There are points in history when the road divides. One road leads to a better future, a fairer society, where everyone is looked after properly and is able to benefit from the fruits of their labour. The other road leads to barbarism, where the law of the jungle reigns and the rich and powerful are able to loot at will.
We are now standing at such a junction. One road is for those who actively support the current doctors strike in Nigeria. The other road is for those who refuse to take this step and so condemn everyone to even worse public health services, greater insecurity and a dog eat dog world.
The National Association of Resident Doctors (NARD) started a national indefinite strike from Monday 2nd August over poor working conditions, irregular payments of salaries and a hazard allowance not reviewed since 1991. Only one family of the 19 doctors that died of Covid-19 has been paid any life insurance. Abia state owes doctors about 18 months salary, Imo state owes eight months, Ondo state four months and Ekiti state two months.
All socialists, humanitarians and those who want a decent life for all should actively support this strike. We welcome the move by the Medical and Dental Consultants’ Association of Nigeria (MDCAN) and the Nigeria Medical Association (NMA) to join the strike by the doctors of NARD from Monday 16th August, when the doctors will have been on strike for two weeks.
The trade unions for workers across the health service combined in JOHESU should seriously consider solidarity action with the NARD strike. They face the same issues of underfunding of the public health services, irregular salary payments and poor working conditions. They provided a warning of an impending strike, but this was suspended when the Government promised negotiations which have so far not borne any fruit.
In real terms the Buhari Government has reduced the amount it spends on health each year over the last six years. So the public health services in Nigeria have inevitably deteriorated and are now even worse than before.
As a percentage of GDP, Nigeria spends not much more than a quarter of the average level for sub Saharan Africa. On a per capita basis Nigeria spends not much more than a third of the average level for sub Saharan Africa (World Bank Database 2016/7). The spending per person has been falling over at least the last five years (World Bank Pulse, April 2020). So 80% of spending on health in Nigeria is direct from our pockets – and inflation and increased unemployment means our pockets are empty.
As a result, Nigeria has worse health outcomes than the average for sub-Saharan Africa. Nigeria has one of the highest numbers of new-born deaths in Africa, with a neonatal mortality rate of 37 per 1000 live births which comes to approximately 250,000 deaths every year. At least one in eight children dies before their fifth birthday, making the under-five mortality in Nigeria one of the highest in the world.
In April, after the last doctors strike, the Government signed a Memorandum of Understanding. But since the doctors went back to work in public hospitals no action has been taken, no payments have been made to the families of doctors who died of Covid-19, no payments have been made of backlogs of doctors salaries.
In the last two weeks, the Government has made no promises, offered no negotiations. They have just offered threats of ‘no-work, no-pay’ and to dismiss the striking doctors. Barrister Femi Aborisade has demonstrated that these threats have no basis in law.
The Government is also threatening to go to the National Industrial Court of Nigeria to gain an injunction against the NARD strike. Such an injunction will only have any impact if the doctors are left to strike alone. Every general strike over the last two decades faced such an injunction – the threat evaporated during subsequent negotiations of a settlement.
So we are now at a junction and we have a choice. We can either actively support the doctors strike and share in its victory or we can watch the country descend further into the barbarism of un-necessary deaths and diseases. Every trade union should be supporting the strike, the least that they should do is send messages of support to NARD.
In return, NARD should recognise that they cannot win this strike alone. They need to be reaching out to JOHESU and other trade unions for solidarity and support. They need to organise townhall meetings to demonstrate that they have the full support of the public.
With the outbreak of cholera and the return of Covid-19, in addition to the multitude of other diseases we face, we need the doctors more than ever. We also need active support and solidarity to be clearly demonstrated to achieve a victory that we so desperately require.
Solidarity with the striking doctors of NARD!
Doctors require solidarity from the other health workers of JOHESU!
The workers united can never be defeated!
Biodun Olamosu, National Secretary, Socialist Labour