‘With about 11,000 members, the strike will affect 91 healthcare facilities nationwide,’ the Secretary-General of the Nigerian Association of Resident Doctors (NARD), Dr Shuaibu Ibrahim, was quoted as saying on the eve of the strike by members of the association, which started on November 1.
NARD is mainly made up of doctors in the public sector – federal and state teaching and specialist hospitals. Resident doctors have already received their medical degree, and are completing additional training in their specialty of choice. It is a stage of graduate medical training that lasts from three to seven years, depending on the specialty.
NARD President Dr Muhammad Suleiman, in a statement after the strike began, said the association’s demands ‘are not selfish, neither are they politically motivated.’ According to him, ‘They are genuine, germane, and patriotic, centred on the survival of the Nigerian health system and the well-being of every citizen who depends on it.’ He added: ‘This is not a fight between resident doctors and the government; it is a struggle for a functional, just, and humane healthcare system.’
Why did the Federal Government fail to take action to avert NARD’s strike before the expiration of its 30-day ultimatum?
Following the meeting of the association’s National Executive Council on October 25, Suleiman had announced that the council ‘has declared total and indefinite strike action’ starting November 1. ‘There is no going back,’ he said.
How did things get to that point? He said the association had made efforts to engage the government after suspending its five-day warning strike on September 14. He added that the two-week ultimatum was subsequently extended by 30 days on September 26.
‘This grace period has since elapsed, yet the Federal Government has failed to demonstrate the political will necessary to address the legitimate concerns of Nigerian resident doctors,’ he declared.
NARD has 19 demands, which he described as ‘minimum demands.’ Notably, he highlighted welfare issues, saying, ‘There are allowances of over two years, there’s 18 months, there’s seven months, there’s four months, there’s eight months. There’s an allowance error that is over 10 years old. There’s a failure to review even the basic salary of doctors in this country for 16 years.’
The figures he mentioned are astounding. He said: ‘For all healthcare workers, I think the outstanding owed is about N35 to N38 billion. If it’s just resident doctors, we’re talking about maybe N400 million, but for all doctors in Nigeria, it could be N600 to N800 million.’ Are these figures correct?
NARD also noted that ‘The current unsustainable practice of spanning duties across several days poses serious risks to physicians’ well-being and patient safety.’
The association complained that ‘Doctors continue to work excessive hours far beyond international standards without adequate rest, in clear contravention of established guidelines and international best practices.’
There are other concerning complaints, which informed the association’s 19 demands. Resorting to a strike demonstrated the association’s frustration. It was a statement on the government’s seemingly contemptuous unresponsiveness.
NARD’s strike has the blessing of the Nigerian Medical Association (NMA). This speaks volumes about the government’s shortcomings. The Secretary-General of the NMA, Dr Ben Egbo, was quoted as saying, ‘It’s like the only language the government understands is strike, and it’s quite unfortunate.’
He noted that resident doctors ‘are part of the NMA,’ adding, ‘We are very much behind NARD in this fight. Their demands are essentially the same as the demands of the NMA. We’ve been at this for a long time.’
His reference to the long-term struggle for a better healthcare system in the country further underscores alleged neglect by the government over the years. He observed that the healthcare system ‘is gradually failing.’
NARD called for President Tinubu’s decisive intervention. ‘You are the father of the nation. Come into this matter, weigh in on it, and solve it for us,’ Suleiman said.
The Federal Government should not have allowed the situation to deteriorate to this point. The government’s inaction has serious consequences for those who need healthcare services in public hospitals across the country. The people should not have to pay for the government’s failure to do the right thing at the right time.
NARD’s strike not only highlights problems in the country’s health sector but also exposes neglect by the authorities. The situation that prompted the strike partly explains the escalating exodus of medical practitioners from the country, which has been detrimental to its health sector.
The brain drain phenomenon afflicting the country has not spared its health sector. More than 16,000 doctors are estimated to have left its shores in the last five to seven years. The alarming flight has been blamed on poor leadership, corruption, poor remuneration and insecurity. For instance, more than 700 medical doctors trained in Nigeria were said to have relocated to the UK between December 2021 and May 2022, a period of six months. According to the NMA, Nigeria-trained doctors are leaving in droves for Saudi Arabia, Oman, Kuwait, Qatar and the United Arab Emirates.
The situation calls for urgent intervention by the authorities. The country cannot afford to continue losing its healthcare experts by failing to provide an enabling environment for their work.
It is noteworthy that the country’s doctor-patient ratio is alarmingly poor, and nowhere near the standard often referenced as ideal, which is one doctor per 600 people. The situation is worsening as doctors continue to leave the country for pastures new. With only about four doctors available per 10,000 people in Nigeria, it is unsurprising that there are issues regarding availability of, and access to, quality primary healthcare services in the country. The problem is compounded by the flight of nurses and medical laboratory scientists.
Importantly, in April 2001, heads of state of African Union countries met in Abuja and pledged to set a target of allocating at least 15 percent of their annual budget to improve the health sector. It is disappointing that Nigeria has consistently failed to meet the standard of the Abuja Declaration. The trend of underfunding in the country’s health sector continues unabated.
NARD’s strike sounds the alarm bell. The strike is not just an industrial action, but a symptom of a much deeper, more urgent problem. The situation demands more than the routine cosmetic appearance of resolution.