Of JOHESU, health sector squabbles and the brigandage of health workers in Nigeria, By Ibrahim Idris

Minister of Health, Onyebuchi Chukwu

Do JOHESU members think they are more equal than the others (apologies to George Orwell)? What is good for the goose should also be sauce for the gander.

Any keen observer of what has been transpiring in the health sector within this period would certainly feel very sad about how everything seems to be working upside down in a system that is ferociously getting consumed by the days, by an untamed monster in the name of JOHESU; an acronym that stands for an amalgam of health workers other than those that are medically qualified.

For the records, JOHESU is an illegal body that is strange to the Nigerian Labour Laws. It is, in fact, curious that the federal government would easily submit to the blackmails of this anomalous creation even when it should be firm in locking up some of the characters behind this racket in jail.

Such thriving illegalities is what makes us as Nigeria, a unique country where leaders have lost all moral grounds to stand against injustice or reprimand miscreant actions. They rather deal with issues in reactionary pattern just to save face when in actual sense, it is deeply buried in a mess.

The health sector these days is effectively a captive of mobs action going by the way things are unravelling very fast in a furious manner. Not even the so called characters of a Hollywood flick blockbuster: The Inglorious Bastards, can surpass the level of lawlessness and brigandage being displayed by this cohort of workers. And like a medusa, it keeps on rearing its ugly heads with no end in sight.

What actually started like a joke taken too far, has now transformed before our eyes into a cancerous tumour that is eating deep into the fabrics of sanity and morality in the health sector. It is rather unfortunate that the penchant for industrial actions by JOHESU has been so misused to the extent that it has now turned into a revolving door syndrome- with the system practically held at ransom by preposterous and illogical demands that are not only alien to the scheme of service but entirely contradicts the norms of international best practices.

Ironically this group of health workers that include among others the cleaners, porters, nurses, laboratory technologists and the pharmacists, have thrown caution and decency to the wind to have allowed their spines to take over their collective faculty of judgement, all in a blind quest to rape a vulnerable system.

In fact, at a point it was widely reported in the media, that they once ran so wild and hysterical to the extent of storming an Intensive Care Unit (ICU) of one of the public hospitals and switched off a ventilator; leaving behind a critically ill patient who could not breath unsupported. Can you imagine! Just hold your breath a bit more. For some of us that have keenly followed the disturbing developments in the healthcare sector, that action was a fraction of what one expects from this coalition of desperadoes when it is juxtaposed with the cruelty they meted out to the ex Chief Medical Director of ABUTH, late Prof. Bandipo. They tied the old man down and kept beating him until life was snuffed out of him, slowly and painfully. Incredible you may say, but you should remember it is not a moon tale- it happened!

But the question that always bogged my mind when I see people who are supposedly educated and civilised behaving like riffraffs is this: must health workers go down this irresponsible lane just to prove a point that they are equal to a medical doctor in terms of merit and metrics? Perhaps, a regular lesson on ethics carefully built in their curriculum at school will help in restoring sanity to this unholy alliance which, albeit ignoramus, thought by behaving like rogues its members can acquire the nobility of a medical doctor, even undeservedly. It is pertinent to highlight that God did not create us all equal, but we are all important in what we do. There is no way a society will recognise you for what you are lacking in competence and productivity just by attempting to muscle it with killer instinct for compensation.

For the benefit of doubt, let us dissect their demands on why they want to go on another round of irritating national strike coming up almost two months after they had totally shut down the public hospitals in a gangster mentality. I thought there may be genuine reasons for these incessant desperate measures until I got to read the communiqué signed by JOHESU’s hydra headed leadership.

Among the demands, they want the federal government to allow them to be skipping salary grade level 10, which in essence means that from grade level 9; all JOHESU members will now be promoted to level 11- effectively translating into jumping career by about 6 solid years! If I could recall correctly, it was the Obasanjo’s administration of public sector reforms that brought about the current consolidated salary structure which became operational in Nigeria in 2006.

Even though this salary structure came with full complements of all grade levels, unlike in the HATISS which had no grade level 11, only the health workers with exception of medical doctors (among all the public servants) found a dubious way of skipping an entire level. This cheating continued unabated until it was finally fished out by the eagle eyes of the former Head of Civil Service, Steven Orosanye, who ordered that such fraud which has cost the federal government billions of naira to be immediately stopped- a directive that did not go down well with this group of workers, hence the apparent resort to mob justice.

Truth be told, there is clear and present danger in government willingly or otherwise submitting to this kind of prebendal demand, which we all know it encourages rent seeking psyche to proliferate, and at the end it will only open up the Pandora’s Box there by dashing hopes of putting the system on a sustainable path to greatness. What if all other workers in all the MDAs now insist on skipping grade level 10? Can government shoulder this efflux from its coffers? Do JOHESU members think they are more equal than the others (apologies to George Orwell)? What is good for the goose should also be sauce for the gander.

It is disturbing enough that health sector crisis has snowballed to reach its zenith that even nurses, who are mostly auxiliaries with very shaky academic background being certificate holders whose merit is below that of Ordinary National Diploma (OND), are threatening fire and brimstones that they must be appointed ‘Consultants’ and Chief Medical Directors. And the race for this petty Vanity Fair has now found comfort in other hospital supporting staff like cleaners, porters, laboratory technologists and pharmacists.

I am afraid, from the way the unions keep coming up with all sorts of make belief demands, very soon, chauffeurs working in the ministries would go on strike demanding that they be accorded the status of Permanent Secretary, and the ‘other ranks’ in the army would categorically go for the position of Chief of Army Staff- after all we are in the era of equality!

I want to make an appeal to JOHESU to be a bit more refined in its incredulous transformation. Her members ought to know that the privileges they derived from being part of a health team are not all that sacrosanct. Government has the liberty to be tough when pushed to the wall by ordering for their sack and employ fresh graduates who would be more amenable to standard practice.

They should also remember that there are hundreds of thousands of graduates of biological sciences and biochemistry who have better university grades that are parading the corridors in search of jobs, and despite being even smarter than most of the third graders that have populated the health sector these days. With single advert, the government can get all that it wants to keep the system running.

I once read a report that showed that over 50 percent of the laboratory test results in Nigeria are unreliable; which has contributed greatly to misleading clinicians into making the wrong diagnosis. Yet, the technologists have resisted all treaties to make them realise that they need to catch up with what is done in the established global trend by collaborating with pathologists to help in producing qualitative test results. Nigeria’s public hospitals can learn a thing or more from the way standard private laboratories in Nigeria are operating. It is reassuring that every test result is signed by a pathologist to ensure quality. This is how a health team should operate anywhere in the world. And a pharmacist should focus his/her attention on how to curtail counterfeiting by putting into practice his/her university knowledge on drug manufacturing. As it is now, people just see pharmacists as mere drug dispensers or peddlers. Majority of them are now experts as drug reps of marketing labels; a job that even market women can do with equal precision and mien.

It’s painful to see our drug markets being overtaken almost completely by semi-literate business men who import up to 70 percent fake drugs into Nigeria from countries like India and China.

As professionals, if they can ensure that the drugs we buy every day are qualitative, wholesome and genuine, I guarantee you that Nigerians will respect them more. In a nutshell, I think what we need now is for all professionals and even non professional groups working in the health sector to work harmoniously with each other to improve the healthcare delivery in Nigeria. And this vicious cycle of incessant national strikes must stop or be stopped now. It is an ill wind that blows no one any good!

Ibrahim Idris is Coordinator, One Health Initiative, an Abuja based NGO

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