Ekene Ngwu: How politics in the health sector is affecting the fight against Ebola (Y! Politico)

by Ekene Ngwu

It has been five weeks since the first Ebola fatality in Nigeria, and proactive efforts expected from the health sector have been marred by politics.

The Nigerian Medical Association (NMA) had been on a strike action embarked on July 1st, 2014, three weeks before the first case of the deadly Ebola Virus Disease was reported in Lagos, Nigeria.

The medical doctors’ association had listed a 24 ‘minimum point’ demand in an open letter addressed to the Secretary to the Government of the Federation.

Among the demands included the appointment of seven Deputy Chairmen of the Medical Advisory Committee, opposition to the appointment of directors in hospitals, which distorts the chain of command headed by doctors and induces anarchy, exposing patients to conflicting treatments with negative consequences.

They also demanded that the title ‘Consultant’ should not be assigned to non-doctor personnel, as it will lead to chaos in the health system.


Some of the demands related to financial remunerations included a 90% increase of the call duty allowance for Honorary Consultants, increase of doctors’ hazard allowance from a meagre N5,000 to N100,000 per month, and that all doctors on CONMESS 3 salary scheme and above must be paid specialist allowance not less than 50% higher than what is paid to other health workers.

They also demanded that the physical assault of NMA members by laboratory scientists tolerated by the Federal Ministry of Health must stop.

The NMA also insisted that the position of Chief Medical Director in any hospital must continue to be occupied by only a medical doctor.

Finally, it is no longer a question of who is right, and who is wrong. Everyone involved have played some right and some wrong cards too, but for the current challenge posed by the EVD, I advise that these strike and counter-strike actions be shelved.

The Federal Government suspended doctor’s residency programme on August 13, but rescinded that decision two weeks later, agreeing to meet some of the demands of the doctors. The strike has been called off and the NMA is still negotiating with the federal government, but it seems the National Association of Nigerian Nurses and Midwives may embark on a strike action in opposition to the government’s position and NMA’s demands, including the required qualification for the position of a ‘Chief Medical Director’.

It is now very obvious that the Nigerian Medical Association is at loggerheads with the Joint Health Sector Unions (JOHESU), over management positions in public hospitals, as well as financial benefits. Many doctors had earlier accused the Federal Government of taking sides with this joint union of other healthcare workers (excluding doctors), who appeared to have ganged up against doctors in Nigeria.

While all these were going on, a number of Nigerians died of the deadly Ebola Virus Disease (EVD), including doctors and nurses. May their souls rest in peace, and may those healthcare officials who fell in the fight against Ebola be honoured by all and sundry in Nigeria, especially the government.

If actually, there’s a gang up against doctors, what led to the deterioration of the relationship between these stakeholders in Nigeria’s healthcare industry?

What has made ‘the less qualified’ healthcare practitioners uncomfortable with the doctors’ management and leadership positions in their industry?
Many doctors have echoed that members of the JOHESU becoming “consultants” in their fields will threaten doctors’ leadership of the healthcare team, and conflicting decisions on patients’ treatment. For instance, doctors who are consultant pathologists, and have been sole decision makers in the pathology departments/laboratories of teaching hospitals do not want the medical laboratory scientists to become “consultants” and make conflicting or joint diagnostic decisions with them.

While it is understandable that it is better for ‘the most qualified’ healthcare practitioner (a doctor) to take the lead, a consideration of the opinion of others should be encouraged, rather than questioning the competencies of the ‘less qualified’.

I do not see too many reasons why ‘a consultant pathologist’ (doctor) and a ‘consultant laboratory pathologist’ cannot work passionately together towards patients’ wellbeing.

I suspect that the power and perks that come with management positions are the crux of the matter as well as protests due to continued bruised egos of the ‘less qualified’ healthcare practitioner who some egotistical doctors may have constantly reminded the limits of their job, by dismissing their professional opinions.

I believe the dangerous politics and the current situation is due to a gross failure in the stakeholder management, stakeholder engagement, internal, external and crisis communication abilities of the managers and leaders in the public healthcare sector.

Pharmacists, nurses, laboratory scientists and healthcare staff have continuously complained about some Nigerian doctors who have an unnecessary superiority complex and have continuously referred to ‘others’ as incompetent, less qualified, and dispensable.

It was also reported that while JOHESU was on strike awhile ago, a crisis ensued, as doctors where willing to take over the responsibilities of their subordinates; implying they are dispensable, instead of deploying crisis communication strategies and helping to harmonize the situation using stakeholder engagement strategies.

As important as a doctor’s role in a hospital is, and as the leader of the medical team, rubbing it in the faces of every other healthcare professional is unnecessary.

Doctors cannot expect to use “invective” on their subordinates and expect total loyalty and continued support; especially that stakeholder management, relationship and communication in the sector will continue to deteriorate with such behaviour.

Hospital management and administration is not just about ‘treating patients’, therefore doctors need to learn a lot about communication and public relations, which includes management functions such as stakeholder engagement, and effective internal communication. Deploying these strategies with a diplomatic humility will ensure that their subordinates do not question their authority, and will change the faulty perception of doctors as arrogant.

Doctors also need to realize that they are in an industry where other practitioners can never be ‘their seniors’ and that ‘the most qualified professionals’ will be criticized more often, but they must counter that perception of being ‘arrogant and egotistical’ by relating with their subordinates, patients and the general public, in the most respectful ways.

Without these strategic management and stakeholder relations’ strategies, more issues will definitely continue to arise.

Finally, it is no longer a question of who is right, and who is wrong. Everyone involved have played some right and some wrong cards too, but for the current challenge posed by the EVD, I advise that these strike and counter-strike actions be shelved.

While the “average Nigerian” can be escapist and would hardly make difficult sacrifices for the good of all, I urge healthcare practitioners to work closely with all levels of government as well as private individuals and philanthropists, to provide isolation centres in all local governments, and to procure abundant protective kits.

Despite the fact that a protective kit can be used only once, and costs around N17,000, I urge every Nigerian doctor to personally procure at least one, in other to be prepared, in case an Ebola carrier visits his clinic or hospital.

I believe that doctors and nurses are the most patriotic citizens of this country, but more than ever, they need to put their differences aside, eradicate Ebola, and become the heroes we all have known them to be.


Ekene Ngwu (@KenisCruise) is a Digital Media and Public Relations Consultant, and has been head of research, and a reporter at Supersport TV. He is also a documentary producer with experience in Nigeria, USA and UK.

Op-ed pieces and contributions are the opinions of the writers only and do not represent the opinions of Y!/YNaija.



One comment

  1. The stand of Nigerian doctors on the issue of hierarchy in office managerial positions is quite obvious and extremely unnecessary. The doctors and other medical practitioners(nurses

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