THE NIGERIAN HEALTH SECTOR: "SOME TRUTHS AND SHAPESHIFTERS" PART 2
Continued from PART 1
By Jide Akeju
The 5 affiliate lions that make up the JOHESU “voltron” are: Medical and Health workers Union of Nigeria (MHWUN); National association of Nigerian Nurses and Midwives (NANNM); Senior staff association of Universities, Teaching Hospitals and associated Institutions (SSAUTHRIAI); Nigeria Union of Allied Health Professionals (NUAHP) and the Non Academic Staff Union of Educational and Associated Institutes (NASU). Of these 5 unions, only 3 are listed as written above amongst the 43 NLC affiliates I counted on the NLC website. There is no union like NUAHP and the closest union to SSAUTHRIAI is SSANU which represents the senior staff association of Nigerian Universities. In a draft released by the JOHESU to protest the non-inclusion of any of their members by the FG to the recently concluded confab, the leadership urged the president to urgently include members of the professional bodies in JOHESU at least.
They mentioned the Association of Medical Laboratory Scientists of Nigeria (AMLSN), Pharmaceutical society of Nigeria (PSN) and the NANNM as potential sources of nominees for the national conference. The PSN, AMLSN and the Nigeria society of Physiotherapist are supposed to be members of the NUAHP together with some unspecified professional groups. If the NUAHP is not listed in the registry of the NLC as seen on the website (except they are a recent addition), how are they part of JOHESU or are they the ones referred to as the Assembly of Healthcare professionals on the JOHESU letter head? Is the SSAUTHRIAI an amalgamation of the SSANU and the Academic Staff union of research institutions (ASURI)? These issues with nomenclature and combinations greatly confuse me and their legality is debatable. How are the Non Academic staff unions of health institutes separated from those of education and the “associated” ones?
How has this heterogeneous community continued to exist and present a seemingly united front in their arguably misguided struggle? I want to believe that some more dominant members of this “Frankenstein” are using their vantage positions to pursue selfish agendas at the same time of misinforming their numerous followers and inciting the public against doctors. The head of JOHESU is a certain Ayuba Wabba who is also the head of the MHWUN and also doubles as the National Treasurer of the NLC. Dr. Ayuba P. Wabba is listed on LinkedIn as an Environmental Health Officer at the Ministry of Health in Borno state. This is the fellow who has been mandated to lead the JOHESU alliance to achieve all sorts of demands that range from skipping of CONHESS grade levels, consultancy appointments to “deserving” members, directors and membership of hospital boards; they also want the termination of illegal posts of deputy chairman medical advisory committee, establishment of residency programs for other health professional bodies and a special entry scale for intern medical laboratory scientists amongst many other demands. The recent interview granted by the Chief Medical director of the University college hospital (UCH) Professor Alonge seems to suggest that the consultant orthopaedic surgeon is supportive of the clamor for consultancy status by other healthcare professionals. The JOHESU members have jumped on this to scream vindication and forget so easily that the man who has voiced support to their demand is also the one guilty of appointing several senior doctors as DCMACs in UCH which they regard as completely illegal. The JOHESU through its many affiliates have rained insults and derogatory remarks on doctors irrespective of the ranks of the doctors concerned. Their usual rhetoric is always about “what doctors are enjoying” at their expense. I wonder if house officers, medical officers or resident doctors are the ones getting appointed as DCMAC or directors. If resident doctors are insisting on better funding for the health sector, how does that translate to reducing the hazard or uniform allowance of records officers, morticians or nurses? They have had several meetings with government representatives especially the ministers of health and labour where promises were made to pacify them. These promises have been repeatedly broken and one wonders how gloating over the sack of doctors by the same FG that has deceived them translates to their demands being fully met. The president of the Nigeria society of physiotherapy (NSP), Oyewumi Taiwo in a press release on the 31st of July 2014 condemned the NMA for embarking on an illegitimate strike and described the venture as a “cheap ego trip” also saying that the NMA has failed in leadership. How has the NMA failed in leadership?
Does the NMA nominate who becomes the minister of health or the medical directors of hospitals?
Is the NMA actively consulted with respect to policy issues regarding national healthcare delivery?
The minister of health that has overseen the sack of the bulk of doctors currently in the system must be a strong member of JOHESU just like the many Chief medical directors who refuse to implement directives that are meant to favor doctors on their books. The minister of health that deceived JOHESU is the same person that NMA do not trust. Information on the website of the NSP indicates that the onset of a residency program for physiotherapists in Nigeria is imminent.
They hope to start with seven specialties: Cardiopulmonary physiotherapy, Community physiotherapy, Neurophysiotherapy and mental health; Orthopaedic physiotherapy, Paediatric physiotherapy, Sports physiotherapy and Women’s health similar to what is obtainable in the United states where majority of their physical therapy doctorate programs have ten specialties Cardiovascular and Pulmonary, Clinical Electrophysiology, Geriatrics, Neurology, Orthopaedics, Pediatrics, Sports, Women's Health, and Wound Care. Physiotherapy was a 4year course in Nigeria until the late 1990s when it was increased to 5years; about the only country in the world where the basic degree is 5years. Most nations offer 2, 3 or 4 year programs. The introduction of an expanded program that involves greater specialization was introduced in the USA, this is generally not a worldwide practice and only one institution in the United Kingdom offers something similar to the Doctor of Physical therapy program popular in the USA. JOHESU affiliates readily point to other climes to justify their demands. It can be deduced that the agitation for a residency program by the NSP has been copied from the USA, it is not what anyone can term as best global practice and regarded as excessive in some climes where masters or PhD programs are viewed as sufficient postgraduate training. Do the NSP have the requisite facilitators and experienced trainers to oversee a qualitative residency program or are they just copying and pasting what is practiced in another place without adequately evaluating the pros and cons?
Concluded in the Final Part
Dr. Jide Akeju