Doctors’ strike and the ‘flown abroad’ syndrome by Mike Ikhariale

On Monday, July 1, 2014, the Nigerian Medical Association, NMA, the umbrella organisation under which medical doctors in the country are unionised to promote the common interests of their members and the medical profession generally, embarked on a strike action that it described as both “total” and “indefinite.”

As much as I do not support the frequent disruptive outcomes of strikes in this country, given the dire straits in which the nation’s health care delivery system has found itself, I am “totally” and “indefinitely” in support of the strike. It is not normal for professionals like doctors to walk out of hospitals with patients dying unattended to but if only to limit the casualties in the long run, then, this action as unpalatable as it is, becomes inevitable.

In any case, it is almost turning a way of life in Nigeria that until a dispute, economic or political, gets to a boil at which point combatants resort to the most unorthodox and deadliest of strategies, government does not see reason to respond civilly and promptly to such demands. The result has been that key institutions of states like universities and hospitals are perpetually placed under lock and key just to make the most elementary of demands noticed and responded to accordingly.

I am particularly alarmed by the decadence that the nation’s medical institutions and facilities have fallen into. The other day, gory and shameful photos of the decadence that has befallen LUTH, a premier health institution where doctors and other professionals in the medical industry are supposed to be trained and mentored for the need of the medical needs of the country, were published to the astonishment of many. The decadence at LUTH is replicated all across the country with the situation progressively worsening as you move away from the urban centres to the rural communities.

The NMA has catalogued what it considers as wrong with our hospitals and medical professions; it listed the longstanding underfunding of health institutions and the demonstrable low attention paid to medical personnel by the government. It also drew specific attention to their professional dissatisfaction with the non-recognition of the profession in key positions in government.

I don’t see anything too impossible in what they are asking for. Even the more economic ones like their call for the increment of hazard allowance to N100, 000 monthly and the establishment of a health trust fund that will enhance the upgrading of all hospitals in the country are not too much. In view of the annoying undeserved opulence regularly displayed by our “Excellencies”, their wives and aides, the amount the doctors are asking for contextually pales into chicken feed.

There is nothing more indicative about how disdainful our leaders treat our doctors and the medical facilities in this country than the fact that it has become the fad that once a member of the nation’s elite class develops any medical condition, be it common cold or the serious ones like cancer, the only possible destination is outside Nigeria.

Whether it is the President of the Republic, his wife and family or a private individual eking out a living somewhere, all medical challenges must now be taken abroad as if there is an official conclusion that our hospitals are now no-go areas. The majority of Nigerians that fly out of the country daily are actually going for medical treatment. Whenever there is a medical problem, the first thing that comes to their minds is how to get out of the country. Yet we are supposed to have hospitals manned by men and women who are well-trained in the various fields of medical practice.

The other day I was discussing a running nose with an academic colleague and he told me that I shouldn’t just take it as a common cold as had been casually diagnosed by “our doctors” and that I should proceed immediately to South Africa. Right there inside his car he put a call across to South Africa and in a jiffy I was speaking with a medical person who clearly laid out a whole range of possibilities towards resolving my problem.

I was impressed by the professionalism exhibited and when I compared the information I got from just a telephone conversation with my earlier physical visit to an hospital in Lagos, it was already clear to me that the long-distant conversation had addressed my needs as against the dismissive “Prof, you alright and there is nothing wrong with you” that I got here even when my nose was dripping like a tap. The fellow I spoke to in Pretoria probably attended the same medical school with the one I visited in Lagos but it was obvious that while one was working with antiquated and obsolete tools the other was taking full advantage of science and technology in their latest forms.

In many respects, anyone who truly loves himself must think twice before submitting his body to medical processes in this country. If he is not scared about the likelihood of power failure at critical moments in the treatment regime, it could just be the possible absence of water or other elementary medical materials like bandages and needles at critical stages. It is really that bad. But how did we get to that abysmal level of degeneration?

The simple answer is that our leaders have failed woefully to fund our health infrastructure and diligently take care of the personnel manning them. The working environment of Nigerian doctors is at best antediluvian and, indeed, hellish. I once visited a private hospital as I have been warned to avoid government ones if I love my life. I was shocked to find the doctors there sharing one blood pressure measuring machine in turn. They were running in and out of their rooms to fetch the only functioning machine. I was heartbroken and almost walked out in disgust.

Just because Nigerian political leaders and their cronies have illegitimate access to public money with which they regularly fly abroad for medical treatment, they have decided to kill our hospitals and frustrate their workers. When it suits them, they indecently compare themselves with great leaders like Obama and Cameron; they flying around the world rubbing shoulders with them. Have they ever asked themselves if there will ever be any situation that will make leaders Obama and Putin come to Nigeria for medical checkup or treatment even for a tropical disease like malaria?

Little wonder therefore that nearly all the rich and powerful citizens of Nigeria who have died lately have all “passed away” abroad usually in India, South Africa, England and the USA. I think it is shameful that our leaders are now dying outside the shores of this country because whenever their cases go critical, the only thought worthy of consideration is to fly them out. Apart from the huge financial outlays involved (more than what the NMA is asking for), it is also an indication of a failed state when it is taken as the norm that the health facilities within cannot provide the most elementary of medical services.

Dying abroad is neither edifying nor prestigious. It is laughable to those in whose lands we now go to die. How many foreigners come to Nigeria to die? Not even from Benin Republic or Togo! To solve this problem once and for all, I expect that our doctors to remain steadfast in their demands through strikes and/or other non-strike means until our hospitals are good enough for both the rich and the poor. Docs, it’s Aluta Continua!

Pls Don't Remind us of Hippocratic oath during Doctors' Strike

...... if u see a strike, dont go reminding us of the hippocratic oath which u know nothing about. We wrote it. We swear it, we know what it means.
JOHESU on the other hand is an irrational organisation made up of other health workers, infact, basically everyone who works in a hospital. From accounts department to cleaners and the aggrieved non doctor health workers, whose sole aim is to frustrate the health sector.
In a hospital, there is the director of admin, as powerful as the CMD. An office open to every one and in most hospitals, if not all, has never been smelt by a doctor.
How can someone who is not a doctor be fighting for chief medical director. So the accounts department in a police station should start fighting for Inspector general, cos they work with the police?
How can nurses start talking about consultancy? They have matrons, CNO's and all what not. Consultancy is a position, not bestowed upon anyone. U go thru a residency program, write exams and become one under a recognised medical post graduate college.
And by becoming a consultant, u have the sole responsibility of the patient. Every other person, from the resident doctor to the nurse and orderlies are mere aides.
I don't know how to start explaining this bcos no one would understand. Its like 2moro, assuming when Nigeria was under military rule, civil defence would come out and demand to become president. But when the war starts, u send the soldiers. That u march in front of ur civil defence office DOES NOT make u a military combatant.
And if the same benefits given to these soldiers are given to the boy scouts, every one would become a boy scout.
Medical doctors were not selected. Its open to everyone. If u want to be a consultant or a CMD then u go and study medicine. U dont wake up one morning and decide to convert ur profession to what it is not.
U say Nigerians are subjecting their patients to quacks. Who are those quacks? Are they not the same people who believe by working inside a hospital they've become doctors? Thats exactly what JOHESU is doing.
The federal govt acted like they did during the fuel subsidy, kidnap, bombings and all their plain acts of ignorance. And the medical profession has just had enough of the stupidity.
The Chief medical director office is the BIRTHRIGHT of medical doctors as much as being president of Nigeria is the birthright of a nigerian citizen. U cant come from Ghana, live here for 30yrs and demand to be president.
There is a medical salary structure worked out based on relativity. No doctor has ever fought the govt based on how much they chose to pay other health workers. But relativity keeps it sane. Without the cleaners in a hospital, it wont function. So therefore, they should strike till they are paid higher than the graduate workers? Bcos they are equally important?
Keep salary structure relative, keep qualified people in their due offices and provide an enabling working environment. I dont think thats an irrational thing to fight for.
And saying NMA is envious is only laughable. Envious of who if I may ask? Of the nurse? Are u seriously for real?
JOHESU members can blog all they want and seek cheap sympathy for as long as they want. The fact still remains that the truth is the truth.
I can't chose to become a doctor and 2moro start complaining about Mikel Obi's salary. If I wanted, I could have become a footballer.
I urge Nigerians to understand that this strike, as much as it affects them, is not directed towards them.
ASUU strikes over salary, college's off education and polytechnics are on strike over money. No one has called them evil. We strike over common sense and people start ranting.
There are laws. In Nigeria, u cannot become president without at least an SSCE. If u chose not to go to secondary school, then thats ur problem. U chose ur profession, or u failed to meet the standards of the one u chose and hence went to another. Which ever way it happened, thru ur own fault or circumstances surrounding u, u dont try to turn an existing system upside down to suit ur selfish needs from wat u imagined a particular profession gains financially , at the expense of quality, efficiency and common sense.
GOODDAY

What if NO GIRLS WERE KIDNAPPED at CHIBOK?..Francis Nmeribe

I do not expect this article to be popular with anybody.  I do not expect any accolades either.  But in security, perception is reality for the person involved.  Most Nigerians’ reality today is that 200 plus girls were kidnapped from a secondary school in Chibok, Borno State some 77 days ago while in their boarding facility while preparing to write their West African Examination Council (WAEC) Senior Secondary School Certificate Examination. As a person who lives by my analytical skill as a security practitioner, I have been following the whole saga and trying to read between the lines.  I am beginning to feel that there is strong probably no school girls were kidnapped in reality and that the whole issue has been a written piece of drama which the authors are set to keep updating to ensure there is no end as an end would expose the possibility that no one had been kidnapped.
If you have not gotten too angry to continue reading this piece, I would provide you with red flags which show that the equation does not fit together and therefore, grounds to question the story of kidnap of more than 200 girls from a school boarding facility at Chibok, Borno State.
One, so far, nobody has given an exact number of girls who were in the school that night and exactly how many were abducted and the exact number of girls who escaped before they were taken away.  Everything about the numbers have been conjectures of about 200, 274, 300 girls kidnapped or 20, 40, 60 girls had escaped.
Two, the principal of the school Mrs. Asabe Kwabura had given two different versions of how the kidnap incident happened.  In one account, “she said that she was in Maiduguri for a medical checkup and her daughter called her to tell her insurgents are attacking the school”.  In another account, Mrs. Kwabura “said that the insurgents had come to her in the guise of soldiers and told her that they need to move the girls to a safer location and she allowed them”.  Who did she call to confirm the need to move the girls?  Who did she call to tell what the “soldiers” had told her before permitting them to take the girls, should that be the true story?  If the school was not safe for the students, why and how come it was it safe for Mrs. Kwabura and her daughter that resides with her? Is it not interesting that such a begging muddle would be in place and we are ignoring it and playing into the hands of Boko Haram and all those in the same ship with them.
Three, when the first video of the “abducted girls” were shown, we were shown video of chubby happy Islamic girls who were reciting the Koran and Hadith perfectly “though they were just forcibly converted to Islam only a few weeks earlier”.  What magic did the busy Boko Haram fighters use in achieving such a feat impossible for even Albert Einstein?  If they can do that magic, we had better allow them to come and teach our children science and mathematics.
Four, on the first day when the parents of the “abducted Chibok girls” were asked to identify them from the video; the news report was that none of the girls were their daughters.  By the second day, the identification parade moved to the governor’s office and 4 girls were identified.  By the third, fourth, fifth days, we heard, 20 girls, 40 girls and 60 girls had been identified.  And that was the last we heard about identifying the girls.  What about the remaining two hundred and something if 274 or 300 girls had been abducted?
Five, a sixty year old woman was listed among those that were abducted.  Even if we assume that she is doing adult education, how come up to date, nobody has come forward to say that his or her sixty year old mother or sister or aunty was among those kidnapped if she were to be childless at that age which is possible.
Six, Mrs. Asabe Kwabura in one news report said that 43 of the girls had been accounted for and 230 are still missing.  But every day, the report in the media is that 274 girls are still missing.
Seven, some Northern leaders are already preparing us for the inevitable – the time when there would be no real girls to use in proving some girls were ever kidnapped.  Sani Shehu was quoted by the Nigerian press to say that “by the time the girls are released, they would not know themselves again and some of them may become militants”.  In the business of persuasion, that statement is tantamount to ‘preparation’ – getting us ready for the day that we could not have any girls who can vouch to being taken. Then it would be said, “They have been so confused, they cannot remember who they are anymore”. And also as soon as more female bombers join the boko haram terrorist group, it could be said that they must be the Chibok girls who have been indoctrinated.
Eight, Olusegun Obasanjo, one of the marauders of Nigeria that I distrust greatly joined forces with the North and said that “he is afraid that before long, all the Chibok girls would be impregnated by their captors”.  These are all preparations.
Nine, check it out – no single parent or parents or relations of the “Chibok girls” have come forward to discuss about their ordeal to the Nigerian press.  All that has been heard were from parents that spoke through governor Shettima of Borno State or other governor’s office officials.
My security background and instincts find it difficult to stay comfortable with these obvious conflicts and misleading statements preparing us to accept what next lie that could be sold about the Chibok school girls’ abduction.
Therefore, my imagination is running riots presently and if you have liberty to create so much embarrassment for the Nigerian nation and government, I am at liberty to imagine that the true situation is that we are being beguiled by a ruse calculated to embarrass the Nigerian government and people and also achieve sinister agenda clearly connected to the Boko Haram Agenda.  My grounds are adduced below.
One, it is not hidden anymore that the Boko Haram programme is an agenda planned and executed to bring home the threat made by no less than three eminent Northern politicians including Junaidu Mohammed, Atiku Abukakar, Muhammadu Buhari to mention but a few, that they would make Nigeria ungovernable for Jonathan if he wins the elections in 2011.  This threat has been repeated in several other ways and guises especially with the learning that President Jonathan might want to contest for a second term in 2015.
Two, when you listen to ‘Abubakar Shekau’ talk, the same statements he makes is the same that all Jonathan’s opponents are making.  After each terrorist bomb attack on the Nigerian soil and people, ‘Abubakar Shekau’ boasts how he is better than Jonathan.  He boasts that Nigerian security forces and the President are weak.  It is this same statement that the opposition and most northern elite use.  Even the failed governors’ of the North-East talk in exactly the same language and term of how Boko Haram fighters are better than the Nigerian soldiers just with the same words ‘Abukakar Shekau’ would use when boasting about his successes.
Three, since the 1950s, the United States of America have always wanted to have a military base in Nigeria.  So far, this has failed through the efforts of Nigerian students in the 1950s and 1960s and the military leaders of Nigeria and current leaders to resist the chocolate coated sword from America. An embarrassment like the kidnap of so many girls and apparent failure of Nigerian soldiers to rescue the phantom girls is enough to announce shame on a leadership and force their hands to accept help of American troops.
Four, a year or two ago, the U.S. Intelligence predicted that Nigeria would disintegrate in 2015.  Is there a chance that all that is in motion is an operation to actualize that prediction?
My counsel to the Northern peoples of Nigeria – this country is better than anything else.  If you do not live and let live, you would lose the oil money that has served you so well in the past.
To America, my counsel is that it is a wiser step to support and help Nigeria to stand in an equitable manner.  If Nigeria disintegrates, there would be no space in America regardless of you’re the efficiency of your immigration security officials and apparatus.
My one counsel for President Goodluck Jonathan, and he needs to do this before his luck runs out.  “President Jonathan should realize that we have a civil war on our hands with boko haram being the armed forces of the rebel North.  He should put on the cap of a President at war and go ahead and prosecute the war against boko haram as a war”.
Good luck to all.

Welcome to the World of NARCOLEPSY: Doctors are the best hospital managers, study reveals

Welcome to the World of NARCOLEPSY: Doctors are the best hospital managers, study reveals

Doctors are the best hospital managers, study reveals

Would hospitals have fared better over the last 30 years if doctors were in charge? New research suggests they may have done


Almost 30 years ago, what was then the biggest change to the health service since 1948 was ushered in by a report that noted: "If Florence Nightingale were carrying her lamp through the corridors of the NHS today, she would almost certainly be searching for the people in charge."

That report, by Sir Roy Griffiths, led to the introduction of general management of hospitals in place of decision-making by consensus and organisation by administrators. It was not a template for getting rid of leadership by doctors – Griffiths said they should become more involved in running budgets – but in practice few were appointed to the new general manager posts. The men (and a few women) in suits took over.

There is today little challenge to the thrust of what Griffiths recommended. But the failure to engage doctors in management is lamented widely. And a new study raises the thought that hospitals might have fared better over the past three decades if more doctors had been encouraged to seek, and been selected for, chief executive roles.

The research has been carried out by Amanda Goodall, a visiting fellow at Cass Business School in London, who has found a clear correlation between high-performing hospitals and leadership by doctors. Her study is based on US hospitals, but she sees no reason why similar results would not be found in the UK. Surprisingly, she says it is the first analysis of its kind.

Goodall took the top 100 hospitals in each of three specialties – cancer, digestive disorders and cardiac care and surgery – as ranked by the respected US News and World Report league tables for 2009. She then researched the backgrounds of their chief executives. Of the top 100 cancer hospitals, 51 had chief executives who were qualified doctors; of the top 100 units for digestive disorders, 34 had medical chief executives; of the top 100 cardiac centres, it was 37.

The remarkable thing about these figures is that, according to other research, there are some 6,500 hospitals in the US and only 235 are led by doctors. So the high-performing doctor-leaders identified by Goodall come from a very small pool indeed.

Her study, to be published in the US journal Social Science and Medicine, further established that doctor-led hospitals had quality scores some 25% higher than other units. And when she stripped out of her analysis of the three lists of top 100-performing hospitals those that featured two or three times (52 in total) she found that the correlation still held strong for the remaining 160 units that featured only once.

Goodall, whose principal post is that of senior research fellow at the IZA Institute in Bonn, Germany, says: "It seems that age-old conventions about having doctors in charge – currently an idea that is out of favour around the world – may turn out to have been right all along."

Her next step is to examine the correlation over a longer timescale.

This notion that practitioners make the best leaders is becoming familiar territory for Goodall, whose previous work suggested that many of the best universities are headed by academics. It's something that Julian Le Grand, professor of social policy at the LSE and a former senior policy adviser to Tony Blair, instinctively goes along with.

"I was always rather impressed with the quality of the doctor-managers I met in the NHS," Le Grand says. "They have that great thing that they command the respect of their colleagues, which is a fundamental problem where chief executives come in from outside."

He adds: "I'm reasonably convinced by the evidence of [Goodall's] research. I think we should be moving as fast as possible to try to encourage doctor-management, as well as academic management of our universities."

Welcome to the World of NARCOLEPSY: # BringBackOurDoctors!

Welcome to the World of NARCOLEPSY: # BringBackOurDoctors!

Welcome to the World of NARCOLEPSY: THE TROUBLE WITH THE NIGERIAN HEALTH SECTOR

Welcome to the World of NARCOLEPSY: THE TROUBLE WITH THE NIGERIAN HEALTH SECTOR