Patients suffer as Nigerian healthcare workers continue strikes; who cares?


This piece is contributed by Chima Onoka. Chima is a friend and colleague. In this honest piece he contributes his thoughts about the ongoing strike that has paralysed public tertiary centres across Nigeria. I wonder how many other colleagues are thinking the same. As we remain quiet…and watch our hospitals deteriorate further, I cannot help but to agonise about Franz Fannon’s famous quote 

 “Every spectator is either a coward or a traitor”. 

Patients suffer as Nigerian healthcare workers continue strikes; who cares?
Chima Onoka

Just about a month ago, at about 11pm, I saw a dishevelled pregnant woman outside the gate of one of the tertiary hospitals in the South East region of Nigeria. She was standing – arms at her hips, and her husband – running up and about!

What was wrong?  She was in labour. No one told her that the hospital she was registered at for Antenatal Care, the big hospital with consultants, resident doctors and ‘necessary equipment’ was shut down. The gatemen did not allow her into the premises because resident doctors had shut down the hospital – they were on strike to protest about delays in payment of wages that were 5 months in arrears! And of course – they move about monitoring the ‘SUCCESS’ of the strike. This woman had obviously agreed on the advice of many, including ‘health professionals’ and the government including MDG champions to leave traditional birth attendants, maternity homes and quacks to ensure delivery in the right kind of facility.

While I mused over the events leading to this and the gory sight before me, a big pick-up van pulled over at the bidding of the woman’s husband. The husband talked to the man who after a while, came out and aided the husband to move the woman-in-labour into the van. The next moment, they were off to God-knows-where.

No one really cares

Does the government care? 
Maybe they do but as far as this strike issue is concerned, no one can really say because they made a commitment to pay the new scale. It is however pertinent to note that many states have continued to say that they cannot pay, and that is quite straightforward. But, really, Can’t They Pay? The fuel that has continued to oil the fire of the strike and other strikes in the country is the ‘IRRESPONSIBLE’ manner in which our politicians deal with the resources of the country. Name it: from the house of reps, to many of the state governors (who their ‘subjects’ have to praise like gods – because they provided a borehole with money that belongs to the same people), to local government chairmen (whose only idea about why they are there, is to collect, share money and mobilize for the governors next election bid or else get replaced by a transition committee), to the state assembly men (who are there to receive money and approve everything that will facilitate they- or impeach anyone in the way of this ‘assignment’). I choose not to mention the senators and the honourable senate who sometime ago felt that one way of encouraging senators to be attending sittings is to increase the ‘sitting allowance.’

Do doctors care? 
I know a tertiary facility in the southeast region that for over 4 months sterilizes all materials in another hospital. So many things are wrong that affect patients and no one ever talks about a strike for these things that ‘affect patients’ – as long as they don’t affect the doctors ‘pockets’ negatively. Negatively I say because this chaos keeps the hospital in disorder, drives the patients away from the hospital – and into the waiting arms of the devouring private clinics, mostly owned or run by the same who ‘don’t mind’ the chaos in the public hospital. Maybe this is how private hospitals ‘complement’ in providing health services to the people.

Looking around, I think doctors don’t really care anymore and the generation is gone. There are many countries (low – middle income countries) where doctors earn a lot less, but we go to them from Nigeria for patients we cannot manage or have even contributed to their mismanagement. India comes to mind readily. I think those in Nigeria don’t care again except for one thing – their pockets – even if it takes the shedding of blood of ‘patients’ – the very reason why the doctor has the job, and salary in the first place.

Do the people care?
There is a nationwide strike in our tertiary care centres across the country and you will hardly read a word about it in our newspapers, hardly hear a word on radio, nor on TV. It is not part of the discussion, simply not on the agenda. As for the woman I saw, there is no one who cares! What doctors just demand for is the wages of those in developed countries. I laugh. Why? Most doctors in Nigeria have no idea about the existence of, and extent of application of ‘Performance Based Management’ of health workers that goes on in those countries and how it is linked with the engagement in service and flexibility of wages. Unfortunately too, our government is yet to see that the effective use of resources should demand that salary increases are channelled to improvement in performance and output. No one cares! After all, they don’t want to be monitored too.

Perhaps conscience and compassion are no longer part of the practice in a place where many don’t manage to eat two meals a day. The few amongst the health professionals who still have compassion should persist in their good work. Though the pocket is important, there is more to life than the pocket, and service to humanity especially in care for the poor, despite all odds is still a virtue. It is lawful and acceptable to make demands for better wages – but it is not expedient to do this at all cost – most of all things – the cost of lives.

As I ruminated over all these, all I could do at that time was to say a prayer for that woman – let her not join the list of 101 women who will die today in Nigeria because they are pregnant. If she does, she will only be remembered by the ‘care-less team’ government, politicians, and their new ‘care-less’ doctor compatriots as a ‘STATISTIC’ – one of the 1000/100,000 maternal deaths that they talk about – and for this lovely woman, the single unit of data she represents fails to call her name – she is dead – face unknown, family unknown, vision dead, children orphaned, husband widowed, a generation lost.

And for the hundreds who are currently dying from cholera in the North of Nigeria, the thousands who are rushing back to quacks, chemists, traditional birth attendants and to native concoctions or even to nothing, giving a deposit to their carpenters to start preparing their coffins – the strike rages and the new strikes are being planned.

Our new Minister of Health just had the usual political ‘reception at Afikpo’ this weekend, and our doctors are looking for ways to make additional money as they must be paid for the strike period – else – they go on another strike!

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

Discussion2 Comments

  1. fmc ido-ekiti strike: management not ready to pay salary to staff despite federal goverment directive putting the whole of ekiti state goverment hospital at shutdown

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