum health package through a universal health fund.
Currently, Nigeria can only boast of a Universal Health Coverage of less than 6%, whereas less endowed countries like Rwanda, Kenya and Ghana boast of a Universal Health Coverage of over 60%. Nigeria has no excuse not to have a Universal Health Coverage of over 75%.
Most distressingly, we bemoan the slow pace of actualisation of the National Health Bill whose provisions would guarantee a minimum basic package of healthcare for every Nigerian. If we, the custodians of healthcare delivery in Nigeria would not raise alarm over this, who will?
C) Other Health sector Challenges, including the revitalization of health infrastructure at all levels, restoration of professionalism, e.t.c.
In the face of overt difficulties and sufferings, NMA is pained that it had to embark on this action at this point in time. The last time NMA declared a national strike was 6 years ago. It is therefore with the traditional signature tune of empathy that the strike has been given a human face.
The Association while restating her resolve to ensure the reversal of the afore-stated destructive trends in the health sector, calls on all Nigerians from all backgrounds to appeal passionately to government to do the needful to avert the full blown strike already scheduled to begin by 6 January 2013.
A stitch in time, though belated, can still save nine!
Dr. Osahon Enabulele
President, Nigerian Medical Association;
Vice President (WAR), Commonwealth Medical Association
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