The two week-old strike by the National Association of Resident Doctors (NARD) has crippled activities in most teaching hospitals across the country, causing the premature discharge of patients. A common feature in these hospitals is empty chairs.
Weekly Trust reports: The normally busy National Hospital,Abuja is now a shadow of itself. The hustling and bustling that characterise the hospital has gone. Most of the wards were empty yesterday with only handful of patients seeking for attention that was not provided. There was a lone patient in the emergency unit. A nurse told Weekly Trust that the hospital was not admitting patients because of the strike. “Those you see on admission now are people with minor cases, or those who are yet to settle their bills. We have since stopped admitting patients. The house officers who normally do most of the work are on strike,” she said.
The Head of Department Information Management Services of National Hospital, Mr. Tayo Haarstrup, said the hopspital was trying its best to attend to patients who come to hospital, despite the strike. “The over 70 consultants in the National Hospital are working. Our nurses are working, the casualty personnel are working. All the clinics and laboratories are working. At the onset of the strike management met and decided that we will manage our in-patients. We did not deliberately discharge any patients. Any patients discharged are those the consultants felt are okay to go home. Generally patronage has been low because of the strike. Since most people are aware of the strike they will naturally seek medical attention elsewhere. But who ever comes will be duely attended to.”
At the University of Abuja Teaching Hospital, Gwagwalada, the impact of the strike was apparent, as patients were not being admitted. Only in-patients were being attended to by the few consultants and other house officers the hospital management was able to call up in the interim in order to render skeletal services.
The hospital premises looked less busy than before the strike, as patient traffic has reduced sharply and most of the sections in the hospital, where patients usually gather to receive medical attention were empty.
The Chief Medical Director, Dr.Peter Alabi, told Weekly Trust that the system was affected by the strike but it has not stopped the rendering basic services.
“By next week the strike would be three weeks old. We have been able to carry out some skeletal services especially as regards treatment of in-patients. We have been able to keep the patients who were on admission before the strike. The consultants have been working round the clock to make sure the patients are fit before discharge. The clinics are running regardless of the obvious challenge, the consultants are running the clinics. The house officers are assisting them. This morning, we met with the various clinical departments. Probably by this weekend, we might be able to start admitting patients with emergency cases.’’
Giving some of the reasons why the resident doctors’ strike is biting hard, especially the toll on patients who cannot afford the money to go elsewhere, the CMD explained that the resident doctors’ strength was in their number. Whenever they embarked on strike, it was bound to hamper services if the management of teaching hospitals are not able to seek alternative health care.
“They technically form the largest group of the medical workforce in most teaching hospitals. However, as a consultant, you cannot just go and operate a patient alone, he still needs their assistance.
“Naturally, people have been aware of the situation and are taking their patients to private hospitals or the FCT hospitals. We don’t formally refer patients, as the patients themselves don’t even come due to the awareness about the on-going strike.
“The challenge is that, the poor people are the most hit, privileged people can take their patients to private hospitals and get what they want; but what about the poor?
“The people we are fighting might not even feel the impact of the strike, so everything boils down to the poor masses. I am appealing to the resident doctors to resume work as government has shown commitment to deal with the issue.’’
Bala Shehu, a relative of a patient told Weekly Trust that they were there to admit a sick persons but had been unsuccessful because they were rejected as they could not afford the huge bills in the private hospitals.
‘’We went to one of the private hospitals in Area 1 last night and were told to deposit 70,000 naira before admission; where on earth can we raise such sum? If it were in Gwagwalada, you can be treated with as little as 10,000 naira or a little above it, but in the private hospital, that 70,000 naira is just a deposit, we still be asked to add more.’’
Kano
As a result of the ongoing strike embarked upon by resident doctors in the country, activities at the Aminu Kano Teaching Hospital (AKTH) have almost halted, checks by Weekly Trust revealed. Though the hospital opens as usual, only skeletal services are offered as the premises were deserted with very few parked vehicles, while the hospital staff and some students were seen wandering.
Only the very few critically ill inpatients were still on admission and being attended to by consultants and nursing staff of the hospital. As at Wednesday, only 21 patients, describes as critically ill, were on admission in the hospital while all other wards and departments were empty as there were not much consulting going on.
Even the Accident and Emergency (A & E) ward of the hospital, where patients in need of urgent medical attention are usually received and given first aid was were empty as such patients were referred elsewhere owing to the strike. The situation was same with all the special clinics of the hospital with exception of physiotherapy and dialysis centres, which were operating as normal.
At the pharmacy outlets of the hospital, activities were also minimal as the staff sat all day, almost redundant. The situation in the laboratories is no different as just few lab investigations were being conducted for inpatients and those referred to the hospital’s labs by other hospitals.
Malam Aminu Inuwa the Chief Public Relations Officer of the hospital, said “it is obvious that the strike by resident doctors has affected the hospital, resulting to a scaling down of activities as the clinics have practically closed down; no more admissions are done as only the few critically ill patients admitted before the strike began are being attended to by consultants and the nurses. Apart from the doctors on strike, all other staff report to work daily while the laboratories and pharmacies operate though not much is done and, by implication, the revenue generation of the hospital has also dropped,” said Inuwa.
Chief Nursing Officer at the hospital, Ibrahim Shu’aibu Rano, said it was unfortunate that the strike by the resident doctors has affected all other sectors of the hospital. “The fact is all professionals want to practise their profession and the hospital as a body has over 20 professions working together as a team, therefore, when one is affected, others also get affected. The worst part of it is we see patients in dire need of help but there is nothing we can do to them to help them since we are not doctors.
“Even at our level, we run our shifts and resume office daily but stay redundant till the end of the day. We only come around daily to warm our seats, as we have no patients to work for. You can imagine that we had over 320 in-patients last five weeks, but as I am talking to you today, there are only 21 patients on admission in this hospital.”
Jos
As the strike embarked by the National Association of Resident Doctors (NARD) entered its third week with no end in sight, the effect of the face - off with the Federal Government seems to be felt by patients who are being forced to return home or look for alternative (for those who can afford it) to manage their ailments.
The turnout of patients at the ever busy new site of the hospital has dropped significantly, due to the strike.
Efforts to speak with the management of the hospital on the statistics of deaths recorded as a result of the strike as well as other difficulties faced, proved abortive. Reports of fatalities could not be ascertained.
The absence of patients at the Plateau State Specialist Hospital, where the strike was said to have been suspended, was similar to the situation at the JUTH. A male nurse who also spoke to our correspondent said the strike had indeed been suspended there.
One Mama Bitrus in the hospital told our correspondent that she was waiting to be attended to “because I was told that the strike has been called off but I have been sitting here since morning and I have not been attended to”.
According to Mama Bitrus, “although I have seen some nurses roaming around but there are no patients in the hospital, I just came because I was told that the strike was called off but from the look of things the things are still not stable.”
The President of the Association of Residents Doctors, Jos chapter, JUTH, Dr. Bupwatda Pokop Wushipba, blamed the government for insincerity on the matter. “It is rather unfortunate that the Federal Government is not doing what it should do,” he observed
He said as an association, the doctors had offered compromises on their position in order to end the strike by asking the government to “give two or three months’ arrears, we would call our members back, we have gone to that extent to show that we are willing to end this for the sake of the suffering masses.”
Asked whether they had considered the consequences of their action, of which repercussions are being felt more by the masses, Dr. Wushipba said “we have looked at that angle; that is why we stepped down our demands, you go on strike you expect that something should be done, it is all about negotiation, let us meet midway; we are ready for that for the sake of the masses, we are not adamant, I want to assure you that we have the masses at heart and that is why we stepped down our demands.”
Our Lady of Apostles (OLA) popularly referred to as Ola hospital is one of the hospitals coping with the fallout since doctors in tertiary hospitals went on strike. Patients troop there early to beat because of the num the crowd.
A large waiting room was full with patients of all ages, male and female waiting to be attended to.
The Medical Superintendent Officer in the hospital Dr. Victor Koledoye who confirmed that the population of patients to the hospital has increased as a result of the strike by resident doctors, said “naturally it should be expected that if one of the major tertiary hospitals is on strike there will be backlash on the peripheral hospitals”.
He said there were a lot of critical cases which should have been referred to these tertiary hospitals, stressing that “but with the current strike we have to try our best to manage the situation here.”
Asked whether they were sufficient space to admit more patients considering the current situation, Dr. Koledoye said “depending on the time the patient comes, you know patients come and go, it is not a static phenomenon, we discharge and admit but on our part we live up to the challenge where we ensure that patients who are fit to be discharged are allowed to go, even if it means as late as three o’clock in the morning in order to create room for other patients.”
The Medical Superintendent Officer said “we only ensure that we work harder especially on the part of the accounts department, who have to work extra hours to prepare patients’ discharge bills in order to create more room for incoming patients, that is another emergency response on our part too.”
Maiduguri
As the ongoing nationwide strike by resident doctors continues, activities at the University of Maiduguri Teaching Hospital (UMTH) have been paralyzed.
The premise yesterday was deserted by patients who probably might have gone somewhere else for treatments as a result of the strike action.
According to a source at the hospital, currently the hospital was not admitting patients as a result of the strike because according to him 80 per cent of the services provided by the hospital were usually the responsibility of the resident doctors.
He explained that conventional medical services had stopped at the hospital, adding that the hospital only made arrangement for emergency cases. The source also said that most of the patients had been discharged and few consultants attend to patients.
Another source told Weekly Trust that the strike action was having adverse effect on health services in the state because most people rely on the federal health institutions since the state hospitals lack the resources to provide healthcare services.
Efforts to obtain comments of officials of the residents’ doctors union as at the time of filing this report were not successful.
Zaria
At the Ahmadu Bello University Teaching Hospital (ABUTH), Shika, Zaria, the doctors’ strike has virtually paralysed the medical activities of the hospital. The ever-busy inpatient centre has now become a ghost of itself while most of the hospital’s medical wards are virtually empty.
However, some doctors of the rank of consultants, nurses and other medical staff of the hospital were offering skeletal services. As a result of this, some patients could be seen at the hospital’s G.O.P.D. and a handful of medical wards.
Our reporter met a patient who is critically ill at the Male Medical Ward. The patient who simply identified himself as Tukur said he was still at the hospital for three reasons.
“One, my condition cannot warrant transfer to another hospital because it is only this hospital that can handle my sickness in the whole of northern part of the country. Two, as you can see the senior doctors, nurses and other staff are still attending to us,” Tukur said.
According to Tukur, his last reason of remaining in the hospital has to do with finance. He said the sickness had kept him in the hospital for the past two months; hence it has exhausted all his savings and even that of his close relatives.
“This is why,” he added, “I have resigned myself to fate. I am waiting for help from Allah. The senior doctors only come here occasionally because they cannot serve the whole hospital. It was the junior doctors who take care of us and they are not on duty. I can’t see reason why the authorities and the doctors cannot reconcile their differences. It is really unfortunate the way things are being handled in this country. If one is not privileged to be rich or top government official, his plight and that of his family are next to nothing.”
The consultants and nurses were also seen offering services at the hospital’s Accident and Emergency Ward, which has the highest population of patients in the hospital now. The A & E is almost full to capacity and this was why only serious cases were being admitted “as the small number of doctors at hand tries to handle existing ones, including serious cases.”
ABUTH’s President of the Association of Resident Doctors (ARD), Dr. Pwandi Alfred Luwa, told Weekly Trust that the strike has paralysed all medical activities of the hospital, describing it as successful.
“I have to confess that it was against our wish that we had to go on this strike because we are aware of its negative impact on our people. However, the strike remains our only option as the government has refused to meet our demands, which we have cut down to four. The four demands were meant at improving our hospitals and the country’s health care system in general. What we are demanding is the equipping of our hospitals with the appropriate facilities in order to stop the medical tourism that our top government officials and their compatriots go abroad. We are also calling on the government to restore oversea training for doctors as Nigeria has the best class of doctors in the world. For that reason, there is need for doctors to be sponsored for abroad training in order to update ourselves with global development in the medical sector,” Dr Luwa said.
All efforts to get the Chief Medical Director of the ABUTH, Professor Abdulmumini Hassan Rafindadi, proved abortive as the CMD was said to be out of the hospital at the time. Calls put through the CMD’s phone by this reporter were not returned.
There were reports of deaths among patients of the hospital; but these could not be confirmed.
According to Dr.Tunde John Aremu NARD National President, ‘’actually the contentious issue now is the arrears of newly approved Consolidated Medical Salary Scale (CONMESS) which we insist the government must pay us. We had the same demand with doctors working with the Federal Capital Territory (FCT) and they sourced for money and paid the doctors.That is why the FCT doctors are not on strike. Minsitryt of Education also had the same problem. When the staff of the Education Minsitry embarked on one week warning strike, government quickly sourced for money and paid them. Why can’t the Ministry of Health do the same thing? The same Ministry owns us five years monetisation allowance which they had not paid. We know somebody is not telling us the truth in the Minsitry.’’
On the issue of NARD members from the south, who disassociated themselves from the strike, he said it was normal. “In every association there is always a discordant tunes.The strike is going on in all the geo-political zones except the South-West. But even if it is one hospital that it is on strike it should concern government .This strike is regretable and painful on our part but government has to be blame. We gave 21-day ultimatum and a warning strike but yet the government did not bulge”.
On the rejection of the strike by their parent union, Nigerian Medical Association (NMA), he said they had the liberty to go on strike with or without the support of the NMA. “It is true that we are affiliated to the NMA but it is also true that he who wears the shoe knows where it pinches. We have our own modus operandi based on the resolution of the National Executive Council (NEC) which we abide by.”
Dr. Aremu said the issue of Hippocratic Oath did not arise because ‘‘the oath has been overtaken by events. Look when the Hippocratic Oath was adopted doctors were at par with royal families of the time in terms of salaries and welfare. They never envisaged that time would come when medical personnel would even agitate for tools to work with. Right now most doctors are leaving the country because the enivironment is not conducive for practice.”
The special Assistant to the Minsiter of Health, Dr. Inyang Oko, said the government has started paying the new CONMESS last month but that the arrears would be addressed by the supplementary budget President Goodluck Jonathan has already presented to the National Assembly. “Immediately the 2010 budget becomes law the Ministry wrote to Ministry of Finance requesting for the N15 billion appropriated for the new salary scale.It was later realised that there was a shortfall of N70 billion which could have taken care of the arrears but we took the N15 billion to enable us commence the payment of the CONMESS.We have started paying the new scale from June.The bone of contension now is the arrears from January which they said must be paid.The arrears and allowances have been captured in the N70 billion supplementary budget. We will pay them as soon as the supplemantary budget is passed we wil pay immediately. We have been pleading with them to see reason with us even before they gave the ultimatum. In fact, Vice-President Namadi Sambo, personally intervened and gave personal guarantee to fastract the process through the National Assembly so that the money is paid to them soon. The Sultan of Sokoto, Alhaji Sa’ad Abubakar also pleaded with them to call off the strike for the sake of helpless Nigerians who patronise the hospitals. We are still engaging them to see reason with us.”
Oko told Weekly Trust that the Minister of Health had already set up a committee with members drawn from NARD to review residency training in Nigeria.
