I was highly elated when I read the letter from JOHESU,Joint Health Sector Unions, dated August 4th,2014,threatening our amiable Secretary to the Government of the Federation(SGF) with indefinite strike as from two weeks,starting from August 18th,2014, should the recent decisions the SGF reached with Nigerian Medical Association(NMA) be carried out. I think time has come for the government to take a decisive stance in this imbroglio just like the biblical Joshua did in those days by urging the Israelites to choose the God they would serve. We cannot continue like this in the health sector,today it is doctors' strike and tomorrow,it is JOHESU 's strike while the patients are dying in their numbers.
THE ORIGIN OF JOHESU
Initially,the individual paramedical associations in the health sector discovered that little importance was attached to their individual industrial actions,since whenever they went on strike with their demands,they would find out that the hospitals could not feel their absence ,thereafter they would come and beg to return to work. That was because medical doctors specialised in all the fields of the medical profession since the Act establishing the hospitals empowered the doctors to do so hence in those days,when nurses went on strike alone,doctors called house officers along with patient's relatives took over nursing care of the patients. When medical laboratory scientists went on strike,specialist doctors called pathologists(medical microbiologists, chemical pathologists, haematologists, histopathologists) and the hospitals' side labs manned by doctors became fully operational in order to fill up the gap created and the doctors called ophthalmologists were there should the optometrists misbehave,also the work of physiotherapists and dieticians is what anybody with MBBS certificate can easily do. If Radiographers went on strike ,the doctors called Radiologists would take over the radiology department,this is how it was and has continued to be in all the units/departments of the hospitals till date. Also,pharmacists discovered that their work in the teaching hospitals was fast turning into 'sale's boy/girl' job which anybody that understands doctors prescriptions can do,no wonder even in private pharmacy shops owned by pharmacists,they make use of auxiliary nurses and SSCE holders for selling their drugs to the members of the public but coming to government hospitals they want to sit down and be 'cutting' their own 'national cake' and at the end the government will be forced to 'crown' them as consultants without the required training. Consider for an instance, their counterparts in other climes are currently brainstorming on how to find the cure for Ebola virus disease,while our Nigerian pharmacists are busy struggling with doctors in alliance with other non-doctors in our hospitals abandoning their laboratories but when a doctor who specialised in pharmacology blazes the trail in finding the drug treatment of Ebola virus disease,they will then come to contest with the doctor. Many of the drugs used in this country are imported simply because the pharmacists have left their statutory functions. Can a medical doctor clamour to head a drug manufacturing company or a pharmacy shop,citing international best practices as the reason?
In view of the above,many of these paramedical professionals decided to come together to form an alliance,what I may call a coalition,in the name of JOHESU,and to ensure that the impacts of their industrial actions were felt in the health sector they incorporated clerical workers,cleaners,security men,mortuary attendants,in fact anybody that works in the hospital except the doctors hence the aim of forming JOHESU was and is still to fight doctors in the health sector. The name Joint Health Sector Unions is a misnomer ,the rightful name which summarises their aims and objectives should have been:Anti-medical doctors union(AMDU) or better still,Non-medical doctors union in the health sector(NMDUHS).The members of JOHESU have more differences than similarities,believe you me they will soon incorporate the taxi drivers that ply within the hospital premises ,the patients' relatives etc and by extension(possibly outside the hospitals) the herbalists,traditional bone setters,traditional birth attendants,patent medicine dealers,maternity home operators,homeopathic clinic operators into their amorphous body in order to increase their numbers.
ACTIVITIES OF JOHESU
When they go on strike,they lock up all the accessible places thereby intentionally shutting down the hospital and rendering the efforts of the doctors nugatory.Imagine a scenario where everybody in an organisation gangs up against the manager(the doctors)?The aim of their daily meetings is how to measure up with doctors and overthrow them with or without the requisite qualifications,the same way comrade Napoleon led other animals to overthrow Mr Jones ,the manager of the Manor farm,in the Animal Farm by George Orwell .Even if NMA comes out to say that Jesus is the founder of Christianity while Mohammed is the founder of Islam,the members of JOHESU,acting as gadflies,will be so fastidious that they will find a fault in this obvious maxim. The funny thing is that the so-called medical insurgents are either medical drop-outs(those that failed out of medicine while in the university) or those who could not secure admission into medicine through JAMB UTME. The 'real' paramedical professionals that willingly chose their courses as first choice in JAMB UTME know their positions in the scheme of things in the health sector hence they don't struggle with the doctors for the leadership of our hospitals,clinical departments because they were aware that their courses were PARAmedical before choosing them but for those that found themselves accidentally as paramedical professionals,they want to measure up with their friends who are now medical doctors at all costs hence they look out for countries that allow paramedical professionals to answer doctors and force us to implement that in the guise of INTERNATIONAL BEST PRACTICES. They will tell you countries where non-medical doctors are chief medical directors of tertiary hospitals without first considering the fact that majority of those hospitals abroad are privately owned. They cannot cite states like Arizona state of USA where it is a crime to add 'Dr' in one's name even with PhD if one is not a certified medical doctor. In Nigeria here,many,if not all,the catholic hospitals are controlled by reverend sisters who are matrons(senior nursing officers),has any doctor complained?Any doctor who chooses to work there,knows that his /her boss is the reverend sister ,the same is applicable to other missionary and community-owned hospitals in Nigeria. The law establishing our public tertiary hospitals made it clear that only professionals that are MEDICALLY qualified not PARAMEDICALLY qualified are eligible to occupy the offices of the chief medical directors.
Meanwhile,JOHESU members want to be 'ordained' as consultants thereby creating chaos in the health sector .Many Nigerians have poured out their ignorance on the pages of the newspapers since the NMA strike started,a man said that he checked the synonyms of consultant in the dictionary and found out that it could be an advisor,expert, etc,he went on with this show of shame to ask what was wrong for non-doctors to answer consultants .Such fellow has failed to understand that no two similar words are the same in English language,for an instance, long and tall are synonyms but one cannot say that 'the man is long'.Also,one word can mean different things in different contexts. Let us use the word 'cell' for an instance,to the physicists and engineers, it means a device that converts a chemical energy in the electrolytes into electrical energy,to the biologists it means the smallest structural and functional unit of life while to the police it means a small room where suspects are temporarily kept before being charged to the law courts. This is an example of the uninformed public that our honourable minister of health was challenging the doctors to come out for a public debate. More so,the proposed debate violates one of the principles of natural justice, which is Nemo iudex in causa sua(no one will be a judge in his own cause/case) as the general public are the recipient of the ongoing NMA strike.
THE WAY FORWARD
Now that the government has recognised the real owners of the hospital,they should go on and privatise other allied health units. For more than one month that NMA embarked on their indefinite strike, all activities in the hospitals have come to a halt even when all the keys to all the accessible places are in the custody of JOHESU members. We have experimented in this past one month that the patients go to the hospital to see the doctor who will now determine whether the services of the paramedical professionals will be requited or not. Now,let us carry out another experiment since JOHESU has given the government a two-week ultimatum.The government should increase the salary of doctors with enough welfare packages and at the same time implement the terms of the recent agreement with doctors while JOHESU is allowed to proceed on strike on the following conditions:
(1)Private security firms be contracted to man the hospitals
(2)Private cleaning services firms be contracted to clean the hospitals including sterilization of hospital equipment.
(3)Private accounting firms will be contracted to take over all clerical activities in the hospitals
(4)Private firms be contracted to take over the servicing and maintenance jobs of our current Works departments.
(5)Private firms will be contracted to take over the management of our mortuaries.
(6)Meanwhile,the striking JOHESU members will be placed on no work,no pay and their salaries will be divided into three,one part is added to the salaries of doctors,the next 1/3 goes to the payment of the private firms while the remaining 1/3 is used for infrastructural development within the hospital complexes.
(7)Any member of JOHESU that willingly wants to work with doctors will be allowed to come in after swearing an affidavit of facts that he/she will not participate in any union in the health sector,will not struggle with doctors for leadership positions,in fact the person must understand the full meaning of 'para' attached to his/her profession. When that is done,the hospital management,on its own part, will ensure that such an individual is protected from the expected aggression from his/her former (by then defunct) JOHESU members .
With the implementation of all our 24 demands by the government and increment of our salary packages ,doctors in different units/departments,who are ubiquitous in the health sector, will now fill up the gaps created by the striking JOHESU members restoring the status of the hospital the way it was when the paramedical professionals were individually going on strike on their own before forming the amorphous group called JOHESU.
Dr Paul John
(A Port Harcourt -based medical practitioner)
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