Nigerian resident doctors down their tools for second time in 2023

NIGERIA—The Nigerian Association of Resident Doctors, NARD, has declared “an immediate & indefinite strike” over grievances including demands for a pay rise after the removal of a subsidy on petrol.

NARD embarked on its second strike this year to protest unpaid salaries and demand improvements in pay and working conditions.

In a brief statement, NARD cited its demands for the immediate payment of the 2023 Medical Residence Training Fund, the immediate release of the circular on one-for-one replacement, and the payment of skipping arrears, among others.

Moreover, the statement noted that having considered all the numerous ultimatums, appeals, and engagements with the government, NARD would commence with their strike on the 26^th of July 2023.

Resident doctors are medical school graduates training as specialists and are pivotal to frontline healthcare in Nigeria as they dominate the emergency wards in its hospitals.

The union represents around 15,000 resident doctors out of a total of more than 40,000 doctors in the West African nation.

NARD said that the failure of the government to review members’ salaries before and after the subsidy was removed, and shortages of manpower as doctors leave for better-paying jobs abroad, were among the reasons for the strike.

The doctor’s industrial action appeals & notices have been pending, moreover, since the new President does not yet have a team of ministers after he was sworn in at the end of May following disputed elections in February.

The speaker of the lower house has been negotiating with the doctor and urged them not to strike.

Nigerian doctors frequently strike over what they say are poor conditions of service and they have walked out from their jobs three times in 2020, at the height of the COVID-19 pandemic.

A two-week ultimatum was offered.

NARD had issued a two-week ultimatum to the Nigerian government at the beginning of July to commence the implementation of all pending agreements or face industrial action.

This was disclosed in a communique issued at NARD’s Extraordinary National Executive Council Meeting.

According to the communique signed by the President of NARD, Emeka Orji, the two-week ultimatum, which would end on 19 July, would give the government adequate time to begin implementation of the resolutions of the Memorandum of Understanding (MoU) previously agreed on.

The communique reads in part, “NEC observed with disappointment that it is now seven weeks since the end of the five-day warning strike action embarked upon by the association to press home her demands and that the resolutions of the conciliatory meeting chaired by the then Honourable Minister of Labour and Employment were yet to be implemented, seven weeks after, despite the set timelines for their implementation.”

In May a warning strike happened

The doctors had on 17 May embarked on a five-day warning strike following the failure of the Nigerian government to meet its demands.

The association had in January issued an ultimatum to the government to resolve issues affecting its members, including the immediate implementation and payment of the new hazard allowance and arrears.

The doctors, however, commenced the strike due to the government’s reported failure to meet their demands.

The union suspended the strike after signing an MoU with the federal government.

The doctors, among other grievances, are demanding the immediate payment of the 2023 MRTF, tangible steps on the “upward review” of the Consolidated Medical Salary Structure (CONMESS), and payment of all salary arrears owed its members since 2015.

The union also wants immediate massive recruitment of clinical staff in the hospitals and abolishment of the bureaucratic limitations to the immediate replacement of doctors and nurses who leave the system.

They also want the immediate review of hazard allowance by all state governments and private tertiary health institutions where residency training is done.

A looming healthcare crisis in Africa’s most populous country

The World Health Organization reports that Nigeria has a ratio of four doctors to 10,000 patients as of 2021.

However, the Nigerian Medical Association told The Associated Press their records show a ratio of two doctors to 10,000 patients generally, and one to 10,000 in some rural areas, which would make Nigeria’s doctor staffing one of the worst globally.

Salaries for resident doctors have not increased since 2009, Dr Orji said, and the value of the local currency against the U.S. dollar has fallen by 480% since then.

A highly qualified senior doctor earns less than US$900 a month while those with about five years of experience earn between US$400 and US$600.

At state-owned Abia State University Teaching Hospital, resident doctors say they are owed 24 months’ salary in arrears.

Out of the seven months so far this year, they have been paid only for June, said Dr. Erondu Nnamdi Christian, the head of the resident doctors’ association at the facility.

Consequently, resulting in an average of 200 resident doctors in Nigeria relocating abroad every month over the last two years, seeking better pay.

Their positions are left vacant, further worsening the relatively affordable healthcare services in public hospitals in the country of more than 210 million people.

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