The health authorities should fulfill their obligations, but health workers should also be reasonable

Recent statistics published by the World Health Organisation (WHO) reveal that the life expectancy at birth in Nigeria is 53/55 years (male/female) while that in the United Kingdom is 79/83 years respectively.  If the comparison is unfair because of the wide socio-economic gap, a comparison with another low middle-income country such as India perhaps may be in order. Life expectancy at birth in India is 64/68 (male/female), which is still over 10 years ahead of Nigeria.

While life expectancy alone does not determine the expected number of years an individual would live with optimal health, it is in Nigeria largely a reflection of the state of our health care delivery system. Nigerians are afflicted with diseases every day, many of them fatal because of inadequate attention. Causes of death in Nigeria, according to the WHO, include lower respiratory tract infections, HIV/AIDS, malaria, diarrhoea, preterm birth complications, birth asphyxia (suffocation) and birth trauma, meningitis, stroke, ischemic heart disease, and protein energy malnutrition. These were lengthened recently with other health challenges like the Ebola virus and Lassa fever. Many of these life-threatening ailments are prevalent in other climes but they are mostly subdued with good health care.

Ordinarily, these health challenges are enough problems to keep our health workers up and doing. Unfortunately, industrial strikes have been the norm. No year passes without one strike or the other in the health sector, some lasting for months while patients are unattended to. In the course of these strikes, patients die.

Early in 2015, doctors paralysed activities at all public hospitals in Nigeria because of an industrial strike. In addition, other workers in the health care professions under the aegis of the Joint Health Sector Union (JOHSUN) called a strike that caused lots of misery and deaths. Now there is a palpable fear of another strike in the sector as a result of a crisis in the Federal Ministry of Health, which has taken a new dimension as four of the directorate level doctors alleged to be sitting tight despite reaching the mandatory retirement age, took the government to court.

The controversy started with a memo from the Office of the Head of Civil Service of the Federation on April 23, 2012 warning that medical doctors on Grade Level 17 should retire like other directors after eight years on the position. The letter asked those who wished to be exempted from such rules to transfer their services to any of the government hospitals. Now some groups are preparing for a possible industrial action against the ministry’s alleged poor handling of the issue while the Federal Civil Service Senior Staff Union, Federal Ministry of Health branch, is said to have commenced marathon meetings.

Whatever may be the issues driving the current agitation, we believe that it is time all Nigerian health professionals take a long hard look and ask a few questions: why am I in this profession? What is my duty to my patients who ordinarily should be my first priority? How do we resolve workplace problems with the authorities so that innocent lives are not unnecessarily lost? Similarly, it is also time that the government and policymakers asked themselves the hard questions: what drastic changes do we need to put in place for this permanent cycle of strikes to come to an end?

While we urge the health authorities to be pro-active in resolving outstanding issues, we believe that it’s time health workers stopped turning industrial actions into a relay race, passing the baton of one strike to another at the expense of human lives. They must remember at all times the oath they swore to: to protect the lives of the ordinary citizens. Any time they go on strike, they violate that oath.