The ongoing strike by the Joint Health Sector Unions (JOHESU) is a week old and has crippled healthcare delivery in many parts of the nation.
However, the full weight of its impact is yet to be felt, PREMIUM TIMES can report today.
"Total collapse of the health sector is what will happen if this strike is allowed to continue. In the comity of nations, when the mortality and morbidity rates were rolled out, Nigeria was ranked 179 out of 183 nations and that was even when we have full complement of all the staff in the health sector but now that 95 per cent of the workforce has withdrawn services, your guess is as sure as mine. The indices will further nosedive and we will further depreciate in the ranking and its not the best for our health system," the National Vice Chairman of JOHESU, Ogbonna Chimela, warned in an interview with this newspaper.
JOHESU, the association of health workers apart from medical doctors and dentists, last week Wednesday began an indefinite strike over failure of the federal government to honor the agreement it had with the union last September.
While this is on, the Nigerian government seems to be in a dilemma on how to resolve the protracted issue.
Chief among what the union is asking for is salary adjustments, a demand Nigerian doctors have vehemently opposed, warning the government that acceding to such demand would precipitate a crisis that may lead to the collapse of the health sector of the country.
It remains to be seen, however, how the government will pacify JOHESU members without provoking the wrath of medical doctors.
Meanwhile, as the strike continues unabated, the noose it has put on the necks of patients in critical condition, pregnant women and nursing mothers and even ordinary Nigerians in dire need of healthcare is further tightened.
Checks by this newspaper have shown that essential services and healthcare delivery at federal health institutions have significantly dropped as a result of the strike.
But here are five things likely to happen in the health sector if the strike continues.
States and local government health institutions will join scanty walk ways at the National hospital Abuja as a result of the ongoing strike.
About 30 days before the union embarked on its indefinite strike, it issued an ultimatum to the government that this is going to be a 'mega strike' that will cut across all health institutions in the country.
"This one is the mega strike. If it begins, it will start with the federal then states will join, the local governments will join. Let the health system in Nigeria be paralysed for the first time", the union had warned.
When the strike commenced on Wednesday, the JOHESU leadership said it has already ordered its members in the states and local governments to be on red alert to join the strike in 15 days.
"Already we are counting their days, we ordered their leaders to give 15 days ultimatum to them (states and local governments) and that will expire on the 2nd of May and if the government did not meet our demands on or before that day, then the state and local government health institution staff will now join the strike, it will be a complete shut down of the sector as we warned."
Health workers under the Federal Capital Territory Administration (FCTA) corroborated JOHESU leadership when questioned by this newspaper.
"Yes, we are under JOHESU, we are yet to stop work but we have been notified to join the strike in two weeks time if the government is yet to meet our demands," a nurse at Wuse district hospital said.
The strike, already a week old, if allowed to persist for another week, states and local government health institutions will likely join.
Reduction, withdrawal, transfer of patients to other private hospitals
When PREMIUM TIMES visited the Abuja National Hospital to observe the level of compliance to the ongoing strike, the facility looked almost deserted.
Only a handful of the personnel, especially doctors, were seen in the emergency wards and other areas attending to a few patients.
Some patients in critical condition were being evacuated to other hospitals as there were no hands to attend to them.
A woman in labour was seen struggling with her condition as nurses and midwives were not around to attend to her.
According to the hospital's spokesperson, Tayo Haastrup, the situation is bound to get worse if the strike is allowed to linger.
"Activities presently is not as full at it should be, the nurses that are supposed to be on the bedside of the patients are not there, they have joined the strike. We only motivate the doctors to make sure they monitor critical issues both at the ICU and other areas so as to make sure there is no serious issue because we don't pray that lives will be lost during this period," Mr Haastrup said.
It was a similar situation at the Federal Medical Centre, Jabi Abuja. Most of the wards at the facility was deserted.
"All JOHESU members here have joined the strike, the nurses, lab scientists they have all joined, what the hospital is doing at the moment is 'adhoc' service," Musa Sani, Head of Administration at the hospital said.
"Patients in critical condition are still treated in this facility but we fear that they will soon be transferred to other hospitals as we only run adhoc service for now," he added.
Low Admittance of Patients
Both spokespersons of the National Hospital Abuja and the Federal Medical Centre, Jabi confirmed a rapid reduction of inflow of patients since the industrial action commenced.
This they said will further nosedive if the strike is allowed to continue.
Mr Sani of Jabi Federal Medical Centre said the facility can only run 50 per cent of the services it renders before the strike and as a result, the number of patients have reduced drastically because the staff on duty could no longer attend to the patients that come in when there is no strike.
He said the aforementioned figure will further reduce as the strike continues.
For Mr Haastrup at the National Hospital, the public is already aware of the strike hence the drop in patients rushing into the facility.
While appealing to the striking workers to reconsider and go back to the negotiation table with government for the sake of lives hanging in the balance, he said the situation will further deteriorate if the strike continues.
Boom in Private Hospitals
Every passing day of the strike is a blessing for private health practitioners as many private hospitals, maternity and traditional birth attendant centres in Abuja and other parts of the country are now experiencing a boom in patronage and business.
Nigerians seeking medical attention and treatment have now turned in large numbers to private hospitals.
Some of the patients still at government health facilities in Abuja told our correspondent that they are on the verge of moving to private hospitals in the city.
Mariam Mohammed, whose son had a cancerous growth, decried the incessant strike in the health sector. She said she has already made plans of transferring his son to a private hospital.
She said the government and health workers should quit playing with the lives of patients.
For JOHESU leadership however, medical doctors working at government hospitals, who run private clinics will also benefit from the strike as they will be more than happy to send patients to their private clinics.
Continuation of Rivalry between medical doctors and others
The major driver of the ongoing JOHESU strike is the demand by its members for salary adjustment, which the NMA has consistently opposed, warning the government that acceding to such a demand will spell doom for the health sector.
The rivalry between medical doctors and other health workers is an age-long battle that is always reignited whenever any of the warring groups makes a demand from the government.
The genesis of the crisis can be traced back to 1985 when the late Olukoye Ransom Kuti was the Minister of Health.
This may seem an over-flogged issue but the wounds of the rift is further deepened as last Wednesday's strike continues unabated.
As JOHESU announced it will embark on a strike on Monday, the NMA leadership at a press briefing Tuesday described the union as an 'illegal body' and that government should thread cautiously while dealing with it.
Having the higher number of workers in the health sector, the strike by JOHESU will become more or less a burden on medical practitioners.
Doctors will now have to work twice than they used to and this will further increase disaffection among health workers as the strike continues.