If the Government Hospitals are getting worse by the day ,is it Doctors that have been ruling this country too?

Azzez Fashina Wrote..First is, I'm tired of everybody talking about government hospitals getting worse under the management of doctors, citing the UCH/commonwealth example and so on. PLEASE, is everything not getting worse in Nigeria?? Was Nigeria not once the toast of the African continent?? Who are we today?? Is it doctors that have been ruling this nation?? Are our roads not getting worse?? Are there not many government parastatals that were once doing very well and are now failed or gone out completely?? NEPA, NITEL, Nigeria Airways, is it doctors that were managing these too??? Kindly tell me one thing/sector that is getting better in Nigeria. My dear friend, EVERYTHING in Nigeria is declining and the government hospitals are not left out of the rot. It is in NO WAY the fault of any doctor. The government is BAD!!

Secondly, like someone rightly pointed out, lets not mistake the position of CEO of a hospital (like they have in developed nations like the US), for the CMD of a hospital. Anybody can be the CEO but not anyone can be CMD. As fate will have it, the present structure in Nigeria gives the CMD the dual role of being both the chief executive officer (the managerial role) and the chief medical officer (the head of the doctors in the hospital). If this structure is to remain, then the head of doctors can only be a doctor and hence the CMD. If johesu feels strongly against this, then they should be asking for a total change in structure and organogram and not a change in personnel. It doesn't work like that. Not even in the developed nations.

Lastly, I find it very funny when people pick some certain issues and say let's adopt 'international standards' from the western world. It is quite hilarious. For want of time and space I can't go into lengthy explanations but get this please, Nigeria is NOT the US. We can aspire to be like them but let's do it the right way. There is a trend. Its a whole package. You can't just pick out some parts to adopt while neglecting the others. For one, nearly all americans have health insurance. And this singular fact has affected every aspect of their healthcare system from management to the actual healthcare delivery. We have NOTHING! Let's be wise to understand our peculiarity as we aim to copy them. Let's collectively do the right things first!

Steve lemadoro continued....Indeed we have said in different fora that the only reason Nigerian hospitals are still functional is because they are being run by doctors.Medical training teaches self denial, delayed gratification and an austere life that borders on asceticism like no other profession.That is why despite severe financial difficulties services and training have been maintained.As it was rightly pointed out, tertiary healthcare delivery in the public and private sector has tremendously improved under the watch of doctors, some examples will suffice. Laparoscopy was introduced into Nigeria years ago, from early to mid eighties it disappeared.Nigerian hospitals had been so severely damaged by the so called administrators that when doctors took over in 1985 they had to start virtually from the scratch.Of course because the facilities for training in these areas had been destroyed training was in limbo.Gradually, the rebuilding began and today laparoscopy has moved from diagnostic to operative.From sokoto to azare to yenagoa enugu, Ile ife and Lagos, Laparoscopic surgery has become so common place that, it has become a non issue.When people go to world laparoscopic institute in india, the primary trainer now advise continuation of training at professor chukwudebelus training institute.From St Nicholas and OAU Ife some years ago, renal transplantation is common place now.AKTH does as many as 3 per week sometimes.As a matter of fact, AKTH and Ife have been cleaning up the complications of transplantations done in India. AKTH I reliability gathered has also done a number of cutting edge surgery in ENT.Interventional radiology is the norm in maiduguri now.And we all know cardiac catheterization and pacemaker placement is being done In Abuja.Cidacrest is blazing the trail in ortho.Even my tiny FMC in ondo state offers illizarov technique in ortho, TURP in urology and many more.I will bore US all if I have to talk of widespread options now In Assisted reproduction, open heart surgery in Enugu,laser eye surgery in Lagos and so on. All these largely brought to bear through personal effort without a Kobo in compensation for subspecialization for doctors.Meanwhile most manufacturing pharmaceutical industries have closed shop, what we are left with are companies marketing drugs made in India and Pakistan.Even at that, the leading ones are not run by pharmacists.The only exception I am aware of is Emzor. Leading Private laboratories are either run by pathologists or by Indians, where are our friends the lab scientists? They have not demonstrated their ability to run facilities in their domains let alone a private hospital, yet they want Nigerian hospitals handed over to them.We care too much for Nigerians to allow that. Perhaps after this struggle we should have a TV series showcasing the miracles of medicine occurring through the gifted fingers of Nigerian doctors everyday in our hospitals.MDCN has said that is no advert.Nigerians don't know and it is about time they are told.

The Complexities of the doctors strike

The Complexities of the Doctors’ Strike. 

By Dr. Goke Akinrogun
17 July, 2014

I must confess the present strike embarked upon by the Nigerian Medical Association (NMA) gives me a gummed-lip on a rather touchy development with all the attendant casualties. What I have resolved is to allow the issues to discuss itself, getting the informed to layout the issues on both sides. As a starter, I am inclined to get across some of the arguments espoused by a popular Lagos NMA activist, Dr. Majolagbe Taofik, posted as “THE NIGERIAN HEALTH SECTOR; JUST BEFORE THE WATERLOO” inwww.tques.blogspot.com . It makes an interesting reading though not necessarily the core-views of this column. 
“It is over two weeks now since the Nigerian Medical Association pulled her members away from work. No doubt NMA received the worst bashing from the general public. This situation is so because people lack depth into the issues that have caused the present action of the doctors and of course the fact that they cannot phantom why the doctors would appear callous as to abandon their patients.
“If we must avoid the impending doom, it is imperative that we take a critical impartial analysis of the present issues, so that we can take decisive steps to avoid the worst coming to being. Rather than just always criticise the doctors for withdrawing services, it is better to first understand the issues dispassionately; next we can then query the decision of the doctors to have taken the strike option to pursue their agitation.
“Without prejudice to any of the disputing sides, I make bold to say that health service requires the collaborative efforts of various professionals and other allied workers whose only goal is to come to a positive outcome of patient care. Every part of this whole has its integral role that it plays and one part may not claim superiority over the others.
“However, in any scenario where we have different people coming together to achieve a single goal, there must be direction and this direction must be provided by leadership. The problem in the Nigerian health sector is that leadership has been misconstrued as superiority and as noted earlier, this problem has been on for decades. I also make bold to say that both sides are guilty of this misnomer.
“Much as we try to have a clear understanding of the distinction between leadership and superiority, we must however be clear as to who is the Captain of the ship. It is commonsensical that only one captain is needed to direct this ship, and anything other than that leads to chaos; which is exactly what we must avoid.
“It is also commonsensical that the best person to captain the ship is the most knowledgeable person about the entire process and without doubt that positions falls to the doctor. That the doctor is the one with the most knowledge of the patient is what the other health professionals find discordant to their ears and this has been the bane of the long standing conflict.  But no one gets annoyed or argue when the lawyer says that he is the only learned person. Why should this concept be a problem within the health sector.
“What the other health workers are asking for is not just a name, but to use and be accorded what is due to the term consultant. Other than that they also believe that it is their right to also head the health team.
“Let all be clear that the term consultant may refer simply to an advisory role between a professional and its client; within the hospital setting however, this is not so. The term consultant refers to a specific role which describes a relationship between a patient and a physician who has completed his specialisation in a particular part of medicine. It is a position of responsibility as well as authority.
“The implication is that if a doctor does not become a specialist, irrespective of many years of practice or getting to the highest position in service, it still does not confer on him the title consultant. What do we then make of a nurse or pharmacist who wants to attain the same status? It has been believed that because these other health workers now pursue postgraduate degrees up to attaining a PhD it is therefore expected that it is okay for them to receive such status. But pursuing an academic career is completely different from specialisation. Even a medical doctor who decided to attain a PhD does not get the title consultant.
“The implication of having other health workers attain the status and role of consultant is that it provides more than one captain to direct the ship. For instance the consultant pharmacist may believe that he is a specialist in the field of drugs and therefore may decide on what drug a patient may or may not be given. Everyone else including nurses and laboratory scientist may decide on themselves what they want or do not want for the patient. There exists no other word for this other than chaos!
“How would a patient get well with conflicting orders? Indeed who would be ready to get on board a ship with more than one captain? Well I wouldn’t, even if the ride is for free.”

My Dear Colleagues by Dr Lawal Anka

Do not let anyone look down on you. You are the only original in the whole world. You are one of a kind. No one is like you on the face of the earth. No one will ever be like you. You are fearfully and wonderfully made.
Anyone who tries to be like you can only be an Imitation. You are unique, You are special. Never sell yourself short. Never devalue yourself. You are not embarrassment to your profession. Don't look down on yourself.
Your uniqueness means there is something only you can do. There are problems only you can solve. You have something to offer your people.
Your uniqueness means there is only you can contribute to your people/world. You are not here just for decorations or to a while away time. You are not here to escort people. Inside you is the ability to and potential to do remarkable things. To make a difference and become a reference. You are not doing yourself favour when you compare yourself to others.
You can live a life of significance,a life that counts. You can do more than you can. You can win. Confess who you are, not who you are not.
What they say you can not do,you can do. Where they say you can no go, you can go. What they say you can not achieve,you can achieve.
You must believe in yourself. Your believe determines the kind of people you create for yourself. The people can not devalue you if you have confidence in yourself. Your thinking determines the way you acts and the things you do.
Change your associates from so called people and the places you go. Change the things you subject your eyes and ears to. Learn to fill your mind with positive, inspirational, educational, motivational and nourishing mental and spiritual diet.
Others can only frustrates your effort and count you out of the contest of life. Please don't give up on your faith. Don't compromise your stand. Just continue to do the right things and put in your best.
What make you great is not what you have, but what you do. People don't care how much you know, until they know how much you care about them.
You are known by the goodness of your deeds. You can never lose by doing good. Your only opportunity to make a difference is while you as still alive. Don't die with intentions. The best intentions have never won a medal. Only what is done is rewarded.
Don't allow your name to written only as a footnotes in history. You become great by doing great things. Don't forget, the song you don't sing now cannot be sung in the grave, neither can the book you refuse to write or the love you couldn't express. History doesn't make men, men make history.
Your value determines who you are and what you will become in future.
Be kind to yourself, your colleagues, your patients, patients relatives and other hospital staffs. If you are committed to helping and to seeing to the growth and success of others, others will be equally committed to your success.

The end is truly near by Dr Muhammad Abubakar Yusuf

By now it should be obvious to all JOHESU members and their blind supporters that without DOCTORS no hospital can function and infact they have no job!. All hospitals are empty all over the country. Nurses couldn't do their nursing care because Doctors have not admitted, Pharmacists couldn't dispense drugs cos Doctors haven't prescribed, Lab scientists could not process any sample cos Doctors haven't ordered, Account section couldn't function (No IGR) because Doctors are not working, Record dept are yawning of no work cos Doctors are on strike, the periop nurses could not sterilize instruments cos no operation lists from Doctors, Cleaners couldn't mop cos Doctors are not there to perform procedures, the securities have less work to do cos the hospitals are deserted and so on and on.............. This has glaringly shown how important a doctor is in a hospital setting. Without these supporting staff a doctor can still function but without a doctor they are jobless and that was why when they are on strike they locked up the wards, hide equipments and connived with the securities to repel patients from the hospital entrance!!!
The End is truly Near

Alternative to the crisis in the health sector...Adamu Audu

The federal government must seize the opportunity provided by the current NMA strike to bring sanity to the health sector for the sake of ordinary Nigerians. 

All the combatants(NMA and JOHESU) should be brought to a round table discussion and all the various demands analysed. 

As for hazard and specialist allowances/skipping,these are very simple to approve. For directorate,every degree holder in the sector should be able to rise to a director either in the hospital or ministry depending on available vacancies. 

On issue of consultants,all health workers including ward attendants should have opportunity of becoming consultants. But govt must spell out the procedure and level of training required to become a consultant in each field. Also,the role of each consultant must be spelt out to avoid clashes. Evidence and documents should be obtained from countries where such arrangement exists. 

As for CMDs,it should be changed to CEO and reserved for qualified health administrators surported by several directors in the hospital. When the above is done,medical elders will see reason why they should allow as many doctors as possible become consultants instead of frustrating them as it is been done now. In the end,our patients will be the winners. Whoever is not ready for this should go into private practice.

Now its CHEW vs NURSE....Lord have mercy on the health sector #chai#

Ehrrrrrrrrrrrr....! So e'dey pain for belle?
Chews are in a competition with nurses and they are complaining!
What an irony?

This chat was between Aborisade Ayobanji who-
Works at World Health Organization (WHO) and
Obi Justina Ejelonu

Aborisade Ayobanji in NURSINGWORLD NIGERIA wrote-

I feit neither joy nor elation about a write up that comparing of
nurses with CHEWS.Well!Even the socalled chews were to be
earned million /month i'm not border.I did not choose or joint my
profession becos of money making but rather is a divine called to
be a Nurse.I'm proud of it,thougth the problem we are having is
from our leaders.A poor country like our that doesnt appreciate the
hoslistic care given by Nurses

See the conversation that followed between, two persons on the NURSINGWORLD NIGERIA forum! Enjoy..

" Obi Justina Ejelonu
Aborishade,take correction.ur tenses r terrible and pls dont let the
chews see it o."

" Aborisade Ayobanji
@ Obi Justinal ,E. u must be a dog! Always barking, see idiot barking
dog, prostitute, even in your wall in the facebook, u are know to be
criticism.e.g "1 i cant believe Abba morro............2 why must the
Lamido of Adamawa make such statement! 3 subsidy probe............. 4
Ejigbo torture watch out............. WHAT IS UR BUSINESS
ABOUT,LAMIDO? FAROUK ?SUBSIDY PROBE? AND EJIGBO TORTURE?"
I GUESSED U ARE THE ONLY PERSON FINISHED SCHOOL OF HEAITH
AND TECH, IN UR FAMILY. How can a person with unclear profile had
gut to comment any how, u must be one of the product of broken
family that is destrubing the conmmunity and society. A woman for
that matter! Big fool! U have never comment about good things, no
wonder ur said u had bad dream. Bcos ur head is full with silly
thought. OBI JUSTINAL NEEDS TO BE DELIVERED."

" Obi Justina Ejelonu
Obviously,u dont deserve to be a nurse.i wont exchange words wth u
cos im a trained graduate nurse.
Just go get brighter grammer and relearn English tenses.
We are d future leaders of nursing and of course u wont come close
cos u will bring shame to us with ur bad English.the Chews are far
better than u.u can insult all u can but i dont care...........if u r d best
ur school produces,d school should close down."

" Aborisade Ayobanji
Are u not igbo lady? Whatever u called urself, u are a disgrace to this
profession, get lost with ur decorated certificate, where were u when i
started nursing, claiming graduate prostiute. can u teach what u did
not know? Idiot!
Like · Jun 4
Aborisade Ayobanji
@ Obi j.E pls can u tell me, the name of the university that produced, a
fake graduate like u! No wonder u can not add it in ur profile. we are
awared that there some schools in the Estern part of this country that
does not know by NUC. Because of ur atitude u dont even have a
single mutual friend on ur facebook. that means i am very correct with
my assessement, a lady from broken family,frustration are written
boldly on your picture on facebook (see the picture! see the mouth!
ominivorus talkkcative!. does farouk and Abba knows about ur
destroctive critisim, i pity a man that will cope with a frustrated lady
like u.I am imagine the kind of agony and pain this idiot will be given
to the proposed husband ,big idiot claiming trained graduate AT
WHERE! I WANT TO KNOW IT. BIG FOOL CAN U TEACH WHAT U
DON'T KNOW? U ARE IDIOT!"

" Aborisade Ayobanji
U are under curse already!u have loaded a big problem to ur
generations. u are talking to an elder person any how.Did u know me
before? Miss Dog! U are barking any how,prostitute U are not well
reformed,like mother like daughter,it shows that u are a disgrace to ur
family and ur musroom university that produced half bake so called
graduate nurse, is it how u were taught in ur fake school? nill manner
of approach.I started nurse when u were still in primary school.That
one is enough to curse u, where were u in 1998 when i started
nursing . what did u know about the profession? I guessed may be u
are the only graduate in ur family that is why are barking any how, u
idiot. Dog, is only God knows the number of lectures u have infected,
carriers, miss distributor. See her mouth. My advise is pls take ur
drugs regular because i dont need to consult specialist before are rule
out that u are psychosis pls come to fededral neuropsychiatric ARO
ABEOKUTA OGUN STATE FOR BETTER TREATMENT, UR AREA THERE
PEOPLE ARE BUY CERTIFICATE WITH MONEY U CAN NOT GET
CORRECT TREATMENT THERE."

" Obi Justina Ejelonu
Hahahhaha......Elders dont talk like this o.who edited this one for u?

Obi Justina Ejelonu
I just noticed uwrote 'are' instead of 'I'.
I dont want to disgrace u ortherwise,i know what to do.that is Y we r
saying u people should give us space to prove that nurses are
professional.if u like graduate 1900.....u no sabi speak English and
hence not fit to compare to even chews.
Can u write what NSHI GOODLUCK wrote in nursing world......?lai
lai....From ur languages,u r so enethhical,unprofessional,un...

Obi Justina Ejelonu
Elder Aborishade,if u use such words like 'PROSTITUTE'on me again.i
will take it up with u.dont dare me.."

" Aborisade Ayobanji
U must be mad! Pls do ur worst.If u dont do ur worst u are a bastard!
Did u know me before! U must be mad, why did u put ur mouth on this
matter, since u dont want insuit and u are insuit ur father mate, lack of
home training, bad egg in the society, idiot! U must tell me the name of
ur school that taught u to be insulting an elderly man. Nill mannerism.
Try it! U will be disgraced, who are u to correct my grammar, idiot!.
Accepted know body above mistake, u taught u can harashing me any
how, pls try it! u will not like to watch the second part. Big fool! the
only educated in the family. U are a disgrace to ur claimed school and
also to that broken family u come form. If u are barking with
everybody responds, as i saw it in ur wall, pls stop this irritating
character, if u continue like this sorry is ur name!"

Hmmmmmmmmmmmmmm....!
So much for the replacement of Doctors in the health sector!
Lord have mercy.

Honourable, Distinguished, Excellency by Mahmud Jega

The first time I ever heard someone use a title to describe a professional other than a doctor was in Enugu in 1982. I had tuned in to the state radio station soon after I arrived in town and it mentioned “the Deputy Governor of Anambra State, Engineer Roy Umenyi.” I at first wondered if the “engineer” was a name, since there are some queer English names such as Farmer, Hunter, Seaman, Cook etc.

Right through my primary and secondary school days in this country the titles we knew were Malam, Alhaji, Mister, Miss and Mrs. There were also the clerical titles Father, Pastor, Deacon, Archbishop and Cardinal. Chief was the commonest title in the South for politicians and important people. Religious revivalism of the 1970s brought other titles such as Uztaz, Alaranma and Sheikh. “Evangelist” also made its debut around that time. Some Mazis [S.G. Ikoku] and Ogbuefis [Alex Nwokedi] also came up. Chief M.K.O. Abiola popularised Aare and Bashorun and there was a High Chief [Gabriel Akin-Deko]. The only titles however that suggested a man’s profession were Doctor and Professor. A doctor was a medical doctor, a veterinary doctor or a PhD holder, while professor suggested that a person has risen to the zenith of an academic career.
Right from the First Republic, members of Parliament were addressed as Honourables. Speakers and regional premiers were addressed as The Right Honourables, a common tradition in the British Empire. I once stumbled on my father’s 1964 diary [he was private secretary to Sir Ahmadu Bello then] where he made a note that the Premier told him to arrange some puffs for “the Speaker of the Sierra Leone Parliament, The Right Honourable Mr. Banja Tejan-Sie”.
Now, during the long years of military rule in this country, state military governors were addressed as their Excellencies. That was how regional governors were addressed in colonial times. Nigerian ambassadors abroad as well as foreign envoys in Nigeria were also addressed as their Excellencies, a worldwide tradition. In the North, His Royal Highness was used to address emirs while His Eminence was reserved for the Sultan of Sokoto. In the South, His Majesty was more commonly used to address Obas and Obis.
Once upon a time, the highest title in Nigeria was “Sir,” i.e. a person knighted by the British Queen with a KCMG [Knight Commander of Saint Michael and Saint George]. The men who bore the title “Sir” were the grandest in Nigeria in those days. They were not so many. They include Sir Abubakar Tafawa Balewa, Sir Ahmadu Bello, Sir Kashim Ibrahim, Sir Aderemi Adesoji, Sir Adetokunbo Ademola, Sir Darnley Alexander, Sir Akanu Ibiam, Sir Abubakar III, Sir Usman Nagogo and Sir Mobolaji Bank-Anthony. I still do not know why Queen Elizabeth did not confer KCMG on Dr. Nnamdi Azikiwe and Chief Obafemi Awolowo.
Not long after I heard about Engr. Roy Umenyi [inventor of the Biafran gun ogbunigwe], Nigerian engineers of all hues took to using the title before their names. While the title helpfully tells you that this man trained as an engineer, it does not say whether he is a civil, mechanical, electrical, agricultural, chemical, space or computer engineer. Neither does it tell you whether the person has a degree or an HND, the on-going skirmish to abolish “dichotomy” notwithstanding.
Because engineers got away with it, pharmacists took after them. We began to see names with “Pharm” preceding them. The title “doctor” also became confusing when herbalists adopted it. The biggest herbalists even adopted the title “Prof.” Titles took a small beating in 1993 when General Sani Abacha appointed Military Administrators for the states and said they should not be called Excellencies. This did not reduce their power one bit.
Architects soon joined the fray, affixing “Arch” to their names. In 1992 they got much leeway with having a governor, Architect Kabiru Gaya. The habit spread far and fast. One day I opened a newspaper and saw a man addressed as “Surv.” so-and-so. He was the Surveyor General of the Federation. Not long afterwards I saw a man addressed as “Stats.” so-and-so. He was Statistician General of Nigeria, so the title means Statistician. I was really puzzled. I too have studied statistics courses and I know some things such as mean, mode, median, standard deviation, normal distribution, Bell curve and confidence interval. Maybe I should add “Stats.” to my short name.
One day I saw “Bldr” as a prefix to a Nigerian name. I learnt that the man was a Builder. I was amazed. It was not like he was the one who built the Taj Mahal, the Golden Gate Bridge, Bhurj Khalifa, Kremlin palace or the Great Pyramid of Giza. I thought that with all the building collapses that we are experiencing in Nigeria these days, a man should be ashamed to call himself a builder, not to talk of attaching it as a prefix to his name.
But then, why should he be ashamed? All the big and deep potholes that adorn Nigerian roads have not discouraged anyone from attaching the prefix Engineer to his name. The fact that most Nigerian bridges have no railings has not dampened any engineer’s spirit either. I was amazed that anyone will call himself a statistician in Nigeria when nobody believes the figures dished out by the National Bureau of Statistics. Anytime CBN says inflation was 7% in the last quarter, people will sneer that the cost of a measure of corn almost doubled. They don’t want to hear anything about a composite index.
I attended a seminar in Kaduna in the 1990s and a fellow paper presenter was addressed as “Consultant” so-and-so. I at first thought he was a consultant surgeon. I later heard that he was a freelance media consultant. I then began to see with Nigerian doctors why they don’t want nurses to get the title “Consultant Nurse.”
Then there come the Honourables. With the return to civil rule in 1999 every local government chairman and councillor, every member of a state assembly and House of Representatives, every commissioner, special adviser and special assistant to President, Vice President, governor, deputy governor or speaker became an Honourable. Trust politicians not to stop there. Anyone who once held the office and in fact, anyone who is aspiring to get any of those offices in the future is immediately addressed as Honourable. All these would have been okay with me if all these men and women have become honourable in conduct. Why are men and women called honourables when much of their conduct is injurious to the public treasury, to election laws, to civil service rules, to parliamentary ethics, to cultural norms and sometimes even to the human spirit?
The people who make it to the Senate need a title even grander than Honourable, so they are called Distinguished. How I wish all of them have distinguished themselves in a certain way. A man who did not so much as attend Senate sittings for the constitutionally prescribed minimum number of days is still called Distinguished. For that matter, the man who sat through the entire Senate tenure without sponsoring a bill or moving a motion is still distinguished.
Then there are the Excellencies. The President, Vice President, governors, deputy governors and ambassadors are accorded this title, evidently the highest in the Nigerian pyramid of ridiculous titles. A man who has not done anything excellent must still be addressed as His Excellency. Is it not better if we break it down into His Poor, His Average, His Good and then reserve His Excellency only to the one who did something excellent?
The My Lords are also there, the judges of high, appeal and supreme courts together with their shari’a and customary court soul mates. Of all the titles inherited from the colonial era, this is the one that sounds most strange to the African ear, since God is the lord. The way we are going, someone will one day hand out a business card with the honorific title Armed Robber preceding his name.