The Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Amaku, Awka, has been embroiled in industrial crisis in the last two months following an impasse between the doctors and the Anambra Government.
The Association of Resident Doctors (ARD) and Medical and Dental Consultants Association of Nigeria (MDCAN) at the hospital are currently on indefinite strike over improved working conditions.
The Resident Doctors dropped their stethoscope since May 13, while their senior colleagues, the Consultants joined on June 24.
The doctors seem more united and resolute this time than ever to agitate for full implementation of the Consolidated Medical Salary Scale (CONMESS) by the Anambra Government.
They claimed that doctors in the state were the least paid in the federation with the government paying between 38 and 40 per cent of CONMESS.
Also adumbrated as part of the problems were medical infrastructure and Condition of Service for the doctors working in the state-owned teaching hospital.
They are of the opinion that the absence of the Condition of Service was responsible for lack of promotions and in-service problems bedeviling the system.
Dr Chukwudi Okani, Chairman of MDCAN, COOUTH, says the strike is to press home their demand for improved working condition.
Okani, a Consultant Pathologist, reveals that no fewer than 59 full time, honourary and part time Medical Consultants who work at the teaching hospital will not return to their duty post until their demands are met.
The chairman says consultants are worried that six weeks after the Resident Doctors went on strike, there had not been noticeable signs that government is willing to address the issues that led to it.
“Due to the working conditions here, qualified doctors don’t come here to practice and those who agree to come, see COOUTH as a stop-gap where they can stay and look for something better, those of us here are mainly those who have their families here.
“There is a salary structure for doctors which Anambra Government is implementing at between 37 to 40 per cent, and we are calling for full implementation,” he said.
On his part, Dr Obinna Aniagbaso, Chairman of ARD-COOUTH, says the grouse of the association’s members with the Anambra Government are about the provision of adequate infrastructure that will improve clinical and diagnostic proficiency for improved patients care.
Aniagbaso says there is no Conditions of Service which will guaranteed specialist training for resident doctors, granting of in-service training allowance to qualified medical officers and placement of staff on the appropriate salary.
“The meager income hardly meets the bare necessities of life for the doctor and his family, let alone sponsoring professional examination and academic courses of Residency Programme.
“Again, staff of the hospital have been subjected to professional stagnation, without promotion or progress since employment,” he said.
Already, the indefinite strike by the doctors has already taken negative toll on the services of the hospital and patients.
A visit to the hospital reveals that the Male and Female Surgical Wards, Male and Female Medical Wards, Children’s Ward, Gynecology, Antenatal and Baby Care Wards of the hospital are empty.
The in-patients have been advised by the doctors to go and seek medical care elsewhere as they were no longer available to attend to them.
However, COOUTH still renders emergency and skeletal services in the Out-Patients Departments, Accident and Emergency and Children Emergency Response Units.
Few patients are still trapped in the “proverbial two elephants fight”, these are patients who have yet to pay their bills for the services rendered so far by the hospital and have to remain in the wards with no hope of getting specialists’ care.
One of the cases is that of Mrs Ujuka Ifediba, a container lorry accident victim who needs corrective orthopedic surgery in her pelvic and lower limb region.
Ifediba has been in the hospital since May 2018 but the surgery has yet to be done on her.
“Doctors have not attended to me for about two months now because they said they are on strike, they have said I should go to another hospital but that is not possible, I cannot move from here because I am in pain.
“I am calling on Anambra Government to give these doctors what they want so that they can attend to us, moving out is not the option,” she said.
The department of Histopathology of COOUTH says it has noticed a surge in the number dead bodies being deposited in the hospital’s mortuary.
Okani, who is the Head Department of Pathology, COOUTH, says the mortuary facility is overstretched that is virtually no vacancy for dead bodies due to the abnormal increase.
The Pathologist said that autopsies he performed on some of the dead bodies showed that some of them died preventable deaths, and explained that the health sector is “very delicate’’ where government should not allow breakdown at a point in the service delivery chain.
“Whenever there is a breakdown of services in the healthcare service chain, there is always a catastrophic outcome, so, now that the doctors who are the main people why patients come to hospital are embarking on strike, you see so many deaths.
“Doctors should not be allowed to go on strike for any reason,” he advised.
Regretting the strike, Dr Basil Nwankwo, the Chief Medical Director of COOUTH, has assured that deliberate steps are being taken to address the industrial crisis at the hospital.
Nwankwo a Consultant Ear Nose and Throat (ENT) surgeon, says the agitations of the doctors are hinged on three premises, including infrastructure and diagnostic, Condition of Service and Salary.
He says the Gov. Willie Obiano administration has invested not less than N2 billion in the last 20 months on capital projects and diagnostic infrastructure in COOUTH to enable the hospital render optimal services.
“The strike is affecting activities in the hospital, presently we are only rendering emergency and skeletal services,” he said.
Nwankwo says it is misnomer for an institution of COOUTH status not to have a Condition of Service since it became a Teaching Hospital over seven years ago, but quickly adds that his management within about 20 months of assumption of office has been able to prepare the Condition of Service which is awaiting the governor’s approval.
“I must say that the hospital is undergoing massive revolution in the area of investment in diagnostics, we have a newly built oxygen plant, Mother-Child Health Referral Centre still under construction, the Mega Laboratory and others.
“Government has been wonderful, the hospital is connected to category A powerline, which guarantees between 18-20 hours of power supply a day, and a transformer has been approved and installed to ensure steady supply.
“We have developed the Condition of Service. The hospital management board has approved it, the government has seen it and made necessary amendments, that document is awaiting the governor’s approval.
“In no distant time, it will be ready for implementation, and that will take care of confirmation of appointments, promotions and indiscriminate application of rules and others.
“For the take-home pay, we are all aware that financially things are tough but my management has presented the issue to His Excellency, we are optimistic that government will act on it.
“I am using this opportunity to call on the striking doctors to return to work and open the door for more robust discussions so that we can find lasting solutions to the issues,” he pleaded.
Some people are of the opinion that the doctors are self-centred and insensitive to the plight of patients, as the doctors argue that they are not losing anything as the strike will enable them to attend to their private business.
Others argue that a well motivated medical workforce is necessary for optimal service delivery in the healthcare sector which was imperative to guaranteeing a healthy society.
One of the striking doctors said the strike was avoidable as its cost and long term negative effect far outweighs the funding the state government should have provided to raise the implementation of CONMESS to between 80-100 per cent.
The source said no fewer than 12 doctors and seven consultants who have been trained by the institution, some of them with mastery in handling of hi-tech diagnostic equipment may not return as they have found better paid jobs.
He said more were likely to resign and feared that there will be manpower gap and generational gap as the institution might be forced to lower their guard and employ doctors who lack experience as trainers of future doctors.
The source who lauded the efforts of the state government at boosting infrastructure and Nwankwo-led management for developing Conditions of Service, said implementation of CONMESS which was the major problem afflicting the welfare of doctors stops on the table the governor.
“Consultants are not just clinical service providers, we are teachers who train those in Residency to take over but by the time we lose seven specialists with more on their way, we may be forced to fast-track their promotion to fill the gap.
“This strike is avoidable, the solution is simple, just pay the federally agreed salary structure for doctors which is CONMESS.
“From the information available, additional subvention of about N22 million to the hospital will make doctors in Anambra to be at par with their contemporaries in other states and there will be industrial harmony,” the doctor said.
Another stakeholder who pleaded anonymity wondered why the doctors were so determined to ground the system this time around over the same issues that they had lived comfortably with since 2012.
The stakeholder said the impasse might actually be a battle for the soul of the teaching hospital by members of a Christian denomination members who were entrenched in the system.
According to the source, it may actually be a cold denominational war, one group is highly entrenched here, they control over 80 per cent of what happens in COOUT, but it could be they are not comfortable with the management headed by a man from another denomination.
The state government has also appealed to the doctors to return to work as it was working to address their demands for increased salary.
Mr C-Don Adinuba, the Commissioner for Information and Public Enlightenment in the state, said the strike was a profound disservice to the people of Anambra.
He described medicine as a great vocation, noting that medical doctors had throughout world history been recognised as a group whose members lay down their lives for the benefit of humanity.
“Governor Obiano has gone out of his way to raise the standards of the hospital and improve a lot of the people who work and study there.
“In the name of the people of Anambra State, we appeal to the doctors to return to work because of the Hippocratic Oath they have taken to save life.
“We appeal to them to give the government time to conclude essential work on the new national minimum wage before it could start paying doctors a new and separate salary structure,” he said.
Whatever the reason may be behind the ongoing imbroglio in Anambra healthcare system, majority of the people are urging the doctors and state government to find a middle ground to bring an immediate end to the face off. (NANFeatures)
