That Thoughtless Sack Of Doctors, By Bámidélé Adémólá-Olátéjú
Once again, President Goodluck Jonathan can’t stop making a vulgar spectacle of himself. In a move that seems pretty blasé to him, he sacked 16,000 resident doctors in one fell swoop. How rational is that in a country in dire need of doctors? According to the World Health Organization (WHO), Nigeria has a doctor-patient ratio of 1:3500 against the WHO standard of 1:600. Despite its huge population, Nigerian medical schools graduate between 3,500 and 4,000 new doctors annually.
Who is a resident doctor? Maybe I have no idea what resident doctors are in Nigeria. In the United States where I live, if you have ever been on admission in a teaching hospital, you are likely to have come across resident doctors. They are usually about two to five young students in lab coats following your physician as he makes the rounds.
Usually, the consulting physician politely asks patients if residents can observe while the doctor completes his bedside examinations. I don’t know what obtains in Nigeria but it is standard that; residents are participants in a program of graduate medical education and training in a specialized area of medicine. They are physicians in training as well as health care providers. Residents work with other health care team members to provide direct medical care to patients. They diagnose medical problems and prescribe appropriate management and treatment plans. These set of doctors may perform surgeries and other delicate procedures appropriate to their medical specialty and level of training. Before embarking on a residency program, they are required to have obtained a Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), or an MBBS if they are International Medical Graduates. These doctors are routinely supervised by more senior Residents or by consultants. They often take medical histories, performs physical examinations, orders and interprets diagnostic studies. In emergency rooms, they are typically in the frontlines dealing with newly admitted patients in emergencies, in the wards, operating rooms and intensive care units.
Why were they sacked? I can think of no other answer other than the fact that he sacked them because he could. Instead of negotiating with representatives who knows the issues cold, the President inaugurated a committee to find “ the remote immediate causes”…and the usual bromide. Isn’t that the usual time wasting strategy Nigerians are used to?
Unfortunately, no one is telling Mr. Jonathan that his love for committees is taking Nigeria nowhere. The country knows nothing will come out of this committee’s deliberations because committees have become another drain pipe, a way to fleece the people, keep party bosses occupied and remunerated at taxpayers expense. He should cut through the chase and do something or look the other way as he wont to do. I understand the unwieldy committee is called – Presidential Committee of experts on inter-professional relationship in the public health sector and top policy makers of the federal government.
What’s in a name! It is headed by former Secretary to the federal Government Dr.Yayale Ahmed. When did hospital management become the civil service? According to the Secretary to the Federal government, Senator Pius Anyim, “Mr. President had directed that there should be no fresh intake of doctors into any public hospitals. He had, as well, directed that Residency Training Programme should be suspended. The idea is that, until we find a lasting solution to this sector, everything should be on hold.”
Really? Nigeria’s leadership does not appear to have sufficient appreciation for the kind of hole it is in, in every sector; healthcare included. The country continues to feed the Western world, the Middle East and even other African and Caribbean states with its doctors because those counties offer better conditions of service and equipment. A nation that should offer juicy incentives for medical education and practice is busy undermining those who are managing to stay engaged in the system. Even in countries well staffed with doctors; doctors are combing out their options and choosing residencies in radiology, anaesthesiology, and pathology due to significant workload and lifestyle issues associated with demanding programs like Neurosurgery, Obstetrics and Gynaecology e.t.c.
Apart from the shortages the nation experiences, the few doctors available will soon be making choices to suit them and not the country. By sacking resident doctors, the country is inadvertently creating a Nigerian face of medicine where doctors will have diminished ability to be the protector of the country’s poor, needy and weakest element in preference for medical procedure, economization of clinical practice to the detriment of physician managed care and patient advocacy.
These vital links in the comatose healthcare system in Nigeria is what the President severed by fiat via a memo to the health ministry. When the state violate doctors, depress healthcare budgets and seek for ways to rubbish their long training and hours on call, the national healthcare system will only suffer further. Lives will be at risk in the hands of physicians who do not care, who apply inappropriate medical techniques, and have little professional respect for the patient-physician relationship as sworn to in their medical philosophy. Again the National Assembly is asleep while Jonathan fast tracks Nigeria’s intellectual collapse more than any other President before him. For months, University lecturers were on strike with him not giving a rat ass until they wore him down. Polytechnic students were at home for months because their lecturers asked for better conditions. The joke is on him, for every anti-intellectual act he commits; he cements his reputation one more time as the poster boy for naked credentialism with a Ph.D that is not worth the paper it was written on. Most often, I wonder if Nigerians wouldn’t have been better off with a tout as President.
For what it is worth, this President’s history of indelicacies and crude mendacity is becoming unaffordable. While ordinary Nigerians are dying from lack of care, he is in Germany on medical tourism. Where are the Churches and independently wealthy Nigerians if any? The time has come for these entities to pick the gauntlet, build hospitals and rescue Nigerians. Do not wait for the Indians, Chinese and South Africans to start investing in healthcare within your borders like they did in telecom before you appreciate healthcare as an investment area. Wake up and leave government out of healthcare, education, agriculture e.t.c. Politicians do not provide health care; it is the job of doctors, nurses, technicians and allied health providers. Politicians do not provide food; farmers do. They do not teach; that is the job of teachers.
Politicians are lazy drones that we feed to teach us how to organize ourselves. They do not have it in them to create wealth, they redistribute. They produce no valuable goods and services, they consume. Get real people and come to terms that the very idea of electing politicians and by extension having a government is to coordinate the country’s security and law enforcement. Even with that, the Caliphate of Gwoza has shown how they have failed spectacularly in a leading role. Do we need Goodluck with that?
Bamidele maintains a weekly column on Politics and Socioeconomic issues every Tuesday. She is a member of Premium Times Editorial Board.