Hugo Naijaman: The Current NMA Strike: A Colleague's Opinion

On July 1, 2014, the Nigerian Medical Association once again rose in defence of the practice of Medicine in Nigeria, and took a step designed at preserving our hallowed practice from the jaws of mediocrity, which seem to have taken all else in this nation. The NMA is leading a struggle to attempt to prevent the Joint Health Sector Unions (JOHESU) from infecting our practice with that bug that we call the Nigerian factor.

I found the following article on Nairaland and thought I should share it on my own space. It was written by a well-respected colleague, Dr E. Omobude. While I do not agree with all the contents (and will therefore issue a clarification of my own position in future), I think it is important that we understand that the responsibility for the current strike lies with the Federal Government and with the JOHESU folks who fired the first salvo. Happy reading.

THE JOHESU BROUHAHA ....... MY PERSONAL OPINION

Commenting on a topic, "most preferred course of choice in Nigerian Universities". According to the write up, medicine came first as the most preferred choice even though it is only offered by about 34 of the about 124 universities in Nigeria. Most contributors gave different reasons why it is most preferred, ranging from remuneration and prestige to excellence. My own contribution viz; "From the comments made by contributors, it seems most people appreciate the fact that medicine is one of the most sensitive (I am trying to avoid the word "most difficult"

course of study in our tertiary institution largely because it deals with human life and the uncertainties (one is not sure if he will eventually become a doctor or not), even the best students in first year could be withdrawn the following year. When I was in school, over 400 of us gained admission to study medicine but less than 120 of us who gained admission together graduated. It is also a known fact that after several attempts at entering medical school, most students eventually settle for related courses like Medical Laboratory Sciences, Nursing, Physiotherapy, pharmacy (Note that a good number of students also choose these courses as their first choice course ab initio).

Having stated the above, it is crass injustice for someone who knew from the beginning that he could not study medicine (for reasons best known to him, be it academic challenges, time spent in the training amongst others) to now realize that the name "doctor" is dignifying, and hence, desires to be called doctor(and or consultant) because he works in a tertiary institution and has garnered some years of experience. This is comparable to technologists who refer to themselves as engineers simply because they know how to assemble machines. What matters most is the qualification and not the number of years spent assisting a medical doctor.

I support that health care workers can and should aspire to whatever they want and to whatever extent. They can still be called doctors. All they need do is complete a masters degree program and a PhD. I know some Nurses who are professors, same with pharmacists. In the USA states of Arizona, and some other states, it is an offense to address yourself as "doctor" if you are not a medical doctor without stating your profession immediately( there should be no room for patients to assume you are a medical doctor when you are not). Let me emphasize that a doctor will never fight to head a pharmaceutical company. We all knew what we wanted before we wrote UME (JAMB) .... This short cut approach must be rejected. I was in Microbiology 300L when I got admission into 100L medicine, I knew what I wanted. I had classmates who were nurses, medical lab scientist, who wanted to become doctors; they took UME again.

Remuneration of doctors should not be compared to any other allied health profession. Google is our friend and we can always ask. Is there anywhere in the world where pharmacists, medical lab scientists, nurses and others earn the same remuneration? If there is any, please let me know.

It is quite unfortunate to see the pharmacists I once respected stoop so low, finding themselves in the nexus of abhorrent disgruntled elements of disappointed and frustrated persons fighting against not only medical doctors but themselves (because they are reducing the practice of pharmacy to drug dispensing). What happened to industrial pharmacy, what happened to drug formulation and research? I was once envious of a classmate who later became a pharmacist. While I was still doing my internship, she was done with hers (no thanks to our extended academic calendar of 6+X years as against hers of fixed 5 years), she was working in a pharmaceutical company, earning a fat salary, had an official car and a driver. Her remuneration and job description was very good and juicy, but that is her calling not for a medical doctor.

In every stratum of life, in every team, there is always a leader, one leader, that's why we have only one pope, only one Nigerian president, only one state governor, only one captain and indeed only one chief medical director (who must be a doctor) which must be earned and not gotten through the back door. Note that only doctors have been appointed Director General of WHO since inception, yet we have other health workers who work for WHO. The present Director General, Margaret Chan should be an inspiration to JOHESU members because she was a home economics teacher before going back to school to study medicine.

My sincere advise to JOHESU is to lead by example, they should propose an arrangement that gives health workers (apart from medical doctors) equal rights viz; the pharmacy technicians should be allowed to head the pharmacy department, auxiliary nurses and B.Sc. nurses should be paid exactly the same salary and have the same type of promotions (since they can all administer injections and dress wounds), laboratory technicians should be allowed to be the assistant head of a laboratory departments assisting a consultant pathologist. If they can successfully implement the above for 5 to 10 years, and the model works perfectly well, then maybe the federal government can look into their request.

Indeed the patient care should be a team work involving the pharmacist, laboratory scientist, nurses with medical doctors at the centre. Any attempt to take the sole responsibility away from the medical doctor will lead to chaos and serious disaster.

I must confess, the turn of events in recent years is not encouraging, it has a most negative effect on the already brain drain that has plagued the Nigerian health sector, what they should be fighting for(collectively, doctors inclusive) should be how to increase the slots for residency training, better remuneration and welfare package across board,how to promote research and get scholarships to further enhance skills and build career, cooperate with doctors to ease the admission of their children into medical school so that their desire can come into fruition. I believed in our generation, we must fight together, my friends who are pharmacist, physiotherapist and nurses know we are not the same, their "ogas" should stop the Tom and Jerry display of ignorance and comic. Yes, I respect them, I respect every other health worker, they have their role which must be respected and indeed the best patient outcome is in team work.

The reasoning that doctors go on strike in order to increase private patronage is not only myopic but a serious neurological deficit on the part of those who have such reasoning. What will you say when pharmacist and lab scientists go on strike, where do patients buy drugs from( they don't only go on strike, but they frustrate the effort of anyone who choose to deliver care by switching of power generators, hiding surgical instruments, locking up stores amongst others). Yes, most doctors have private hospitals in order to meet the increasing demands in the health sector but pharmacist and others also own pharmacy shops and laboratories, committing the most heinous crimes of consulting, examining and treating patients in their shops which is not designated for such, oh what a lawless nation. Most patients have worsened their clinical condition and indeed died from such crimes. Permit me to call their act genocide of the highest order towards Nigerians.

On this note, I appeal to the federal government to call a spade a spade, to consider the sufferings of the poor patients and do the needful. Medical doctors and indeed the patients deserve more than this ill treatment.

Hugo Naijaman

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Saturday, July 12, 2014

The Current NMA Strike: A Colleague's Opinion

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