•Tells Nigerians: We feel your pains but blame FG, govs for strike
•‘Our hazard allowance is N5,000, each senator collects N1.2m’
By Chioma Obinna
The Nigerian Association of Resident Doctors, NARD, convened an extraordinary National Executive Council meeting on April 7, 2021 to review their ongoing strike and the offers of the Federal Government so far.
The NEC, attended by over 100 members from more than 60 centers across the country via zoom after deliberations, voted unanimously that the “total and indefinite strike”, which started on April 1, be continued until the federal and state governments meet their demands.
Sunday Vanguard spoke with the National President of NARD, Dr Okhuaihesuyi Uyilawa, who said that, despite efforts of the national officers of NARD to ensure that the Federal Government does the needful to prevent the strike, government has continued in their insincerity of promises hence the current stalemate.
Why NARD is on strike
It is no longer news that government appointees have continued to renege on the MOU signed by them over the years. This has culminated in fatigue among our ranks and has further worsened brain drain in our country.
NARD gave a two -month ultimatum before declaring her industrial action when it became apparent that the Ministry of Health was not interested in any form of settlement to avert the avoidable action. This is at variance with the falsehood being peddled by the Honourable Minister.
The Memorandum of Action, MOA, signed was after 12 midnight on March 31, 2021 when the ultimatum had elapsed. Without prejudice to our labour laws and other extant laws of the land, the industrial action had already begun before the MOA was signed and, as such, not tenable.
For over 30 years, NARD has had to contend with harsh working conditions, poor infrastructure and poor remunerations and brain drain. In 2020, the country was hit by pandemic, causing health workers to lay their lives for humanity. This was applauded the world over because everyone knows the poor health indices in Nigeria and Africa at large.
Again, our demands are legitimate and government has acknowledged that. The Hon Minister of State for Health, Dr Mamora, wholeheartedly agreed that all the issues raised by NARD are germane and legitimate. He admitted that bureaucratic bottlenecks in government led to delay/ non-implementation of previous memoranda signed with NARD.
What are these demands?
Our first contact to any sickness or disease who we call House Officers have been working tirelessly and, for four months now, they have not been paid salaries knowing the harsh economic realities in the country, worsened now by COVID-19. This was caused by the ineptitude of the Registrar of the Medical and Dental Council of Nigeria.
Our members on the payment platform called GIFMIS otherwise known widely as non-regular payment platform has not been paid for over four months. Is this not the height of wickedness? During the outbreak of the Covid pandemic, Nigerians called on doctors to help combat the spread, this we did with zeal. In this process, we lost 17 of our members while in the frontline of the menace caused by the pandemic. So, we said “please pay the loved ones they left behind”, but all we hear is government has released money and yet none of these loved ones have been paid.
We cried out and said our hazard allowance is just a paltry sum and the worst in the country. People are paid 1.2million for hardship allowance where they sit down and do nothing, yet the ones who face the real day-to-day hazard are paid nothing if you ask me. The specialist allowance for our specialist cadre is still not paid despite the MOU signed in 2017. These are just a few of our demands and government has reneged on them despite being told since 2017.
Our members in the state tertiary health institutions are impoverished. We said this is an emergency and government has done absolutely nothing. How do you owe over 20 months short payment and you expect our members to keep quiet? Abia owes 20 months, Imo is owing several months, how do you reconcile that? The strike has been total and indefinite and our members have been compliant. We are demanding immediate payment of all salaries owed to all house officers including March salary (regardless of quota system) before the end of business on March 31, 2021.
As of today, although payment has been made to some of them, the payment is marred with so many irregularities. Most of them are still not paid. Also, we want immediate payment of all salary arrears including March salaries for our members in all federal (GIFMIS platform) and state tertiary health institutions across the country. None of these doctors who have worked for over four months has been paid.
Our members in ABSUTH (Abia), IMSUTH (Imo) and UNIMEDTH (Borno) are still asking for upward review of the current hazard allowance to 50 per cent of consolidated basic salaries and payment of the outstanding COVID-19 inducement allowance. The hazard allowance has remained N5, 000 for over 30 years. For the Honourable Minister of Labour & Employment to feign ignorance of this on national television leaves a lot to be desired.
This is an all-time low coming from someone who has been in the Senate where the monthly hardship allowance for senators is N1,242,122.70. For the government to be asking for five weeks for its review despite the ongoing strike is really shameful. A sincere government should immediately call all stakeholders together to address these issues once and for all.
We are also demanding payment of death in service insurance for all health workers who died as a result of COVID-19 infection or other infectious diseases in the country. This legitimate demand has been left unattended. On the payment of salary shortfalls of 2014, 2015 and 2016 to our members in federal institutions including state-owned institutions as earlier agreed with NARD, nothing has been done in this regard.
Again, there is the issue of the universal domestication/implementation of the 2017 MRTA by all federal and state-owned training institutions to ensure proper funding of residency training in the country as stipulated by the Act. Nothing has been done about this especially by state governments. For the records, the Medical Residency Training Act was signed into law in 2017. Our members have been crying since then that they should pay us the incomplete sum they signed and no government has not done that.
In 2020, following the intervention of Rt Hon Femi Gbajiabamila, we had N4 billion approved to kick-start the process of payment. Now, this payment was epileptic and we approached them and asked it be looked into because we have our members from 2017 till 2020 who weren’t paid. They said they couldn’t pay the backlog we met and agreed and we said pay from 2019 till now but nothing has been paid. Our members are due for exams now in 2021 and yet they have not been paid. We are also demanding the abolition of the exorbitant bench fees paid by our members on outside postings in training institutions across the country with immediate effect.
This is the only positive result from the conciliatory meeting with government, but there is no circular yet to back the abolition. We asked for immediate payment of 2019, the balance of 2020 and 2021 Medical Residency Training Funds (MRTF) to our members including those under state government employment.
Despite our constant engagement with the Federal Ministry of Health on this issue, it was shocking to us that it took the conciliatory meeting by the Ministers of Labour and Health to be instructed to go and check if funding for residency training was captured in the 2021 budget. We were disappointed over the misinformation spewed out by the Honourable Minister of Labour and Employment.
For the avoidance of doubt, NARD is not a financial arm of government and, therefore, not involved in any form of payment of residency training funding as was alleged in the meeting called at the instance of the Ministry of Labour and Employment. To set the record straight, the offices and officers involved are the National Postgraduate Medical College of Nigeria and her Registrar as well as the Office of Hospital Services and her Director. When the errors in payment were noticed, NARD informed both bodies appropriately for further action as may be necessary.
We also demanded the immediate review of the Act regulating Postgraduate Medical Training in Nigeria in line with international best practices to remove the unnecessary rigours in residency training in Nigeria, one of the factors attributed to brain drain in the health sector. Nothing also has been done here. The reintroduction of medical super salary structure and specialist allowance for all doctors as already approved for some other health workers, no mention was made about this very germane demand of our members. We view this as insincerity amongst government officials which has stalled meaningful negotiations in the wake of the current impasse.
You said some of the demands have been there for 30 years. What exactly has government done to address the issues?
This is the question we enjoin well-meaning Nigerians to ask government. Government appointees signed MOU, the people pleaded with doctors to resume, we listened and suspended strike, then government goes back to sleep. This has been a recurring decimal. Government claiming to be doing something is laughable and should be featured in a comedy skit. They have acknowledged that the demands are legitimate but have not done what they ought to do hence the stalemate we are having.
Are resident doctors paid abroad?
The world over, resident doctors are paid while they provide services and take their exams. In the USA, the Graduate Medical Education Budget is as high as 150 billion dollars. They recruit doctors into residency which has over 31,000 spaces. In England, there are about 16, 000 residency spaces, all these are in cyberspace, you can look it up for proper investigation. They even pay rural allowances in far north of England for over 15, 000 GBP. So, let’s not be disturbed by falsehood spewed by government appointees when they show gross ignorance.
On the threat to fine members in state hospitals should they fail to join strike
The NEC fined all her members nationwide should they fail to join the strike, it is normal union practice to keep at bay erring behaviours. The state institutions are badly hit. We have had meetings with state governors to domesticate and implement the MRTA and yet they have not, only a few state governors like Governor Ifeanyi Okowa in Delta have done it. Governor Fayemi (Ekiti) has also done well and our engagements with him have been fruitful. Governor Makinde of Oyo State is also doing well. So we enjoin other governors to follow in that trajectory.
Doctors in the states joining the strike will definitely affect patients and thereby removing the only olive branch to cushion the effects. What alternative is left for them?
The masses include you and me and our relatives. We know the pains they feel but let’s not forget that doctors are also human, they have children, parents and loved ones they care for too. We also need to be emotionally, physically, and financially stable to give top quality health care to the masses as well. Their hardship is from the failure of government appointees.
Shortage of doctors and brain drain currently affecting health services, how many resident doctors do we have in Nigeria?
Nigeria should have nothing short of 40,000 resident doctors but what we have now is around 16, 000; this has led to burn out and fatigue among doctors. For each tertiary hospital, the strength is dependent on the capacity of the hospital vis a vis bed space and consultants for training. The major cause of physician burn out and fatigue stems from acute shortage of doctors in these health facilities.
Still on your meeting with government, will you say government has handled issues regarding hazard allowance well in the face of a pandemic?
The answer stares at you in the face. Government appointees rake in millions from our commonwealth while those confronting the real hazards get a paltry N5, 000. HIV, hepatitis, Lassa fever and COVID-19 stare at us in the face on daily basis.
What is the way forward?
The cost of the strike is both on us and the people of Nigeria who we provide health care amidst the austere working conditions. We have told government our minimum requirements; when they do that, we will return to doing what we do best which is saving lives.
Many of your members are leaving the country after training. How do we reconcile this?
This again comes from insecurity, harsh economic realities and poor infrastructure. This is what we are crying out for. Government should do the needful to keep doctors here.
Despite the COVID-19 challenge and the fact that you are on strike, President Buhari went overseas for treatment. What is your take?
You should look at the scenario. The high and the mighty enslave and impoverish us. When we take ill, we are left to the poor health care facilities. When they are sick, they go to the UK, their wives to Dubai, their daughters give birth in Dubai, their sons seek healthcare in Germany.
These are real-time issues, corruption is our major issue, if they invest in health care in Nigeria, trust me people won’t emigrate. President Joe Biden seeks help in America, PM Boris Johnson had COVID-19 and was treated in a public facility in the UK because, over the years, they have built good health systems and are still largely investing in public facilities. We continue to push on.