Since last month, April 17 or there about, other health workers in government hospitals in Nigeria, apart from medical doctors, have stayed away from their duty posts, protesting government’s alleged neglect of their demands for better conditions of service.

The health workers, under the umbrella of Joint Health Sector Union (JOHESU) are made up of the National Association of Nigeria Nurses and Midwives (NANNM), Medical and Health Workers Union (MHWUN), Senior Staff Association of University Teaching Hospitals (SSAUTH), Research Institutes and Associated Institutions (RIAI), Nigeria Union of Allied Health Professionals (NUAHP) and Non-academic Staff Union of Educational and Associated Institutes (NSUEAI): these are simply Nurses, Pharmacists, laboratory technicians and record officers, among others.

Whether anyone would admit it or not, the government hospitals across the country have since the strike began, been empty. Medical attention to downtrodden, helpless Nigerians had suffered serious setback even as many private hospitals, owned by medical doctors in most of the public hospitals, have been enjoying swell time, and yet, more than 30 days after the health workers embarked on sit-at-home strike across the country, the government is putting on an I-don’t-care posture at worse and deceptive concern at best.

Whether also anyone wants to admit it or not, the striking health workers are the heart of the health delivery system anywhere in the world, much more in Nigeria. These are the category of health workers that are close to poor patients and therefore, understand their health conditions at close-range.

Indeed, the seeming lethargy on the part of the government suggests a total lack of will to bring the crisis generated so far to an end, and consequently, playing with the health of the poor Nigerians.

What are the demands of the JOHESU which the minister of health, Professor Isaac Adewole in particular and the government in general has so much ignored and about which they prefer to cut corners?

The union is demanding an upward adjustment of the Consolidated Health Salary Structure (CONHESS) Salary Scale, arrears of skipping of CONHESS 10, employment of additional health professionals, implementation of court judgments and upward review of retirement age of health workers from 60 to 65 years among others.

This is in a system where medical doctors, working in the same establishments are placed on grade level 12 fresh from university, equivalent to assistant director in public service. This is in a system where a graduate Pharmacist, Physiotherapist, Medical Lab Scientist, Nurse would have to spend about 10 years in service, from grade level 06, before catching up with such fresh medical doctor at his point of entry, i.e. grade level 12.

While the JOHESU members are crying their hearts out to the government to improve their work conditions, the medical doctors, who, of course, are also employees of the same government, are asking the government not to listen to their supposed colleagues working in the same hospitals.

The medical doctors, at the height of the JOHESU confrontation with the government, warned against acceding to JOHESU demands, and warned that acceding to the demand would precipitate a crisis that might lead to the collapse of the health sector of the country.

The doctors, under the banner of the Nigerian Medical Association (NMA), even had the temerity to describe JOHESU as an ‘illegal body’ and asked the government to ignore its threat.

The NMA President, Mike Ogirima, at a press briefing said: “nobody is preventing them (JOHESU) from getting a salary increase, but all over the world, there is relativity package for medical workers different from other health workers.

“In Nigeria and other countries, doctors are always at advantaged position which is why most of these other health workers are trying by all means to get that degree called medical doctor. But we know the difference because doctors are trained in all paraphernalia of medical practice, that is why all over the world doctors have a different salary package from others,” Ogirima said.

He advised the government to thread with caution in engaging with JOHESU so as not to “allow rascality in the health sector. It is high time the government regulated the activities of this JOHESU. We are not going to fight with them. We are humane and the health of our patients is central.”

Also the NMA chairman in Abuja, Chiedozie Achonwa, said that medical doctors would be in the hospitals and continue to attend to patients as JOHESU members embarked on strike.

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“I think everybody is entitled to make demands for an increase in salary, including JOHESU. But what the government should put into consideration is that there is an internationally accepted relativity in remuneration for health workers and that relativity must be maintained. Any attempt to distort that relativity means they want the health sector to collapse and I don’t think any of us wants that.”
The NMA had earlier in an open letter to the minister of Labour and Employment, Dr. Chris Ngige, said that doctors are not prepared to receive same salary with other health workers. In fact, top on the list of issues raised by doctors was that JOHESU has no justification to demand for adjustment of salary scale as was done in the case of Consolidated Medical Salary Structure (CONMESS) for medical and dental officers in the federal public service.

However, JOHESU members have explained that they were not clamoring for equality with doctors, but equity and justice, even as they advised medical doctors and the Federal Ministry of Health to change their perception of the demands.

Our concern in Greenbarge Reporters, after listening to the two sides, is the issue of doctors opposing JOHESU’s demands on the government. It is like two brothers asking their father individually to give them something, and one of the brothers asking the father not to grant the request of the other brother. In fairness, such attitude amounts to rudeness or bullying or both, which is not befitting of even the lower cadre of the medical worker.

If doctors have no ulterior motive and they really want to show solidarity or esprit-d-corps to the colleagues with whom they work in the same hospitals, they either should have assisted the JOHESU members to fight their course with the government for the purpose of unity of purpose in the health care delivery system or kept quiet and allow JOHESU members to do the fighting.

Indeed, what the doctors have succeeded in doing is refusing to wake up from the old notion or practice in which other health workers, including nurses, were made to be their messengers who should dare not stand to talk to them or with them. As a matter of fact, the doctors are now assuming a posture of “we are masters and can do all things and we don’t need any God-damned other health workers.”

That the government, especially, the health minister is giving doctors an open support on this master-servant perception by doctors, even him saying that doctors are masters in the health care delivery system, is to complicate the matter. As a matter of fact, it is careless and undiplomatic to classify the status of players in the health sector as masters and servants.

A fresh graduate in medicine can certainly not be a master to say, a senior nurse who must have been in practice for over 10 years and, who can guide the fresh doctor through the rudiments of even the hospital system, administratively, professionally and other processes of learning-on-the-job.

The danger that looms in the health care delivery system, beyond the current strike by JOHESU members is the issue of cohesion, collaboration, friendly environment for every worker to operate smoothly, without bloated ego, superiority complex and grudge, which we now face starkly. When the sense of camaraderie is overtaken by such negative attitudinal indices, what we are likely to have is the two sides; doctors and other health workers, working at a serious cross purpose, which is dangerously unhealthy for the government hospitals. It is dangerously unhealthy too that agents of government, no matter the sentiment, is and should take side with any of the two needless combatants.’

We suggest that efforts should be made by the minister of health and other stakeholders in the health system, to calm the frayed nerves, call the doctors to order on a matter that does not concern them and find ways of rebuilding the solidarity or the much needed esprit-d-corps between the doctors and other health workers for the purpose of smooth operations, and in the interest of the common man and advancement of health delivery system in the country. [myad]