“16Then came there two
women, that were harlots, unto the king, and stood before
him. 17And the
one woman said, O my lord, I and this woman dwell in one house; and I was
delivered of a child with her in the house. 18And it came to pass
the third day after that I was delivered, that this woman was delivered also:
and we were together; there was no stranger
with us in the house, save we two in the house. 19And this woman's child
died in the night; because she overlaid it.20And she arose at
midnight, and took my son from beside me, while thine handmaid slept, and laid
it in her bosom, and laid her dead child in my bosom. 21And when I rose in the
morning to give my child suck, behold, it was dead: but when I had considered
it in the morning, behold, it was not my son, which I did bear. 22And the other woman
said, Nay; but the living is my son, and the dead is thy
son. And this said, No; but the dead is thy son, and the
living is my son. Thus they spake before the king.
23Then said the king,
The one saith, This is my son that liveth, and thy son is the
dead: and the other saith, Nay; but thy son is the dead, and
my son is the living. 24And the king said,
Bring me a sword. And they brought a sword before the king. 25And the king said,
Divide the living child in two, and give half to the one, and half to the
other. 26Then
spake the woman whose the living child was unto the king, for
her bowels yearned upon her son, and she said, O my lord, give her the living
child, and in no wise slay it. But the other said, Let it be neither mine nor
thine, but divide it. 27Then the king answered
and said, Give her the living child, and in no wise slay it: she is the
mother thereof. 28And
all Israel heard of the judgment which the king had judged; and they feared the
king: for they saw that the wisdom of God was in him, to do
judgment.” 1kings3:16-28 (KJV)
When the news about the sack of all resident doctors was eventually
confirmed, many Nigerians took to social media to express their unwavering
support for the definitive judgment meted out to the striking, arrogant and
greedy doctors who had failed to respond to the Ebola virus outbreak. Among
those who joined the bandwagon of solidarity with the Nigerian emperor were
other health workers under the banner of the “Assembly of Healthcare
Professionals and Joint Health Sector Unions (JOHESU)” some of who said the
resident doctors were deserving of such a drastic decision after embarking on a
prolonged “illegal” strike action. A sensible individual who claims to be
concerned about the happenings in the Nigerian health sector ought to ask
him/herself a very critical question; “How does one justify the sacking of
resident doctors who are affiliate members of the parent body called the
Nigerian Medical Association (NMA) for a strike declared and enforced by the
parent body?”
Who on earth are JOHESU that
seem to have the Health Ministry and the Government by the gonads?
The creation of this hydra-headed structure still remains a mystery
to me despite a lot of effort to trace its point of origin and insertion. This
body seems to have perfected the art of ”shapeshifting” that seems only to
exists in folklore and mythology. Like the Marvel comics character “Mystique”,
this amorphous organization has found a way to appear as whatever they wish to
any group of people, peddling falsehood and retaining their ”integrity” in the
process. They were out with a press release shortly after the NMA called for a
nationwide strike on the 1st of July 2014 in which they condemned
the strike and declared it illegal. By the 17th of July, they had
sued the NMA and challenged the legal right of the association to declare a
strike when it was not a part of the recognized trade unions in Nigeria and
therefore did not have a right to negotiate any trade issues with the Federal
government (FG). If the NMA does in fact have no right to sit at the table
with the FG, who then is responsible for negotiating on its behalf?
The Nigerian Labour Congress (NLC) is described on its website as
the only national federation of trade unions in the country with “fundamental
aims and objective to protect, defend and promote the rights, well-being and
the interests of all workers, pensioners and the trade unions; to promote and
defend a Nigerian nation that would be just, democratic, transparent and
prosperous and to advance the cause of the working class generally etc.” There
are about 16 listed ways of achieving these for “all Nigerian workers” both in
the public and private sector all clearly stated on the website. The congress
has about 43 affiliate bodies listed on its website with their relevant
addresses and contacts. It is mentioned that the umbrella body is aware of the
existence of a massive and dynamic informal sector of the economy which is
currently not a member of the congress; a status not also extended to the military
and paramilitary services as well as civil establishments that carry out duties
classified by law as essential. The only example given under civil
establishments was the central bank of Nigeria. The JOHESU take pride in their
ability to hold negotiations with FG on labour disputes citing that all 5 affiliate
members are also members of the NLC and Trade Union congress of Nigeria (TUC).
I have to agree with a column written by Ibrahim Idris about 7 months ago in
“premium times” where he described JOHESU as illegal. A quick look at the
current letter headed papers on which their communiques are printed would
reveal 5 logos by the left side margin vertically oriented. One communique
released on the 6th of January 2014 reveals a logo (consisting of
the images of 2 tablets and one capsule surrounded by the acronym) with the
title as “Assembly of Healthcare Professionals and Joint Health Sector Unions”;
another released on the 17th of January 2014 has only the JOHESU
acronym at the top. Subsequently, the letter head has remained as “Joint Health
Sector Unions and Assembly of Healthcare Professionals”. I really wonder how
such a “dynamic” organization gets to command the attention of the FG.
.jpg)
The 5 affiliate lions that make up the JOHESU “voltron” are:
Medical and Health workers Union of Nigeria (MHWUN); National association of
Nigerian Nurses and Midwives (NANNM); Senior staff association of Universities,
Teaching Hospitals and associated Institutions (SSAUTHRIAI); Nigeria Union of
Allied Health Professionals (NUAHP) and the Non Academic Staff Union of
Educational and Associated Institutes (NASU). Of these 5 unions, only 3 are
listed as written above amongst the 43 NLC affiliates I counted on the NLC
website. There is no union like NUAHP and the closest union to SSAUTHRIAI is
SSANU which represents the senior staff association of Nigerian Universities.
In a draft release by the JOHESU to protest the non-inclusion of any of their
members by the FG to the recently concluded confab, the leadership urged the
president to urgently include members of the professional bodies in JOHESU at
least. They mentioned the Association of Medical Laboratory Scientists of
Nigeria (AMLSN), Pharmaceutical society of Nigeria (PSN) and the NANNM as
potential sources of nominees for the national conference. The PSN, AMLSN and
the Nigeria society of Physiotherapist are supposed to be members of the NUAHP
together with some unspecified professional groups. If the NUAHP is not listed
in the registry of the NLC as seen on the website (except they are a recent addition),
how are they part of JOHESU or are they the ones referred to as the Assembly of
Healthcare professionals on the JOHESU letter head? Is the SSAUTHRIAI an
amalgamation of the SSANU and the Academic Staff union of research institutions
(ASURI)? These issues with nomenclature and combinations greatly confuse me and
their legality is debatable. How are the Non Academic staff unions of health
institutes separated from those of education and the “associated” ones?
How has this heterogeneous community continued to exist and present
a seemingly united front in its arguably misguided struggle? I want to
believe that some more dominant members of this “Frankenstein” are using their
vantage positions to pursue selfish agendas at the expense of misinforming their
numerous followers and inciting the public against doctors. The head of JOHESU
is a certain Ayuba Wabba who is also the head of the MHWUN and also doubles as
the National Treasurer of the NLC. Dr. Ayuba P. Wabba is listed on LinkedIn as
an Environmental Health Officer at the Ministry of Health in Borno state. This
is the fellow who has been mandated to lead the JOHESU alliance to achieve all
sorts of demands that range from skipping of CONHESS grade levels, consultancy
appointments to “deserving” members, directors and membership of hospital
boards; they also want the termination of illegal posts of deputy chairman
medical advisory committee, establishment of residency programs for other
health professional bodies and a special
entry scale for intern medical laboratory scientists amongst many other
demands. The recent interview granted by the Chief Medical director of the
University college hospital (UCH) Professor Alonge seems to suggest that the
consultant orthopaedic surgeon is supportive of the clamor for consultancy
status by other healthcare professionals. The JOHESU members have jumped on
this to scream vindication and forget so easily that the man who has voiced
support to their demand is also the one guilty of appointing several senior
doctors as DCMACs in UCH which they regard as completely illegal. The JOHESU
through its many affiliates have rained insults and derogatory remarks on
doctors irrespective of the ranks of the doctors concerned. Their usual
rhetoric is always about “what doctors are enjoying” at their expense. I wonder
if house officers, medical officers or resident doctors are the ones getting
appointed as DCMAC or directors. If resident doctors are insisting on better
funding for the health sector, how does that translate to reducing the hazard
or uniform allowance of records officers, morticians or nurses? They have had
several meetings with government representatives especially the ministers of
health and labour where promises were made to pacify them. These promises have
been repeatedly broken and one wonders how gloating over the sack of doctors by
the same FG that has deceived them translates to their demands being fully met.
The president of the Nigeria society of physiotherapy (NSP), Oyewumi Taiwo in a
press release on the 31st of July 2014 condemned the NMA for
embarking on an illegitimate strike and described the venture as a “cheap ego
trip” also saying that the NMA has failed in leadership. How has the NMA failed
in leadership? Does the NMA nominate who becomes the minister of health or the
medical directors of hospitals? Is the NMA actively consulted with respect to
policy issues regarding national healthcare delivery? The minister of health
that has overseen the sack of the bulk of doctors currently in the system must
be a strong member of JOHESU just like the many Chief medical directors who
refuse to implement directives that are meant to favor doctors on their books.
The minister of health that deceived JOHESU is the same person that NMA do not
trust. Information on the website of the NSP indicates that the onset of a
residency program for physiotherapists in Nigeria is imminent. They hope to
start with seven specialties: Cardiopulmonary physiotherapy, Community
physiotherapy, Neurophysiotherapy and
mental health; Orthopaedic physiotherapy, Paediatric physiotherapy, Sports
physiotherapy and Women’s health similar to what is obtainable in the United
states where majority of their physical therapy doctorate programs have ten
specialties Cardiovascular and Pulmonary, Clinical Electrophysiology,
Geriatrics, Neurology, Orthopaedics, Pediatrics, Sports, Women's Health, and
Wound Care. Physiotherapy was a 4year course in Nigeria until the late 1990s
when it was increased to 5years; about the only country in the world where the
basic degree is 5years. Most nations offer 2, 3 or 4 year programs. The
introduction of an expanded program that involves greater specialization was
introduced in the USA, this is generally not a worldwide practice and only one
institution in the United Kingdom offers something similar to the Doctor of
Physical therapy program popular in the USA. JOHESU affiliates readily point to
other climes to justify their demands. It can be deduced that the agitation for
a residency program by the NSP has been copied from the USA, it is not what
anyone can term as best global practice and regarded as excessive in some
climes where masters or PhD programs are viewed as sufficient postgraduate
training. Does the NSP have the requisite facilitators and experienced trainers
to oversee a qualitative residency program or are they just copying and pasting
what is practiced in another place without adequately evaluating the pros and
cons? If residency program is part of the agitations of JOHESU, which of the
professional bodies are going to benefit? It is clear the NSP are going to reap
significantly. The terminology “Consultant” refers in our system to specialist
senior doctors who are appointed to ultimately take responsibility for patient
admission and management. They are also involved in clinical training and
supervision of medical students and resident doctors. Some of these individuals
do have dual appointments in institutions with affiliated colleges of medicine
where they also teach students outside of the clinical environment; undertake
research and participate in general University duties and activities. It
becomes laughable when JOHESU release a statement contesting double salaries
given to honorary consultants and allegations that some doctors are so highly
paid even more than university professors when in fact a few of them are
university professors. The term is consistent with the British system as well
as some commonwealth nations. It should be easy to understand why some allied
healthcare workers are called consultants in the USA where the equivalent of
hospital medical consultants and specialists are called “Attending Physicians”.
Although Prof. Alonge appeared to support the appointment of consultants from
other health workers, he did point to the fact that a discrepancy exist in the
interpretation of the term as it affects both groups hence a need to clarify
issues. I do not think that is exactly what the deserving members of JOHESU
want. They constantly point at what doctors are enjoying and I guess it is
those benefits they assume doctors are enjoying that has led to the demand.
What is the yardstick to determine who and who is deserving of consultancy
positions? Would it not lead to further rift within the ranks of JOHESU if
certain affiliates do not benefit from the consultancy largess? What would make
the non-professional groups inherent in JOHESU undeserving of being appointed
as consultants? Are the agitators of consultancy willing and competent to
shoulder the responsibilities of patient care and the demands of such appointment?
A hospital consultant position is not a reward for longevity nor is it like the
appointment of delegates to a conference. It is not the peak of a doctor’s
career, a doctor does not necessarily need to be in a residency program and
become a consultant before he/ she can be regarded as successful or
accomplished. We should not just simply adopt terminologies that are used in
other climes and take them out of context to adopt them in our own system.
Nurses have also recently pointed to the appointment of a female nurse as the
US Army Surgeon General as validation of their demands. It is really easy to be
awed by such information but what many fail to do is read just a little about
the woman concerned Patricia Horoho. It is clear that she did not attain such
lofty heights just because of being a member of a gender or profession minority;
she is a first class Lieutenant General highly trained and equipped to manage
such a responsibility that entails human, material and enormous financial
resources. Our people in Nigeria always clamor for equation balancing at the
complete expense of competence. Should the JOHESU not demand for better funding
and standardized education and training instead of striving for potentially
unsustainable projects that could be deflated by politics and underfunding? A
fellow named Nwaneri commented on a link to a JOHESU draft on the 20th
of January 2014. The man commended the JOHESU executive for their resilience
but asked when and if they would also ensure residency training for medical
laboratory scientists and BSc nurses. Someone should quickly lodge a
requisition for NASU residency quickly.
I searched for a JOHESU website but could not locate any so I
turned my attention for a facebook page at least. I did find three (3)
affiliated to institutions in Yobe, Gombe and the Federal Medical Center
Abeokuta (FMCA). The one for the FMCA had 148 members and one administrator
called Otunba Tiamiyu who is also the public relations officer of the Abeokuta
chapter of JOHESU. The” admin” seems to be a young man hell bent on
misinforming him many members and launching constant abuse on the management and
consultants of his institution. The fellow’s command of the English language
and utterances is rather appalling and one can only imagine how such a man is
responsible for representing the interest of any credible association. He
described the resident doctors as toddlers and their protest as senseless; he
was reported in the Leadership newspapers (a paper that I think is sympathetic
to the mission of JOHESU) on the 26th of July 2014 to say that
doctors only jump at strikes to divert patients to their private hospitals in
order to charge exorbitant fees. He rejoiced that the public had arisen to curb
the excesses of doctors who he accused of behaving as gods. These are the kind
of people who peddle all sorts of falsehood and inconsistencies about doctors
and the NMA. They regularly accuse the NMA of incessant strike actions and
easily forget the many occasions the JOHESU have threatened or outrightly
embarked on strike actions that effectively grounded the health sector. A quick
search through google will produce results that clearly show that the
“development” of the health sector has been greatly slowed down by frequent
strike actions detonated by the camp of the JOHESU. May 7, 2012; August 21,
2013; January 15, 2014: these are all dates of outright nationwide strikes
embarked upon by JOHESU. They have been calling for the sack of the current
Minister of health since 2011. They made this demand on the 21st of
February 2011 accusing the minister of sabotaging their interests in favor of
doctors. They continued with this demand in December 2012 and January 2013.
This same minister is currently being hailed for enforcing the sack of resident
doctors who are not contesting CMD or director positions with the JOHESU top
brass. In a letter dated January 17, 2014 and addressed to the Minister of
Health, JOHESU had stated that its good faith, patience and restraint to go on
strike had been taken for weakness by the government. I wonder what JOHESU
needs to do for the health ministry to sack all medical laboratory scientists
in order to restructure the health sector.
JOHESU has claimed that the NMA have no right to negotiate labour
disputes for any reason and to embark on strikes which has been supported
vehemently by a few supposedly experienced public commentators as well as some
journalists who through their reportage express clear partisanship and a
clearly lackadaisical approach to their work devoid of intelligent research and
fairness. One reporter with the leadership newspaper put up two headlines online
in the space of less than thirty (30) minutes that referred to the same story that aimed
to vilify the NMA and doctors. The same JOHESU that claims the NMA has no
bargaining right with the FG constantly make reference to a 2009 bargaining
agreement that was implemented for doctors but yet to be done for them. The
public commentators usually mention that doctors are part of what is regarded
as “essential services” that should never go on strike. In a blog post on the
25th of October 2012 titled “The Right to Strike in Nigeria and ILO
Principles on the Right to Strike”; Femi Aborishade of the Polytechnic, Ibadan
and center for labour studies reviews and appraises the laws guiding strike
actions in Nigeria, the principles recommended by the International Labour
Organization (ILO) on strike actions and how such affects Nigeria especially
the drawbacks. The Committee of Experts and the Committee on Freedom of
Association of the ILO appeared to
justify the scope of restriction of strike action in “essential services” which
was defined in 1983 as those services “the interruption of which would
endanger the life, personal safety or health of the whole or part of the
population”. The Committee on Freedom of Association described that essential services in the strict sense of the
term depended to a large extent on the particular circumstances prevailing in a
country and that a non-essential service may however become essential if a
strike lasts beyond a certain time or extends beyond a certain scope, thus
endangering the life, personal safety or health of the whole or part of the
population. The committee considered essential services in the strict sense may be subject to
major restrictions or even prohibitions; this is inclusive of the hospital
sector; electricity services; water supply services; the telephone service and
air traffic control. It is instructive that the ILO’s committee mentioned “hospital
sector” and not medical doctors because striking doctors renders all other
health care workers redundant likewise doctors left in a health sector paralyzed
by absent health workers is also a waste of time and resources. Essentially services
in the UK are listed as Emergency services, Armed forces, Health and social
workers, Food industry; Agriculture, veterinary and animal welfare; Essential
workers at nuclear sites; Water, sewerage and drainage; Fuel and energy
suppliers; Public transport, Licensed
taxis; Coastguards and lifeboat crews; Airport and airline workers; Postal, media,
telecommunications; Central and local government workers; Essential financial
services staff including those involved in the delivery of cash and cheques; Prison
staff; Refuse collection and industrial waste;
Funeral services; Special schools and colleges for the disabled and Essential
foreign diplomatic workers. If this nation realizes the importance of these
diverse industries to the welfare of their people, why do our leaders assume
they as politicians are more important that everyone else? They utilize
divisive tactics to set sectors that ought to be in perfect harmony and operate
in unison at each other’s femoral arteries while they simply embark on state
funded trips to nations where doctors and health workers are well catered for
to even think of strikes for checkup and definitive treatment. Workers who
ought to know their services are equally as essential as what doctors provide
sit perched on their moral high grounds to condemn doctors for demanding better
conditions for the collective health sector while they move around without
condemnation when they go on their own frequent strikes that shuts down record
offices, morgues, theatres, pharmacies, stores, oxygen supply and wards amongst
others. These frequent strikes are generally assumed to be doctors’ strike by
the average visitor to the hospital. The mischievous members of JOHESU leverage
on this misconception to divert the responsibility from themselves towards
doctors instead.
Nigerians have to arise and make concrete demands from their
government to improve their welfare. They should not just wallow in the mud and
take just whatever crumbs the FG throw at them. The funds meant for developing
the health sector to international standards are constantly being squandered
and those who ought to know better have not chosen to be enlightened enough to ask
the relevant questions and have offered themselves with the associations they
represent willingly or otherwise as tools in the hands of politicians to
perpetually impoverish Nigerians. The story in the book of 1 Kings chapter 3
tells the story of 2 characters; prostitutes who had babies. One woman
canvassed for the living baby to be split down the middle while the other only
wanted the integrity of the baby. The king in his wisdom judged rightly and
awarded the baby to the true mother. The NMA is asking for the status quo to be
maintained while JOHESU members want what they deem is their rights and privileges. This
is not to say doctors are immune to blame in all that has transpired but the
truth is that the things demanded for by the JOHESU if granted would largely
plunge the health sector into further crises that may not even involve the NMA. The Nurses,
pharmacists and physiotherapists would become consultants; directors would
emerge and then a number of the “patch patch” members would be left stranded or
with crumbs. The pharmacists and physiotherapists know that they cannot embark
on any effective strike to get their desired consultancy status and residency
programs without the foot soldiers that would lock the doors and grind federal
institutions to a halt. These unfortunate ones will realize albeit too late
that they were only used and deceived with promises of better welfare packages and
wage grade level increases. Some of them may never get to those grade levels by
virtue of their limited educational qualifications and poverty of additional
training irrespective of the years of service they offer.
The FG approved huge benefits and amnesty for reportedly
surrendered militants from the Niger-Delta region. Some of these individuals
have been widely reported in the local media to be on training or academic
programs overseas. This is not entirely true as many Nigerians from a certain
geopolitical region of Nigeria favored by the incumbent have flooded choice
institutions across the world for undergraduate degrees in the stead of these
militants and to the detriment of the nation’s tertiary educational sector. It is
shocking that Nigerians are unmoved by the nonchalance of the FG to ensuring
equity and providing even good facilities within the country. It is not
surprising that government runs like normal despite the onslaught of misguided
insurgents in the northeast and the over 130days of secondary school girls
stranded in captivity. It is baffling that some Nigerians find it convenient to
tolerate the idea of the President Jonathan's reluctance or refusal to visit
his troops in the north east of Nigeria despite having the resources to do so
in a flash. Why do some Nigerians who are supposedly educated find it very
appropriate to berate doctors who insist on certain minimum standards before
the strike is called off or before moving all out against the Ebola scourge?
For them and some health workers, it is all about a Hippocratic Oath they seem
to know nothing about. Nurses also have their oath but conveniently forget it
when it comes to vilifying doctors. Is it only doctors that take oaths before embarking
on their assignments? Did President Jonathan recite a poem at his inauguration?
Jide Akeju
23/08/2014
No comments:
Post a Comment