To protest, or not to protest – a doctor's dilemma


The protests on the withdrawal of petrol subsidies in Nigeria has provided doctors with an ethical dilemma. Do they join the protests on the petrol subsidy removal and “close shop”, or stay in their clinics and hospitals since the service they provide is  an essential one? In many cases, this is a rhetorical question as even when healthcare professionals intend to get to work – this is not an easy feat – especially in areas where the protests have been most intensive, as has been the case in Lagos, Kano, and Kaduna. Unless ofcourse one lived within the hospital premises. 

Photo credit: Jide Odukoya

The Nigerian press reported that both the Lagos University Teaching Hospital (LUTH) and Eko Hospital, Lagos, two of the largest providers of healthcare in Lagos have been rendering only skeletal services since the beginning of the protests. Suleja General Hospital, Niger State discharged all the patients on admission at the hospital as they  claimed that hospital workers had deserted their duty posts to participate in the protests. In Lagos, hundreds of doctors were said to be ‘on ground’ at the epicentre of the demonstrations at the Gani Fawehinmi Memorial Park in Ojota to provide immediate medical attention to protesters who sustained injuries during the protests. 

The professional associations have also been at a loss regarding how to respond, trying hard to stay on the side of the people. First, the Nigerian Medical Association threatened to ask its members to withdraw its services. The President of the NMA released a statement saying 

“The NMA will not hesitate to completely close down all health facilities in the country if government allows the NLC/TUC civil society strike/protest extend to Friday, January 13, 2012”. 

After an uproar by members of the public, it rescinded its own decision. The Association of General and Private Medical Practitioners of Nigeria (AGPMPN) called on the Federal Government to put palliative measures in place and urged negotiations to reduce the price of petrol, while the Ekiti State chapter of the Nigerian Medical Association on Friday opened a free medical camp, where protesters against fuel subsidy removal could receive treatment for free. So it continued…..and my personal view is that medical doctors should not leave their clinical practice to join the protests. We can show our solidarity by not charging the patients that come to us during the protests or even by working longer hours but not by abdicating our duty of care to patients. The patient with her pregnancy, acute abdomen, stroke or cardiac arrest will come, despite the protests, so we really have no choice but to work and care for our patients. Of course, when off-duty we can do what we choose to…..what do you think?  What would you expect your doctor to do?

Photo credit Jide Odukoya

Ultimately, these protests are about much more that petrol. They are also about a failure of trust in government. The Nigerian government expects citizens to tighten their belts while they go on living in ostentatious luxury. But lately, with more access to information on how our government’s spending borders on the obscene, Nigerians are using this access to information to increasingly look to hold our government to account. This is aptly illustrated by this tweet: 

@aizukanne – Are u aware the VP’s medicine cabinet @ N314m is almost as much and the National hospitals total overhead @ N350m

Find the budget for the Federal Ministry of Health hereIn addition to the lack of trust in our government, Nigerians have also had enough of a government that often just refuses to lead. As with the controversial Petroleum Industry Bill, the Health Bill just lies around – everyone in government ignores it. So, for most Nigerians, these protests are also about a lack of transparency, good governance and a wasteful use of our financial resources (not forgetting human resources), and unless the government uses this opportunity to restructure its relationship with its citizens, it is unlikely that Nigeria will know peace for a while to come.

Something has changed in Nigeria and things will never be the same again. Those that want to – let them listen.

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.

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