Incessant NARD’s Strike: Lasting solution – the desideratum for Nigeria’s imbecilic health system

The lingering strike by Doctors under the aegis of the National Association of Resident Doctors (NARD) has not taken a halt 22 days after the industrial action took off on the 2nd of August, 2021. It appears the health professionals are, this time, hell bent on their showdown with the Government, having fallen victim of ‘promise-and-fail’ breaches, largely on the later’s part. While the Government has continued to make moves with several instruments to bring the strike to a halt, the resolute health professionals appear to be wading off attempts to be pacified without edible satisfaction of their demands by the Government.  The demands informing the ongoing strike this time by NARD centre on the need to push the Government to honour its agreement to pay arrears, hazard allowance as well as insurance benefits to families of doctors who have died of the COVID-19 virus. The Association has said doctors were ill-equipped and under-funded for the job while the facilities in state-run hospitals “are deplorable.”

Disagreements between the body of Doctors and the Government have continued to take course as irreconcilable differences keep taking heady dimensions as the offers of the later appear to be unsatisfying to the former. Following a stakeholders’ meeting over the weekend, NARD had declared its resolve, against proposals of the Government, to steer clear from signing a Memorandum of Understanding (MoU), while insisting on sustaining the status quo of the strike until their demands are met. As outcries continue to greet the lingering strike while many patients across government owned health facilities have been exposed to hazards of little or no medical attention, owing to the Resident Doctors’ strike, who are believed to constitute the largest chunk of health professionals in the Country, stakeholders’ meetings were convened over the weekend on the instance of President Muhammadu Buhari, who had directed the Minister of Labour and Employment, Senator Chris Ngige, to ensure all the contentious issues that led to the strike were resolved.

Although, the Minister of Labour had reeled out seeming resolutions at the instance of the meeting, with a MoU, the implementation of which he said would commence on Monday, the decline of NARD to append approval of consent to the MoU appears to pose conflicting dimensions to the moves of the Government. Hence, the outcome of the meeting involving NARD, the Nigerian Medical Association (NMA), other stakeholders in the medical sector and the Federal Government, to the extent of the contested position of NARD – the aggrieved stakeholders – raises conflicting fronts of disagreements – a reflection of controversial set back.

Clouds over the strike have been thickened when last week attempt to halt the industrial action by a court injunction was shrouded with bottlenecks.  The National Industrial Court sitting in Abuja on Thursday had rejected a request to order Doctors under the aegis of NARD to suspend their nationwide strike. The judge, John Targema, in rejecting an ex-parte application by a non-governmental organisation, Rights for All International, had said he would not issue such an order in the absence of the Doctors and other parties sued in the suit.

In addition to NARD, its chairman, Uyilawa Okhuaihesuya, and the Nigerian Medical and Dental Association (NMDA), sued as defendants in the suit, others are the Minister of Health, Osagie Ehanire, the Ministry of Health, Minister of Labour and Productivity, Chris Ngige, and the Attorney General of the Federation and Minister Justice, Abubakar Malami (SAN). The judge in his ruling had said issuing a restraining order against the Doctors to stop the strike without hearing the defendants would be in breach of their right to fair hearing.

A similar application earlier filed last Wednesday by the Federal Government alongside the Ministry of Health, was also mentioned in the court on Thursday but could not be heard due to non-compliance with procedures. Rights For All International, an NGO that prides itself as a defender of human rights, had filed its ex-parte application on August 16, urging the court to restrain the members of NARD from continuing their strike, with a prayer to order them back to work. As an ex-parte motion deployed majorly for cases considered urgent, the NGO’s application was on Thursday heard in the absence of the NARD and other defendants. The judge consequently ordered that the application and the substantive suit alongside other documents filed by the applicant be served on the respondents. As at the last sitting, an adjournment date to resume the case was however not fixed as Justice Targema, who heard the application as a vacation judge, said the next judge taking turn to sit, would fix a date for hearing.

A similar ex-parte application jointly filed by the Federal Ministry of Health and the Federal Government on August 18, where NARD is the sole defendant sued by the government in the suit could not be heard last Thursday. The Government’s lawyer, D. E Kaswe, had drawn Justice Targema’s attention to the application, but the judge said it had yet to be officially assigned to him by the court’s president to be heard during the judge’s ongoing vacation. According to the argument of the Government in the suit, members of the association “embarked on this strike without proper notice as provided by the extant law.” It also argued that the association being of “essential services providers” are prohibited by law from embarking on strike. “The continued and sustained industrial action by the defendant/respondent is contrary to public policy and equally endangers the lives of the citizenry,” it argued further. Similarly, as at the last sitting, a date for hearing the case is yet to be fixed as only vacation judges could be affixed for determination of cases of urgency following the annual vacation  embarked on by judges for the end of the court year session.

Following the Sunday meeting, the Minister of Labour and Employment, Senator Ngige, had disclosed that the Federal Government will commence the implementation of its MoU with the NMA on Monday. Ngige who claimed they had reached agreements the previous night on all the 12 disputed issues, NARD, was expected to submit the list of the affected 114 affected officers for further verification and when confirmed that they are genuine, and their IPPIS particulars and BVN are in order, they would be paid in September with the outstanding arrears. However, the unyielding declaration of NARD insisting on sustaining the strike speaks a different side of the subject. The National President of NARD, Dr Okhuaihesuyi Uyilawa, who spoke for the Association following the meeting,  declared the resolve of NARD having declined from signing the MoU, to continue the strike, while it will proceed with the court cases at the National Industrial Court.

While the Federal Government has come up with its proposals and promises encoded in its MoU to pacify the aggrieved health professionals, it is important that what Nigerians deserve is a lasting solution to the factors which form the roots of dissatisfaction, spurring phenomenon of incessant strikes in the Country’s health sector. The untoward experience which these inconsistencies have left on record are, to the degree of the ravaging impacts, unsavoury. The ravages are known to have left behind, irreparable damages which by and large, are preventable were the environment of the health system friendly to cater for the population’s demands. Worsening conditions which have continued to drive the brain-drain phenomenon have seen health professionals fleeing the Country in troops to secure better offer outside the Country in nations where the systemic atmosphere provides conditions palatable for health workers to thrive in their profession.

Hence, against the crass approach which has characterised the modus operandi of the Government in bringing abrupt end to industrial actions by impulsive measures borne by immediate pressure, it is paramount for the Government to look forward unto more broader perspective to addressing the rootings forming the phenomenon of unending strikes in the Country’s public health system.

The posture of the Government to making promises which on the dialogue table of negotiations are attempted to pacify health workers to call off strikes at different points, but which on the long run are rather said than done, have always boomeranged into the recourse of industrial actions borne by unfavourable conditions.

It is known that the gross inconsistencies and uncoordinated profile of the Country’s health system have rendered the sector so unreliable that it has become a rot to which even government functionaries will never give a second thought of availing themselves of, for medical treatment. The depth of the systemic inefficiencies have been responsible for the medical tourism which privileged Nigerians have been known for, constituting economic gains to foreign nations which have consciously developed their health system, to the detriment of Nigeria whose Government can be said to be insensitive to the necessities of the health sector. The conditions of the Country’s health system, particularly the  public subsector, have been overwhelming overshadowed with unsavoury narratives. Moving towards the resolute disposition to proffering lasting solutions that stand the test of time is paramount, particularly as the increasing population continue to pose increasing strains on the pressurised health system in the Country. Hence, nothing but a lasting solution is the desideratum for Nigeria’s imbecilic health system.