The Unending Crisis In Our Health Sector; An Open Letter To Mr President (1)

Our tertiary hospitals have been paralysed again because a group of people has embarked on a nationwide strike. Yesterday it was the doctors and today it is the non-doctors in the health sector. What is really wrong with our tertiary hospitals? Patients are dying in their numbers while this crisis subsists. A surgeon will manage a critical patient, optimising the patient and when the patient is now stable to withstand the stress of the definitive treatment(surgery) ,one group in the health sector will embark on a strike that will directly or indirectly affect taking the patient to the operating theater. Expectedly,when the strike is called off the said patient must have been dead.

These patients that die out of avoidable circumstances are someone else's brothers,sisters,mothers,fathers,sons,daughters etc. I recently met a surgical patient at the waiting area of the operating theater crying profusely because her surgery was cancelled that morning due to some reasons that I am not permitted to share in this medium. Although she was not my unit's patient,I was moved to know why a preoperative patient should be crying, I was surprised when she told me that the cause of her cry was not because the surgery was shifted till next week, after all flight schedules are cancelled for the safety of the passengers, but because her case is a multidisciplinary one requiring specialist doctors from different specialties to be in attendance during the surgery hence the said surgery would be better handled in a tertiary hospital setting. Her reason for crying was that any of the two warring parties in the health sector could declare strike anytime and any day and until the strike was called off,she would persevere with her health problem ad infinitum.

How many patients are required to die before this crisis will be nipped in the bud? We are still recovering from the effects of the last NMA nationwide strike. There is no way that this crisis will be solved if your government continues its present pattern of resolving the crisis . The government can never please the two warring parties( the doctors and the non-doctors).It has come to a point that the government chooses one party and wield the big stick against the other party. Even our law court cannot please the two parties. Our Lord Jesus taught us not to serve two masters at the same time. Wielding the big stick can come in different ways like privatising all paramedical services in our tertiary health institutions.

Employment of the services of locum paramedical workers while JOHESU national strike lasts. The governor of Lagos state,a renowned legal luminary, did it to doctors in the state. You may also ask Barrister Sullivan Chime,one of my best governors and also another legal luminary,how he brought to an end the incessant unrest in the Enugu state civil service headed by trade unionist,Mr Osmond Ugwu.

Also wielding the big stick can come in different ways. Let the hospital managements and the federal ministry of health that employed the JOHESU members introduce no-work-no-pay. What strength does a striking worker have when he cannot either feed himself or his family? As the government is painstakingly finding the source of financial sponsorship of Boko Haram insurgents,there is the need to block the salaries of these striking medical 'insurgents' at least there is still a court judgement preventing workers of essential services from embarking on strike. My people say that if a snake does not behave like a snake,the children will use it to tie firewood.

This is the time for your government to take a decisive action. It is crystal clear that this crisis in our health sector is becoming cancerous as the days go by and the only definitive treatment to any cancer is early detection and surgical removal with wide resection margin. Even God in heaven never wasted anytime when Satan started this issue of 'international best practices'. The book of revelation reported that when Satan who was made to be under God ( the way the JOHESU members are naturally trained to assist and take instructions from doctors) suddenly came up with demands similar to what we have today among our paramedical professionals,a war broke out in heaven and the concluding part of that passage said that,'they loved not their life unto death.' My subsequent write up under this subject matter will reveal other ways of wielding the big stick against any warring party.

What is really the bone of contention in the health sector? Non-doctors in the health sector discovered that medical doctors were ubiquitous and that there was little or no area of the hospital where doctors were not found hence any industrial action embarked upon by any individual profession in the health sector ,the doctors there would make it uneventful. Owing to this a group of devious professionals sat down and planned how to form a coalition union comprising all non-doctors in the health sector such that they would be using their 'mass effect' to shut down the health sector anytime they went on strike. Simply put, JOHESU was formed to fight medical doctors in our health institutions .

This was evident when federal government sacked resident doctors ,JOHESU members celebrated nationwide while the others had the effrontery to grant press interviews lauding the federal government for a job-well-done even when the JOHESU members were aware that resident doctors were and are still the labour force of the the hospitals. To them whatever a medical doctor or NMA says or does is wrong until proven otherwise. Your excellency, I don't need to say much here because you have already had the experience with the opposition party which believes that whatever Jonathan-led government does or says is wrong until proven otherwise.

What are the demands of JOHESU members?They want to become chief medical directors of our tertiary hospitals .Their hackneyed platitude is, 'international best practices'. Mr president ,how will you feel when a governor or a local government chairman presides over a meeting(not to talk of an organisation ) where you are present ,the reason being that all of you are leaders? The law that established our tertiary hospitals made it compulsory that only fellows of either the national or west African postgraduate medical college and whose certificates are registrable with Medical and Dental Council of Nigeria (MDCN) can occupy the posts of chief medical directors but now these JOHESU members do not want to obey the rule again hence they want the goalpost to be changed at the middle of the game.

However,when you were about to appoint Dr Paul Orhii,the director-general of NAFDAC ,the Pharmaceutical Society of Nigeria(PSN),one of the major components of JOHESU , wrote a lot of petitions on why you should not appoint Dr Paul Orhii,a medical doctor with LLB and PhD in Neuropsychopharmacology,the director-general of NAFDAC. One of their reasons was that you should not appoint somebody who did not have good knowledge of drugs as the director-general of NAFDAC even when the law establishing NAFDAC did not say that the post was only for pharmacists.

They ignored Dr Paul Orhii's knowledge of pharmacology both as a medical doctor and as a PhD holder in Neuropsychopharmacology and for the fact that the man at the center of the crisis is a biomedical scientist who had participated in a lot of international researches involving drugs before you deemed it necessary to appoint him . They forgot that late professor Dora Akunyili,though a JOHESU member by first decree,had all her postgraduate degrees in pharmacology. However,I thank you for being a man that does not look backwards anytime you embark on any project,you still went ahead to appoint Dr Paul Botwev Orhii as the DG of NAFDAC. The same type of calumny came up when you wanted to appoint the current minister of Petroleum,who has summarily disgraced all her detractors by performing creditably well.

Meanwhile when they saw that you were unperturbed by their campaign of calumny against Dr Paul Orhii,the Lagos branch of the association went ahead to threaten dragging federal government to court over carrying out your statutory function of the appointment of the DG of NAFDAC. They mischievously cited section 9(1) of the extant NAFDAC Act ,Cap N1 LFN 2004 which states that,'there shall be appointed for the Agency by the president,the commander-in-chief of armed forces,on the recommendation of the minister of health ,a director-general who shall be a person with good knowledge of pharmacy, food and drugs.'

They forgot that even an ordinary medical doctor with MBBS certificate has a good knowledge of pharmacy,food and drugs let alone Dr Paul Orhii with overwhelming postgraduate certificates from different universities of international repute .They decided to ignore the fact that a medical doctor is naturally trained to be all-knowing in the health sector no wonder at the end of advertisement of any pharmaceutical product,food or drug there will be a caveat, 'if your symptoms persist after three days,consult your doctor.'

They forgot that the United states version of NAFDAC known as United States Food and Drug Administration (USFDA) has had 21 Food and Drug Commissioners(their own name for director-general) ,13 of which were medical doctors,the remaining 8 being 5 scientists, one veterinarian, lawyer, and pharmacist. Even the current Food and Drug commissioner of USFDA ,Margaret A. Hamburg is a medical doctor. Also,our neighbouring west African country,Ghana,their own version of NAFDAC called Ghana Food and Drug Board is headed by my very good friend,Dr Stephen Opuni,a medical doctor .The same is the case in Japan,United Kingdom,Italy and Netherlands. At WHO level,the coordinator of Quality and Safety Medicine ,Dr Lembit Rago,is a medical doctor. The list is unlimited.

Your excellency,by threatening to drag either your government or any of her agencies to court over a decision you legally made in line with your statutory role as the president and commander-in-chief of armed forces of the African's largest economy and 26th best/largest economy in the world, is to say the least very unfortunate and an affront to your personality. That is exactly what the doctors see everyday in the health sector .Remember that Some of them finally made good their threat by challenging your sagacious decision in suit number FHC/ABJ/CS/250/09 .Expectedly,the federal High court judge finally struck out the suit for lack of merit in April 2012. Instead of celebrating the appointment of a technocrat in the person of Dr Paul Orhii ,they continued their incessant diatribe,venom,sinister plot and anti-medical doctors campaign of calumny. That Dr Paul Orhii was recently elected to the much-coveted chair of the WHO's newly established 193 Member State Mechanism (MSM) on spurious,substandard,falsified,falsely-labelled,counterfeit medical products, meant nothing to this anti-Nigerian doctors union. To them,for being a medical doctor ,Dr Paul Orhii is already condemned.

Now,let us critical analyse their reactions during the appointment of Dr Paul Orhii. They tried to convince us that the constitution must be followed hence they cited the above quoted NAFDAC Act even when they were wrong because according to the said Act,a medical doctor,pharmacist or a Food science technician/technologist has good knowledge of pharmacy,food and drug. Your excellency this group that tries to convince us that the law must be followed tenaciously are agitating to break an extant law establishing the tertiary hospitals which makes the position of chief medical director an exclusive preserve of health professionals whose certificates are registrable with Medical and Dental Council Of Nigeria(MDCN) in addition to being fellows of a postgraduate medical college. Will the members of JOHESU repeal the law establishing our tertiary hospitals before becoming chief medical directors or will they just ignore the law and assume the post ultra vires? Your excellency,let me hurriedly point out that I and my distinguished colleagues have been at the receiving end since this crisis in the health sector started. None of our NMA leaders,both at the state level or nationally,has joined issues with either this amorphous group called JOHESU or any of her component members.

Your excellency,it may interest you to know that while we are busy thinking,researching,reading,exchanging ideas on what to do to ensure that our patients recover,they are at the other end planning how to make us irrelevant in our health sector .Will it not be an act of utter folly if medical doctors start struggling to head a drug manufacturing firm/plant?Can a professor of paralegal studies head the ministry of justice or our law courts no matter the many years of practising experience, if the answer is no,how then is it morally justifiable for paramedical professionals to come and head our tertiary hospitals?How can we then allow people that are trained to assist the doctors to now become the head of our tertiary health institutions? Peace,they say,is not absence of war but presence of Justice. Your excellency,ask them if pharmacists will ever allow the pharmacy technicians to head our pharmacy units in the hospital. Also,can the Bsc nurses allow the RN nurses or the auxiliary nurses to head their units?I am very sure that the medical laboratory scientists will never allow either the medical laboratory technicians or the science laboratory technicians to head their units. Let me borrow some adverbs from my twin brother,a lawyer,it it will be morally,culturally,economically,socially,religiously and legally wrong for these medical doctors' aides to now come and head our hospitals. More facts will be reviewed in my subsequent write-ups under this topic.

Dr Paul John
Port Harcourt,
Rivers State
[email protected]

Disclaimer: "The views/contents expressed in this article are the sole responsibility of the author(s) and do not necessarily reflect those of The Nigerian Voice. The Nigerian Voice will not be responsible or liable for any inaccurate or incorrect statements contained in this article."

Articles by Paul John