The junior doctors in Nigeria have now been on strike for nearly two months. They started their national indefinite strike on 2 August 2021. The strike is over poor working conditions, irregular payments of salaries and a hazard allowance that has not been increased for 30 years. Only one family of the 19 doctors that have died of Covid-19 has been paid any life insurance by the government.
The contempt the politicians have for the doctors strike is shown by the fact that President Buhari had another health check-up in London during the strike and the leader of the opposition party is still in London for health care.
The Nigerian government spends less on public health than most countries in the world. As a result, Nigerians spend more of their own money on medical treatment, and doctors are poorly paid compared to most countries.
In 2001, African governments pledged to spend at least 15% of their annual budgets on health with the Abuja Declaration. But the Federal Health Budget for Nigeria for 2021 is only 4% of the total budget. In real terms, the Buhari government has reduced the amount it plans to spend on health each year over the last six years it has been in power.
As a result, Nigeria has worse health outcomes than the average for sub-Saharan Africa. Every day, approximately 2,300 under-five-year-olds and 145 women of childbearing age die. There are many other easily preventable deaths from malaria, typhoid, dysentery and recently cholera.
Nigeria has one of the lowest starting salaries for doctors in Africa. This is around £250 a month compared to starting monthly salaries of £2,500 in Britain; £4,250 in USA; and £2,600 in South Africa. Is it any wonder that half of Nigerian doctors are now working abroad and most trainee doctors said, in a recent survey, that they planned to emigrate? The British government said it would not recruit any more Nigerian doctors to the NHS in March of this year, but research by a Nigerian newspaper recently showed that more than 350 Nigerian doctors were registered by the General Medical Council in a 100-day period since then.
The government agreed to all of the doctors’ demands in April of this year when the National Association of Resident Doctors (NARD) suspended its last 10-day strike. The other health workers have a similar list of demands that the government agreed to a year ago. In these circumstances, it is disappointing that the joint union of the other health workers, JOHESU, again postponed the resumption of their strike in mid-September.
Similarly, it is disappointing that the two labour centres in Nigeria, the Nigerian Labour Congress (NLC) and the Trades Union Congress have not issued any message of support for the doctors’ strike. The president of the NLC did lead a delegation to Ministry of Health in mid-September in support of the demands of the doctors and other health workers, but no publicity was issued over this action.
The government has made no promises, offered no negotiations. They threatened to dismiss the striking doctors. The government then went to the National Industrial Court and gained an injunction against the NARD strike which the doctors association is appealing against.
On 21 August 2021, the government and the Nigeria Medical Association (NMA), as well as three of its affiliates including NARD, signed another Memorandum of Understanding (MOU). This MOU had specific deadlines for implementation, including the payment of salary arrears, payment to the medical residency training fund, and a ‘no victimization’ clause. However, the government has also failed to meet those deadlines.
The government regularly signs agreements and then fails to implement the trade union demands. Most of the strikes in Nigeria in recent years have been as a result of this policy. So trade unions, especially in the health and education sectors, go on strike, sign an agreement with the government and suspend their strike. The government then takes little or no action and eventually the trade unions have to return to strike action. This was the case with the nine month strike by the university lecturers last year, the week-long strike by JOHESU last September and the current strike by the doctors, amongst many other cases.
The doctors and working people of Nigeria need international support and solidarity to help to achieve the victory for the doctors’ strike that is so desperately required.
Tokunbo Oke
Messages of support should be sent to:
National Association of Resident Doctors, nardnigeria@ gmail.com
Dr Ishaya Godiya, NARD National President, kunidare@ gmail.com
Dr Suleiman Abiodun Ismail, NARD National Secretary, treze0007@ gmail.com
