Doctors in Nigeria begin ‘total and indefinite strike’

Nigeria’s resident doctors began a “total and indefinite strike” on Wednesday, calling for an improvement in conditions as well as the urgent replacement of medical staff who are leaving the country en masse.

In a communique issued earlier this month, the National Association of Resident Doctors said doctors and nurses were suffering from “burnout . . . assaults and harassment” as a result of the lack of staff. Resident doctors in Nigeria are medical school graduates training to become specialists.

The association’s president, Emeka Innocent Orji, said doctors were breaking down and dying from stress, while patients were dying too. He called the situation “an emergency”.

Doctors are among the huge numbers of skilled Nigerians embarking on what is commonly known as “japa”, which translates from Yoruba as to run, flee or escape.

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At least 50 doctors leave the country every week to find employment abroad, the Nigeria Medical Association says.

Dr Oru Inetsol Oru, a senior registrar at the department of internal medicine at Niger Delta University Teaching Hospital in Okolobiri, told The Irish Times by phone that striking was a “very painful decision” to take, but doctors felt their hands were tied.

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The move – which is expected to mostly affect public hospitals – comes after lengthy negotiationsThe matter was now in the hands of the government, he said. “We would be happy if the government can intervene and just carry out the demands so we can come back today.”

Dr Oru said there was a gross shortage of staff, while there were unemployed doctors not being hired as replacements. “The working hours are terrible because of the brain drain. All our health facilities are severely short staffed . . . a doctor has to work around the clock . . . it gets as bad as working 24 to 48 hours straight,” he said.

Some salaries were in arrears, while others had failed to keep up with the rocketing cost of living, which had brought “untold hardship”.

“It’s not just about the salary . . . we also have a lot of other issues,” he added. “We want better working conditions generally . . . We want better infrastructure in our hospitals . . . We want better facilities which will aid in patient management. The facilities that are provided in the hospitals are not just for the doctors, they are to save lives.”

He said it was difficult for medical staff to see patients die while knowing they could have survived with better facilities. “We want the health system to improve, that is why we are fighting . . . We love Nigeria. We hate to see our people suffering.”

Like much of the region, Nigeria has been experiencing a major cost of living crisis. In its communique, the resident doctors’ association also referred to the removal of a fuel subsidy which had made it difficult for doctors to travel to work or carry out other responsibilities.

The International College of Surgeons, Nigerian Section, says an estimated 6,221 Nigerian doctors have moved to the UK over the last six years, with 10,986 Nigerian doctors registered as working in the UK in 2023.

Last year, local media reported that Nigeria – which has a population of more than 200 million – had 24,000 licensed doctors, less than 10 per cent the number needed to meet World Health Organisation recommendations. Nigerian Medical Association president Uche Rowland said that only about one quarter of doctors trained in Nigeria ended up practising there. In some parts of the country’s north, there was only one doctor for 45,000 patients.

Nigeria, Africa’s most populous country, held elections in February, which President Bola Tinubu won with 37 per cent of the vote. But the turnout was the lowest since military rule ended in 1999, and European Union observers said a lack of transparency and operational failures had reduced trust in the process.