The ongoing strike action, recently embarked upon by the Nigerian Association of Resident Doctors (NARD), has further highlighted the precarious levity with which the Nigerian government often handles issues relating to healthcare in the country. The strike, just like many others in the health sector, could have been avoided, if the grievances long expressed by the medics had been handled with more sensitivity and sincerity.
It is even more worrisome that successive governments have not been able to come to a mutually beneficial consensus with this very indispensable group. During the last administration of President Muhammadu Buhari, the NARD spent, at least, four months on strike, amid series of failed negotiations for the improvement of their welfare packages and working conditions. Some of their demands were payments of members’ salaries and proper placement of members in state and federal tertiary hospitals across the nation.
In 2021, President Muhammadu Buhari, who had told Nigerians that he was committed to improving the health sector, spent over 200 days in London on medical trips, while Nigeria spent a whopping sum of $3billion on medical tourism, from 2020 to 2022, according to the Balance of Payments database of the Central Bank of Nigeria. His case was, perhaps, one of the worst paradoxes in leadership. Not all Nigerians were privileged financially and so, while Buhari and a few affluent officials enjoyed medical pilgrimages abroad, millions of Nigerians were denied access to quality healthcare at home.
In 2017, two years after Buhari took over from Goodluck Jonathan, the World Health Organisation, in its analysis of international health systems, ranked Nigeria 187 out of 191, ahead only of Democratic Republic of the Congo, Central African Republic and Myanmar.
It is our expectation that President Bola Ahmed Tinubu’s government will take an exception to the usual lip service paid to the health sector by successive governments. Beginning with the president himself, government, at all levels, as well as other political office holders, must be mandated to work towards upgrading the health facilities in their domains to international standard. This must begin with prioritisation of healthcare in budgetary allocations, as well as formulation of policies that are decidedly aimed at revamping and repositioning the health sector for better service delivery.
One area such policies must target is restricting public officers from embarking on medical tourism abroad. It is our view that unless such stringent measures are taken, the health sector in Nigeria will continue its free fall. As long as government officials, policy makers and other key stakeholders – especially those with access to public funds – believe that they can always find alternatives to the calamity that many public health institutions have become, issues plaguing the health sector will not be given the urgent and utmost attention they deserve.
One of the major issues NARD is contending with is the obviously embarrassing exodus of medical doctors that has become the norm in Nigeria. According to the NARD President, Dr Emeka Orji, over 2800 medical doctors have left Nigeria in two years, in search of green pastures. He said the statistics came from 2022 survey conducted by NARD. Going by this, it means that 100 medical doctors leave the country every other month, putting the country’s doctor-patient ratio at an abysmally precarious level.
Presently, the healthcare delivery system is in an appalling state, with one doctor to attended about 10,000 patients. Worse still, the overburdened practitioners are not provided the necessary incentives or the enabling environment to practice. In most Nigerian public hospitals, the facilities are ill-equipped and in very deplorable conditions. Only recently, the entire nation was jolted by the tragic news of Dr Vwaere Diaso, a young and brainy house officer, who was killed while using the faulty elevator at the Lagos State General Hospital, Odan. According to reports, Diaso was to conclude her horsemanship programme two weeks to the time she met her untimely death in the avoidable tragedy.
It is particularly disturbing that, in their tributes, colleagues of the deceased lamented how several complaints had been made to the hospital management about the parlous state of the elevator, to no avail. Such reckless neglect, mismanagement and misappropriation of funds that have turned most government hospitals to death traps for both patients and health workers must be checked forthwith.
It is imperative that the Federal Government attends to the demands of NARD, as well as the concerns of other healthcare professional groups, in order to forestall the total collapse of the country’s healthcare delivery system. Already, in some states, patients have been discharged as a result of the ongoing strike, with many of them unable to afford treatment in private hospitals. The Federal Government must step up negotiation efforts – with compelling sincerity – to ensure that a devastating public health crisis is quickly averted.