Few facts to note!
-JOHESU is an amorphous body.
-Doctors are human beings who have family members that are also human beings.
-Yes, doctors swore the Hippocratic Oath and will aspire to defend it fully.
-Doctors work round the clock while other health professionals work shift and so has more time to spend with family and other things.
-There’s a health team in the hospital and the doctor is the head…and the doctor will always be the head with emphasis on the word, ‘always’
– Any attempt made by a doctor to press home his point can easily be mistaken for pride
I decided to play an observatory role as regards the ongoing stand off between the medical doctors and the FG(&JOHESU) hoping for a speedy resolution but as the situation has tarried, it wouldn’t be out of place to lend my voice to the fewer of the ‘warring’ groups and cry out for justice and sanity in the health sector. I will prefer that my opinion is read & commented on, if need be, by open-minded, non biased, cerebral and intuitive individuals on the social media. Patience will also be needed to read the lengthy article and also internalize it. I won’t expect anyone to exhibit an uncultured character by name calling and abuses as I’ve seen following many articles such as this. If you belong to such group of people, kindly save your data and battery life at this stage, close this and go do other stuffs on your device, say play games or scroll through your pictures. Thanks.
So let me begin by sharing my opinion about JOHESU. It’s an amalgamation of incongruent groups comprising of Nurses, Pharmacists, Physiotherapists, Medical lab scientists, Hospital technicians, Hospital orderlies, Record Officers and some other persons in the hospital excluding the doctors. It can be likened to the Nigeria Labour Congress (NLC). It is important to note that NLC, when embarking on strike press home demands that affect the groups which makes it up and occasionally defend the cause of each group of workforce within it. Unlike NLC, JOHESU sprang up with intent to use the number of many to champion the cause of a few! If only the sidelined groups to be can know this! The hypocrisy behind the formation of JOHESU will be seen in the course of this article. I tried finding out what the mission of JOHESU is on their website but my search for their website using various search engines (Google, Wikipedia) yielded no result for JOHESU as at the time of writing this. I know NANNM, an association of nurses and midwives. I know PSN for the pharmacists. I know medical lab scientists have their own association-MLSCN; but I don’t know the association of the orderlies or hospital technicians. And so, when a group of associations team up with a group of individuals, we can only pray that their intent is holy. I keep wondering if an orderly will ever become the president of JOHESU or at least the Gen Sec and thus sign releases and preside over meetings. I do hope I can get my hand on a JOHESU constitution one day, if they have. The contents must really be interesting.
Since this article is not a discourse on JOHESU, I’ll go ahead to discuss the contentious issues in the demands of NMA. The issue of relativity has not been vigorously contested by JOHESU so I’ll gloss over that. It is just reasonable that a doctor, who spent the greater number of years (&semesters) in school; who works round the clock and on whose shoulder the chunk of the responsibility of patient’s care lie be remunerated more than other health workers. As has been shown many times, Nigeria is one of the countries where the margin of relativity between the salary of doctors and some other health workers have been significantly eroded. The issue of skipping too has not been so contested as such. Again, it is only unfair to skip doctors from skipping (pardon the pun) which other health workers enjoy and has been enjoying for a long time! The issue of hazard allowance has also not been so challenged. Even JOHESU knows that if implemented, it will cut across board. Doctors, Nurses, medical lab scientist, radiology technicians and orderlies are exceptionally exposed to hospital hazards and I won’t say one group is more exposed than the other because hazard, no matter how small or infrequent can end one’s life and ambition once it occurs. The three issues that have been fiercely argued is the issue of consultancy, CMDship & post of Surgeon-General.
About consultancy, I personally would not have opposed the desire of other professionals within the health sector to become a consultant if the desire for such aspiration is the belief that being a consultant nurse or pharmacist will improve patient’s care but I do have some problems. I have a problem with JOHESU fighting for this as JOHESU where some group of members can never have a curriculum for attaining such status. If it was being fought by bodies such as NANNM, PSN or NSP etc., each body can put forward it’s blueprint, it’s purpose and what it intends to contribute to the health sector and this can be considered, discussed and individualized based on each profession’s peculiarity; Or why should a physiotherapist who is only vast in his field agitate for Nursing consultancy? Or why should an orderly fight for Consultancy status for pharmacists? Why? Has anyone thought about what the nurses or physiotherapists will do should orderlies decide to agitate for consultancy status? Will the FG be told by the populace to accede to their demand too? The other problem I have with it is that many of those agitating for consultancy status ordinarily, without even being a consultant, overstep their boundaries with impunity. Becoming a consultant will not only make them overstep their boundary, they are likely to trample upon the feet of those in the boundary they encroached upon. A nurse who is supposed to provide patient’s case note for ward round & join in the round but prefers to sit at the station will likely not come to work when she becomes a consultant. So they should put their house in order first and then other aspirations can come up. My other problem is the tendency of such status to promote quackery and deceitful therapy to patients. Some non-doctor health workers illegally prescribe medications and operate on patients who are made to believe that they’re being attended to by doctors. Imagine the extent to which such illegality will blossom should they become consultants or bear the name ‘Dr’ within the hospital setting.
About CMDship, one of the grouse of JOHESU is the phrase ‘medically qualified’ included in the requirement for being a CMD. I propose that if it’s causing confusion, it should be changed to ‘medically certified by MDCN’. That is clear enough. They ask for the reason why the post of CMD must be an exclusive preserve of the doctors. Why not?! Why should other bodies agitate for the headship of a hospital? What do they want to do differently that they can’t pass across to the CMD through their head or implement such within their own niche? Have their profession granted them an administrative edge over doctors? As far as Nigeria, at present, is concerned, the post should be reserved for medical doctors. A hospital exists, first because there’s a patient; then secondly, a doctor. Every other person are an ‘addendum’. It is hard to swallow but it is the bitter truth. A man does not leave his house, get in the cab and go to the hospital to see a nurse or a pharmacist or a medical lab scientist. He’s going to see the doctor who now decides if the patient needs nursing care or needs drug or needs to see a physiotherapist or the attention of a social worker or needs to have some tests done in the lab or needs surgery. It is interesting to note that a patient may not even need any of the above personnel or services but just reassurance. Only the doctor can determine that. Only the doctor is so trained to have a broad knowledge about other fields and a deep knowledge about his own field. If a nurse becomes the CMD and a pharmacist approaches him for a policy to be implemented in the pharmacy section of the hospital, chances are that the nurse will not understand how such policy affects the patient as she has been trained almost solely on the art of nursing. She’s likely to protect the interest of her profession. Same scenarios would play out if a pharmacist was the CMD; but a doctor in such a position has considerable knowledge about other fields and as such has significant understanding and appreciation of the workings of each sub sector of the hospital. The post of the CMD goes beyond just administrative.it includes an in-depth understanding of the patient for which the hospital exists in the first place. i must add that not even all doctors can become a CMD in the teaching hospitals. Not without passing through the furnace of residency successfully and even some years after that.
Concerning the post of Surgeon-General, I don’t see Nigeria as yet ripe for such post and I’m certain it’s not a strong reason why the strike has persisted. Given the nature of the Nigerian government and system as a whole, such a post at the moment will be a duplication of role and wastage of resources and so I know if other demands are met save this, all doctors are not likely to go on strike for a long time (maybe for life).
My advice to JOHESU if they must remain amalgamated together is to quit playing the Nigerian type of politics within the health sector and do their job diligently, truthfully and be sincere in their demand and agitations. This will attract respect from the patients, the public and the doctors. We don’t need this unprecedented rife and rivalry in the health sector. It is bad for the patient. Also, they should be proud of their identity and profession and fight against some of their members who pose as doctors- operating on patient, prescribing medications- and assume the management of a patient (things they do based on the supposed experience gained having worked with doctors for a while) only to refer to a hospital when the situation is bad but when they or their relatives take ill, they quickly look for the doctors. They forget that patients are different and management must be individualized. My reason for this advice is that, if government decides to privatize the health sector either fully or partially, everyone will be negatively affected but the least hit will be the doctors. A private hospital owner can decide to employ an auxiliary nurse, private orderlies and security men and technicians. Pharmacy shops are ubiquitous. Private labs will spring up in no time. The doctor is irreplaceable and is licensed to establish his own hospital.
Having said those, I want to correct the erroneous belief that doctors are selfish and fighting for their pockets, a propaganda by JOHESU. While it is true that I’ve seen nurses who spend their resources for patients care, almost all doctors I’ve come across have at one time or the other, even as medical students, use their money to assist a patient. The desire to see a patient get well can be sometimes overwhelming for a doctor at times: doctors donate money for patients, donate blood, go out of their way to make sure blood is provided for patient, goes to the pharmacy to ensure drugs are dispensed, even runs to borrow at the pharmacy when need be, runs to the lab to get sample bottles and return samples to the lab and again return to press for speedy processing and result of the investigation. They plead (&at times quarrel) with nurses, pharmacists & orderlies medical lab scientists all in a bid to make sure patients’ care is optimal. Also, don’t see doctors as wicked when they go on strike. When doctors go on strike, they take nothing from the hospital. They only refuse to come to work. When JOHESU goes on strike, they lock up consulting rooms and keep away the stethoscopes, sphygmomanometers and other devices. The power house technicians refuse to supply electricity even when patients are on life support devices; record officers lock up the case files of patients all in a bid to frustrate the doctor’s effort. When these measures fail to ground the hospital, they coerce the orderlies (where private ones are used) into joining them. They harass doctors and even block the entrance gates of the hospital. Yet, the hospital still manages to function. During the last JOHESU strike, I took and charted patient’s vital signs, gave IV drugs, put up iv fluid, thought the relatives how to make tepid water and tepid sponge and to use the bed pan and I administered medications. Relatives got drugs outside and I managed patients within the confines of my clinical judgment. We may be on strike but many of us still consult patients around us free of charge. We’re not lazy. We only demand sanity. Blame the government. Not the doctors.
I’ll end by saying I hope that one day, the catechist, choristers, altar boys and church wardens won’t one day team up with intent to contest the headship of the parish with the priest of the catholic church .If any of those so desire to head a church, then they must go through the rigours of seminary and the cross of celibacy.