Confusion as NMA threatens to sanction resident doctors over nationwide strike

The resident doctors are on a three-day warning strike.
The industrial action embarked upon by the National Association of Resident Doctors, NARD, is trailed with controversy as the doctors and the Ministry Of Health give different accounts of the cause of the strike with the Nigerian Medical Association, NMA, turning her back on the striking doctors and threatening to sanction them.
The national body of the resident doctors had Wednesday given a directive to all its members to embark on a three-day warning strike which is scheduled to end on Saturday.
The resident doctors commenced the strike to press home their demand from the Ministry of Health and the Federal Government following alleged breakdown of previous communications.
The president of the NARD, Ismail Lawal, said the doctors are protesting poor funding of residency training of its members by the Federal Government. He said the “strike is not to make people suffer unduly” noting that unlike previous industrial actions, concrete plans were on ground to avoid loss of lives as emergency cases would be treated in all hospitals across the country.
A residency training is a structured six year programme which some doctors undergo in order to become specialists in various fields of medicine.
“All we want is for the government to take training of resident doctors as a serious issue, which will eventually be of great benefit to the country,” he said.
Mr. Lawal said that only N20 million was allocated for training of resident doctors in the 2013 budget as against N150 million allocated in previous budget.
“This is a huge difference as you can see and this is the month of June and most of our doctors have not gone on training.
“We have asked for a supplementary budget for the training, but the Federal Government has failed to honour our request,” Mr. Lawal said.
Residents doctors have complied with the strike directive from the association. At the Lagos University Teaching Hospital, LUTH, Idia-Araba, Lagos, only emergency cases were being attended to while the outpatient unit remained shut.
The case was slightly different at the Ahmadu Bello University Teaching Hospital, ABUTH, as the strike paralysed the teaching hospital. Out patients who trooped to the hospital left ABUTH in utmost disappointment, while those on admission were attended to by nurses and senior doctors.
Corroborating Mr. Lawal’s claims on why the NARD embarked on the strike, Emeka Ugwu, President of the LUTH Chapter of the association told PREMIUM TIMES that “we’re on strike because we have to follow our national directive and it has to do with issues about training of resident doctors.
“We believe that Nigerian doctors can be trained to the equivalent of what obtains abroad and Nigerians won’t need to go abroad anymore for medical treatment as what obtains at the moment. We want the government to provide sufficient funds for residency training”.
According to Mr. Ugwu, the NARD had given a 21-day ultimatum which expired on June 18, and also gave an extra eight day extension which ended on June 26.
“We are appealing to Nigerians to please understand what we’re doing; it is in their own interest and the present state of health in the country is quite unfair to them. We however appreciate the present minister of health and the president for providing funds for training but it is not enough,” the Lagos doctor said.
PREMIUM TIMES learnt that some hospitals like LUTH were given about N21million last year to train 500 resident doctors, an equivalent of N42, 000 per doctor while the teaching hospital in Enugu got only N5million.
The University College Hospital in Ibadan reportedly got nothing which affected the residency programme of the doctors.
“In LUTH, we have a large body of residents while an exam costs more than that sum. Is there any course that can be taken care of by that sum?
“We want Nigerians to prevail on the government to provide sufficient funds so that we can have standard healthcare delivery system. We still do have specialists in the country, thus, it’s high time Nigerians get involved,” Mr. Ugwu said.
Health Ministry denies doctors’ claims
The Health Ministry has, however, given a different reason for the cause of the strike, blaming the doctors.
Speaking in an interview with PREMIUM TIMES, Yusuf Isiaka, spokesperson of the Health Ministry, said “the doctors are not being straight forward. There was a meeting with them all up till last week. They are demanding for increase in their allowances and we’re going through due process. They are lying. We are indeed really surprised that they embarked on such a strike”.
Also, Dan Nwomeh, Special Assistant on Media and Communication to the Minister of Health, Onyebuchi Chukwu, said that ”one thing you should know about this labour people is that it is not what is actually happening that they present to the public. It’s their selfish interest that they want satisfied, not the good of Nigerians”.
Mr. Nwomeh said “The health ministry, NARD, NMA and other sectors under the NMA held meetings and there were outcomes which we all agreed on and were duly signed by all parties involved. It’s a local issue involving ISTH (Irrua Specialist Teaching Hospital) and not what they are presently claiming.
“I guess that the CMD is not treating them well but his tenure is to end in August, while the minister of health says he should remain till then and vacate the office thereafter. The doctors want him out by all means out of fear he may elongate his stay.
“These doctors don’t know how to tell the public the truth because the man has committed no crime,”he said.
Official documents made available to PREMIUM TIMES show that the Health Minister, Mr. Chukwu, held a meeting on June 14 with the NARD and the ISTH Branch of the association.
The NMA and representatives of the Board and Management of ISTH also attended the meeting, which was sequel to a strike notice served the Health Ministry by NARD, over some industrial issues at ISTH Irrua.
“All the contentious issues were resolved and a joint statement of the resolutions was duly signed by the appropriate representatives of the FMOH and NARD respectively,” the health ministry said in a statement released before the resident doctors strike.
“However, following a motion for injunction against the planned strike by the Chief Medical Director (CMD) of ISTH , a motion that has not even been granted, NARD reacted by serving fresh notice of a national warning strike; not a local ISTH strike by the hospital’s ARD.
“Though the Honourable Minister of Health has directed that the matter be withdrawn from court in the spirit of the earlier agreement, NARD is now demanding for the suspension of the CMD of ISTH Irrua.
“It should be noted that the demand for the suspension of the CMD was not the raison d’être for the planned warning strike, and was not on the list of demands that were tabled at the meeting between NARD and the FMOH.
“The Honourable Minister of Health therefore condemns the planned strike action and calls on NARD to rescind the decision to proceed on the strike and allow the implementation of the comprehensive resolutions of 14th June 2013,” the health ministry added.
NMA threatens sanctions
The Nigerian Medical Association, NMA, has also distanced itself from the industrial action embarked upon by the resident doctors, threatening to sanction them.
The NMA President, Osahon Enabulele, said he is embarrassed by the industrial action because the medical group had actually reviewed the issues of dispute and “initiated measures to correct the perceived anomalies with verifiable positive outcomes”.
“The Nigerian Medical Association (NMA) regrets the ongoing 3-day warning strike embarked upon by members of NARD which began on Wednesday 26th June 2013,” the union leader stated.
Mr. Enabulele said during its first National Health Summit held in Asaba in January 2013, Nigerian doctors resolved “without equivocation to banish the evils of embarking on strikes at the slightest provocation without allowing for exploration of constructive and peaceful means for dispute resolution”.
He warned that “the NMA would not withhold applying the strongest sanctions on any erring affiliate body or individual member for violating the extant laws/constitutional provisions of the association or for bringing the association/ medical profession to public disrepute or for the blatant disregard for its fundamental principles, values and her mandate to protect the health of Nigerians.
“NMA, therefore, apologises to the entire nation for the hurt and the avoidable deaths and health complications that could result from this strike action by NARD.
“The NMA once more through this forum advises the leadership of NARD to consider all appeals from various quarters to call off the strike to allow for a well articulated, constructive and mature engagement with the relevant offices of government.
“Finally, we appeal to the Federal Government to correct the observed budgetary shortfall and apply all necessary administrative sanctions to any erring head of health institution,” Mr. Enabulele said.

Brain drain
Meanwhile , the resident doctors leader at LUTH, Mr. Ugwu, has stated that there is a direct relationship between the poor residency funds and the ongoing medical brain drain being witnessed in the country.
“A doctor who has given extra six years and is not being given the appropriate environment gets frustrated and would gladly leave the country when such opportunities which often presents itself comes knocking.
“Believe me, Nigerian doctors who end up going abroad perform wonderfully well, thus, we can note where the loopholes lie,” he said.
“The training of a doctor is continuous and can never stop and when they are not getting these trainings, they fall short of providing services befitting of this 21st century. The government should please make sure it doesn’t escalate beyond this,” he added.
Mr. Uwgu reiterated that the present poor budgetary allocations for training of residents has dire consequences for the health sector.
“If hospitals do not have funds to train, then they won’t employ residents and residency training and hospital management requires a balance. Mind you, there’s a cascade effect. Medical students will at the long run be affected as it is resident doctors who do teach medical students (bedside) and which is the main training needed in diagnosis, investigations and clinical knowledge.
“If we don’t have properly trained residents, we’ll not have properly trained consultants (specialists) and medical students. The consequences would be quite dire in the lives of patients at the long run as it would worsen healthcare and medical education than what presently obtains,” he said.



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