About four doctors broke down last weekend due to stress.
As the ongoing strike by a section of Nigerian doctors under the umbrella of National Association of Resident Doctors (NARD) entered its third week on Monday, senior medical officials including consultants, and others who are engaged on temporary basis by some of the affected tertiary hospitals, are lamenting heavy workload.
This is as a few patients with critical conditions who are being attended to by these hospitals are complaining of slow pace work at the facilities, among other challenges they claim they now encounter as a result of the strike.
Meanwhile, all efforts to resolve the disagreement with the striking resident doctors may have finally collapsed as the Nigerian government has approached the National Industrial Court (NIC) to seek an order to declare the strike illegal and enforce the "no work, no pay" rule.
Officials recount ordeal
Joseph Eziechila is the head of clinical services and second in command to the chief medical director (CMD) at the Federal Medical Centre (FMC), Jabi in Abuja. But on Tuesday when our reporter visited the hospital, Mr Eziechila, an ophthalmic surgeon, dropped his titles as he battled to attend to patients in his office.
Apart from four patients who already gained access to Mr Eziechila's office, many others were by his door awaiting their turn to be invited in.
This is as the doctor also struggled to attend to some of his statutory administrative responsibilities.
Mr Eziechila said the hospital decided to reduce the number of cases being attended to at the facility since the industrial action commenced, and that some doctors were engaged on a temporary basis to relieve the few doctors available at work. "But all these strategies haven't changed things."
He said: "I am the number two man in this hospital but I am now combining clinical services with administrative work.
"About four doctors broke down last weekend due to stress. Yesterday, the head of the internal medicine unit said even the locum doctors in his team are breaking down. He said they are planning to further downsize treatment and stop receiving new patients."
He said the situation was worsened by the difficulty in attracting more locum doctors to the hospital, saying those available demand higher pay.
He said: "Before now, whenever there was a strike like this, I would make a few phone calls and get as many locum doctors as I wanted. But this time, the situation is different. I started calling doctors as soon as the notice was issued but only very few of them showed up despite our promise to pay them more than N200,000.
"Hospitals are increasingly becoming ghost places. Some of these doctors see this as an opportunity to write their exams and leave the country because there is high demand for medical professionals overseas due to COVID-19. Countries like the U.K., U.S, Australia and Saudi Arabia are in high demand for doctors. So it's funny when the labour minister threatened to sack the striking resident doctors. Who would replace them?"
Mr Ezichiela said at least five senior doctors in the hospital have left the country within the last three months.
Like Ezichiela like others
Though resident doctors at the Osun State University Teaching Hospital, Osogbo, formerly Ladoke Akintola University of Technology Teaching Hospital, did not join the national strike, doctors at the hospital are lamenting the increasing number of patients being referred to them.
Bello Olalekan, a family medicine expert and senior resident doctor at the hospital, told this newspaper that since the industrial action commenced, most patients at the Obafemi Awolowo University Teaching Hospital (OAUTH) in Ile-Ife, have been trooping to Osogbo.
"Since OAUTH joined the strike, we have been at the receiving end here. There are no spaces for new admission and patients are not taking excuses," he said.
Meanwhile, at the general outpatient department of the National Orthopaedic Hospital, Igbobi, Lagos, PREMIUM TIMES' reporter was told that the only consultant on duty usually attends to 10 patients every day since the strike started.
"And most times, even the numbers would have been shared by workers before the patients arrived. So it is as good as not attending to anyone," an attendant at the hospital, who does not want to be named, said.
The situation is the same at the Federal Medical Centre, Ebute Metta, Lagos, where not more than 30 new patients are said to receive medical attention on a daily basis.
"We no longer take new patients at the emergency unit except the condition is critically bad," a source at the hospital's emergency unit who does not want to be quoted, told PREMIUM TIMES.
At the University College Hospital (UCH), Ibadan, a young man, who identified himself simply as Buna, expressed regret that his mother who had earlier been scheduled for surgery on August 19 would no longer be attended to.
Mr Buna told PREMIUM TIMES' reporter at the hospital that his mother was diagnosed of paget disease of the breast, a rare condition associated with breast cancer, and that they had hoped the surgery would be carried out as planned.
He said many tests were carried out before the diagnosis was confirmed, and that the postponement of the surgery would mean another round of tests to further ascertain the degree of damage whenever a new date would be given.
"We were referred to UCH or Enugu but we opted for UCH because of its proximity to Lagos. But here we are now stranded. Now we need to take my mum back home and only hope they call off the strike as soon as possible," Mr Buna said.
As of the time when our reporter visited the hospital, it was unusually calm with almost all the waiting areas empty without both healthcare officials and patients.
At the FMC, Jabi, in Abuja, a 27-year-old mother, Mercy Aigbe, who had visited the hospital with her baby, Ela, said she was tired of waiting for her turn.
She said Ela needed medical attention for her prolonged cough "but I am tired of waiting here."
She told our reporter that she already called her husband to consider the option of visiting a private hospital.
The ongoing industrial action by the resident doctors, who constitute the largest number of physicians across Nigeria's tertiary hospitals, has continued to take its toll on the country's already overstretched healthcare facilities.
The doctors' grievances are contained in a Memorandum of Action (MOA), endorsed in April by both the striking doctors and the government representatives, including labour and employment minister, Chris Ngige.
They demanded, amongst others, payment of COVID-19 inducement allowance and medical and life insurance for frontline doctors.
The association also decried the undue hardship its members on GIFMIS platform are facing due to the delays in payment of their salaries ranging from three to seven months.
The NARD has rebuffed all entreaties by the government, and also dared consequences following the threats by the labour minister to implement the "no work, no pay" rule against them.
The ongoing strike, which entered its third week on Monday, is now the longest nationwide strike to be called by healthcare workers in the country since the outbreak of the coronavirus disease in 2020.
The labour ministry, however, during the week approached the National Industrial Court to procure a judgement declaring the doctors' strike illegal, and compel them to return to their duty posts.
But when the matter came up in Abuja, the government was not represented by its counsels. The matter was adjourned to September 15 by the presiding judge.
Asked why the labour ministry had no representation at the hearing, Charles Akpan, its spokesperson, said he was not aware of the matter in court.
Mr Akpan also said since the case was adjourned, the minister was yet to give information on the matter.
Meanwhile, an official of the federal ministry of health, who did not want to be mentioned, said the ministry was "tirelessly working" to ensure the issues are resolved as soon as possible.
NARD unfaced by legal option
Meanwhile, the striking doctors have said they would not be intimidated into submission, saying both the threats of "no work, no pay" rule and the legal option by the government could not force them back to work until implementation of their demands.
The President of the NARD, Uyilawa Okhuaihesuyi, said the striking doctors worry about their patients but that the government has left them with no other option.
He said: "An unpaid doctor is an angry doctor and an angry doctor is a dangerous one."