Annah Shiekuma clutched the hand of her sick relative. The diabetic patient gasped for breath as they paced the corridor of the Benue State University Teaching Hospital (BSDTH) on Wednesday morning. Hours had passed, yet no doctor had come by.
“Usually, they come every morning to attend to patients,” she said, her voice tight with worry. “But it wasn’t the case yesterday. It was much later, and I was scared because my relative was not breathing well.”
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Across the ward, Patrick Tile sat slumped in a wheelchair, a file resting on his lap. He had arrived at 8 a.m., hoping for quick treatment so he could return home to his restricted diet. By 11 a.m., he was still waiting.
“I think the strike has impacted the entire system,” he said. “If I had been attended to earlier, I would have gone home. I don’t even know when they will come.”
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Their stories mirror the frustrations of many patients at the hospital as members of the Association of Resident Doctors (ARD), Benue State chapter, began an indefinite strike on Monday, 11 August, leaving only skeletal services and a palpable gap in patient care.
CMD speaks on the strike
The Chief Medical Director (CMD) of BSUTH, Stephen Hwande, has appealed to the resident doctors to return to work and honour an agreement they reached earlier this year with the state government and key health officials.
At a press briefing on Tuesday, at his office, Mr Hwande stressed the need to maintain industrial harmony in the health sector.
“This strike is not about salary arrears,” he said. “It is about the Medical Residency Training Fund (MRTF), a yearly allowance approved by the state government to support resident doctors’ training and development.”
Mr Hwande said Governor Hyacinth Alia approved and released the 2024 MRTF in December last year, earning him an award from the ARD as the first governor in Nigeria to promptly pay the fund.
He expressed surprise that the 2025 calendar year was “yet to run out” and the ARD had embarked on an indefinite strike over the allowance without allowing the government adequate time to process payment.
“The issue of the 2025 MRTF should not form the basis for industrial action at this stage,” Mr Hwande said, adding that financial processes were still ongoing with the relevant authorities.
ARD list unpaid entitlements
In a counter press statement issued on Tuesday, the president of the ARD at the hospitali, Terhile Igbah, detailed the union’s grievances that triggered the industrial action.
Mr Igbah said the dispute was beyond the MRTF cited by the hospital’s management and involves multiple unresolved issues dating back to 2023.
Arrears of CONMESS 2023
According to the ARD president, the current salary structures at BSUTH were implemented in December 2024 after a strike that began on 28 November that year.
However, the 18 months’ arrears from the implementation of the 2023 Consolidated Medical Salary Structure (CONMESS) have not been paid despite the governor’s directive to the chief medical director to forward the financial implications of all union demands.
“The first demand was the implementation of the 2023 CONMESS with 17 months arrears,” Mr Igbah said. “When alerts came in December 2024, we discovered the now 18 months arrears did not reflect. Only the CMD and hospital management can explain how the governor’s directive was not followed.”
Mr Igbah said follow-up discussions with the CMD since January “yielded no positive results,” urging the management to resubmit the financial implications so the governor can approve payment.
He also noted that doctors in the College of Health Sciences and consultants had been paid the arrears in full.
Non-payment of MRTF 2025
The ARD president also accused the hospital management of failing to pay the 2025 MRTF and an outstanding balance despite repeated requests since April.
The yearly allowance, he explained, supports the registration for two postgraduate examinations and update courses, with the examinatiins held in March/April and September/October.
“Doctors had to borrow money for the first batch of exams in March/April,” he said. “The registration deadline for the second batch closes today, 12 August, yet we have not been paid.” He stressed that payment of the MRTF is backed by law and is annually budgeted for.
Incremental step arrears
Mr Igbah further alleged that for the first time in BSUTH’s history, the 2025 incremental steps — a routine annual salary adjustment for all staff — were not implemented, leaving workers on the same pay they earned in December 2024.
“This is highly demotivating for a workforce that is grossly understaffed and overstretched,” he said, pointing out that BSUTH staff handled more than 95 per cent of victims from recent bandit and cattle herders attacks in Benue State.
Deplorable doctors’ quarters
The ARD also raised concerns over the state of the hospital’s doctors’ quarters, which residents are required to live in.
Mr Igbah described the conditions as “pathetic” and “shameful,” citing leaking roofs, lack of staircase rails, and the need for doctors to collect rainwater in buckets during storms.
He said the union provided video and photographic evidence to the authorities and issued two communiqués on the matter, but with “no significant improvement.”
Instead, he claimed, the management recently renovated and roofed a large cafeteria in front of the quarters while the living conditions for doctors “remain in the rain.”
Unpaid arrears for new and upgraded staff
The statement also accused the management of withholding arrears for newly employed or upgraded staff.
Mr Igbah said some doctors work for two to three months before being placed on the payroll, only to receive one month’s salary without arrears for the earlier months worked.
“Many staff are currently owed an upward of four months of such salaries,” he said, adding that the CMD had been given 21 days to clear the backlog.
Mr Igbah called on Governor Hyacinth Alia to constitute a board for BSUTH to improve oversight and ensure that “the cries of the doctors” are addressed.
“It is our sincere hope that our cries have reached you,” he said, “and that in your usual magnanimity, you will resolve these issues amicably.”
‘In Benue, MRTF always paid after strike’ — Resident Doctor
A resident doctor, who asked not to be named for fear of victimisation, told Premium Times that the problem with the MRTF is not new and reflects a culture of neglect.
“In the over ten years I have worked here, there has never been a year the government paid the MRTF without a strike,” he said. “The fact that this money has not been paid up to this moment is because we delayed going on strike. There is this culture in this country where people don’t do their job unless you pressure them.”
He described the situation as “inhumane,” adding that the need to constantly fight for entitlements pushes many doctors to leave Nigeria.
“As medical doctors, we have to do our job as clinicians — and then also write letters, follow up with letters, engage formal and informal channels just to get people in the government to do their job,” he said. “We’re not asking the government to adopt a new policy. This is a policy they already have and have domesticated. We don’t have to tell the government to pay us.”
According to him, “Many of us are fed up with such an approach because nobody follows doctors to do their job. Once you wake up, you know you have to come to work and attend to patients — it should be the same for those handling our entitlements.”
Nigeria’s brain drain crisis
Nigeria’s health sector faces a severe manpower shortage, worsened by the steady migration of medical professionals to countries offering better working conditions.
Despite the nation’s already dire doctor-patient ratio — estimated at 1:5,000 compared to the World Health Organisation’s recommended 1:600 — the exodus persists, draining the system of experienced hands.
Official figures show that at least 5,600 Nigerian doctors relocated to the United Kingdom in the past eight years.
Data from the Development Research and Project Centre (dRPC) indicate that the annual outflow rose sharply: from 233 doctors in 2015 to 1,347 in 2019, before fluctuating in subsequent years — 833 in 2020 and 932 in 2021.
The trend is not limited to doctors. A 2022 UK immigration report revealed that 13,609 Nigerian healthcare workers, including doctors, were granted work visas in one year — second only to India’s 42,966. This mass migration has left hospitals across the country struggling to meet patient needs, further stretching an already fragile system.
