A never-ending cycle of doctors’ strikes and funding debacles leaves Nigerians at the mercy of the pandemic

Doctors in Lagos State embarked on a three-day strike from July 13 to 15, to protest the absence of adequate safety and welfare measures for doctors working with COVID-19 patients.

The Premium Times online newspaper reported that Oluwajimi Sodipo, head of the Lagos Doctors Guild, announced the strike at a press briefing on July 12, in protest of the disparity between COVID-19 hazard allowances for Lagos doctors and their colleagues in federal hospitals.

Doctors working in Lagos coronavirus isolation centres also lacked sufficient Personal Protective Equipment (PPE), health insurance and were also owed two months’ salary, Sodipo said. The Guild exempted doctors working in the state isolation centres from joining the collective action.

As of July 21, Nigeria had recorded 37,225 confirmed cases of COVID-19, 15,333 recoveries and 801 deaths. Lagos State, the country’s most densely populated state, is the epicentre of the disease, with 13,538 confirmed cases, 1,964 recoveries and 176 deaths.

The Lagos State government on July 13 appealed to the frontline medical workers to return to work. The doctors suspended their strike on July 16, due to the “positive disposition” shown by the Lagos State government to their demands.

An unending cycle of rinse and repeat
Strike action by Nigerian medical doctors has become an annual occurrence in Africa’s most populous country. Their grievances are always the same: a demand for increased welfare measures and protection in order to do their jobs better.

The sequencing of the government’s response is equally predictable: initially, it’s high -handed, with a threat to sack the striking doctors if they don’t return to work. Then it usually backfires, forcing the government to back down and concede to the doctors’ demands.

This pattern of events has remained consistent even in the face of a global public health crisis.

In mid-2014, Nigerian resident doctors (those undergoing specialist training) went on strike during the Ebola epidemic over welfare demands. The Nigerian government responded by terminating their appointments, then later soft-pedaled and blamed the media for misrepresenting the facts of the matter.

Six years later, on June 15, resident doctors again went on strike during a major public health crisis to protest poor working conditions and inadequate — or unpaid — welfare measures provided for those working on COVID-19.

Twitter user Dr. Nma Halliday sarcastically compares the ridiculously low monthly health hazard allowance given to Nigerian doctors (60,000 naira, or about $144 USD per year) with the annual newspaper and hardship allowances paid to Nigerian legislators, which amount to 1.2 million naira ($3,000 USD) and 1.24 million naira ($3,200 USD] respectively:

True to form, the government threatened yet again to sack the doctors when negotiations ended in a deadlock on June 17. But the doctors resisted the intimidation and stood their ground. The strike was eventually called off on June 22, following the intervention of state governors and federal legislators.

Controversy over funding for COVID-19

University College Hospital, Ibadan is the first teaching hospital in Nigeria via Hizick27 / Wikimedia Commons / CC-BY-SA-4.0.

During Nigeria’s COVID-19 crisis, some government funds, allegedly given to a teaching hospital in southwestern Nigeria, became an object of controversy. What started as a routine press briefing about the matter quickly degenerated into denials and counter-accusations.

On June 23, Akinola Ojo, health commissioner in Oyo State, southwestern Nigeria, announced that the state government had spent 2.7 billion naira ($6.9 million USD) in their fight against COVID-19. According to the financial daily BusinessDay, Ojo stated that part of the expenditure included the 118 million naira ($304,000 USD) “given” to the University College Hospital (UCH), Ibadan “as support.”

But the following day, on UCH’s Facebook page, the hospital denied having received any COVID-19 funding from the Oyo State Government. Spokesperson Toye Akinrinlola suggested that due to confusion between the names of the College of Medicine Ibadan and UCH, the College of Medicine Ibadan was the likely recipient of the government funds.

This suggestion was “emphatically and categorically” rejected by the College of Medicine’s management, which stated that it had not received any such funding from the state government.

Though separate institutions, the College of Medicine and UCH are intertwined. The College is part of the University of Ibadan, while UCH falls under the supervision of the Federal Ministry of Health, but students from the College of Medicine and other healthcare specialists from sub-Saharan Africa undertake clinical training at UCH.

On June 24, the Oyo State government insisted that the funding in question had gone to UCH’s virology department, and described attempts by UCH management to “disown” its own clinical virology department that also provides “teaching and research” services to the College of Medicine as “self-serving, artificial and contemptuous.”

The following day, the media office of the governor of Oyo State tweeted a screenshot of a press release in which the head of UCH’s Department of Virology acknowledged receiving financial support from the state government for the fight against COVID-19.

A tale of two testing labs
The controversy stems partly from the fact that there are two laboratories approved by the Nigerian Centre for Disease Control (NCDC) to conduct coronavirus tests in Ibadan, Oyo State: the laboratory of UCH’s Virology department, accredited on March 28, and the College of Medicine’s Biorepository and Clinical Virology laboratory, approved on June 9.

Both laboratories are based in the same facility.

The Biorepository laboratory was commissioned on April 17. This molecular pathology lab was initially conceived as a tissue bank, and its foray into the coronavirus testing appeared to signal internal wrangling — possibly a battle for supremacy between the College, UCH and its virology unit.

It has since been confirmed that UCH’s virology department was the recipient of the state government funding but the entire process lacked transparency.

The fact that UCH management and the College “disowned” the virology department suggests that they were not privy to the funding.

Why did the virology department act independently? Into which department’s bank account was the said donation from the state government deposited? We may not have heard the last on this controversial donation.

In the final analysis, scenarios such as doctors’ strikes and funding debacles are bound to recur until the root cause of the problem — inadequate funding —is exorcised from Nigeria’s public health system.

It is untenable that doctors and healthcare workers on the frontline of a pandemic should be paid peanuts while politicians who risk little or nothing earn fat allowances.

Also indefensible is the fact that some public hospital administrators seem uninterested in serving the common good, choosing instead to engage in petty rivalries, to the detriment of the health of their patients.

Until something gives, ordinary Nigerians are left at the mercy of a ravaging pandemic.

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