Written by Dr Abdu Adamu
Before we crucify medical doctors lets us ensure we are armed with all the necessary information to make a reasonable judgment. Most often at times, the general public are blindsided by the government during strike actions with political dramas in an effort to demonize those citizens who dare to fight for what they believe in. Unfortunately, nobody has the resources to match the government in media propaganda as such; the undue advantage. Also, in the court of public opinion, emotion tends to predetermine the verdict. No one dares to stand these two weapons and in the end, this ongoing industrial action by medical doctors might just be for nothing.
Notwithstanding, do you ever wonder why India, South Africa, Ghana, Dubai are not just destinations for fun filled holidays anymore especially for Nigerian folks? If you’ve ever taken a personal trip to any of these places then perhaps you might have sat side by side a frail person enroute these destinations for medical attention. People travel to India for dialysis, Doppler Ultrasound Scan and many more simple procedures because they’d have to wait for months or probably till death do them part before it’s their turn in Nigeria. And for the affluent and (not so affluent) Nigerians, their wives no longer give birth in this country because it’s simply one of the worst places to give birth in the world. I would not even dwell much on that of political office holders because most of their reasons for medical tourism are just ridiculous.
It would even be unfair to cite examples with procedures like transplants, joint replacement surgeries; laser surgeries etc that often necessitate travels to India and Egypt. The truth is that they’re relatively cheaper and access is easier in these places. And they do a better job because all the necessary state of the art facilities are at their disposal. Plus you don’t get consulted by a burned out doctor.
These challenges have lingered for several years in this country and are continually killing our health care sector but no one cares enough to truly do a root cause analysis with a view of instituting long lasting solutions. Many people simply assume it’s just part of being a Nigerian; nothing is meant to work. And the general public that are always at the receiving end don’t even see challenges facing the health care sector as a reason to pressure the government. As far as hospitals are open; we just don’t care about the quality of services – even if it’s outright butchery.
We have the manpower but the will power of the political class to revolutionize the system is lacking – but again who will remind them of the need to?
One of the biggest challenges right now is the fact that conduct and procedures within the health sector are being politicized for cheap gains. Legislatures and Executives in our government are maneuvering nomenclatures and that cannot be allowed to happen. The term “Consultant” is reserved for a medically qualified person who has passed through postgraduate medical training. It’s a standard. Simple and short!
An industrial action within the health care system cannot be rationalized. And considering the proximities of life and death in a doctor’s job, ethical argument usually erupts when strike actions are embarked upon. A rather pan misconceptions exist that doctors are bounded by the Hippocratic Oath and as such are breaching their ethical responsibility during strike actions. First of all, Hippocratic Oaths are sworn by fresh medical graduates and are basically for patients benefitting in doctor patient relationship on an individual level. Doctors have an even greater responsibility to the general public’s health than towards treatment of an individual under their care as such doctors cannot give room for poor quality of care if betterment can only be achieved through strike action. In fact, what is unethical and borderline immoral is when doctors don’t strike during patient endangering circumstances like poor standard of residency training, inadequate funding of health care facilities, empowerment of non-medically qualified individuals to embark on direct patient care etc.
Ethical guidelines are a description of a doctor’s duty and they identify particular PRIMA FACIE obligation which guide moral behavior. Medicine upholds two important principles which are the Duty of Fidelity (obligation to keep promises) and Beneficence (obligation to try to do well, to actively help others). These principles might appear to stand against strike action but one should not forget that keeping promises and doing good applies to current patients and not future ones. Duty of Justice must also be considered. Justice is often defined in terms of fairness and equity but we must understand that justice is not limited to others but also to oneself and family.
In the past when Nigeria was still a dictatorship, most medical doctors left for more comfortable societies with saner governments because of the continuous decay of the system. As a doctor nothing gives you more satisfaction than the lives you save and nothing depresses you more like the death you could have averted.
We are in democracy now. International best practices can be institutionalized in our country and someone must stand for it.
All that is necessary for evil to triumph over such a long time and to such a colossal extent is when stakeholders decide to fold their arms and do nothing. A strike action is sadly the only way doctors can draw the attention of our “democratic” government but it would yield little or no result if the public does not personalize this struggle and join the quest for an improved health care system.
Dr Abdu Adamu can be reached via firstname.lastname@example.org