FASHOLA, DOCTORS AND A SICK DAD

By Emmanuel Onwubiko

Lagos state is in the news since the last couple of days for the very bad reason. The entire medical doctors working in the Lagos state public Health sector proceeded on an indefinite strike to protest what they termed as poor condition of service and the failure of the Lagos state government under Mr. Babatunde Fashola, a senior Advocate of Nigeria to meaningfully negotiate with the striking doctors and reach peaceful resolution.

The situation in the Lagos state health sector degenerated to the worst case scenario when the Lagos state government announced the immediate dismissal of the over 900 striking medical doctors and stated that it was ready to recruit fresh medical practitioners to fill the vacancies left by the striking medical practitioners.

This decision to sack the striking doctors has not gone down well with a cross segments of the society. A lot of groups and highly respected opinion leaders have lashed out at governor Fashola for literary using a sledge hammer to kill a fly by the unilateral decision of his administration to terminate the appointments of the striking doctors.

Those sympathetic to the Lagos state government are of the opinion that the legendary Hippocratic oath sworn to by all medical doctors absolutely forbids them from proceeding on strike. Few days after the medical doctors proceeded on the industrial action, the mass media carried pathetic stories of how poor patients in the Lagos state owned hospitals are left to die because they have no means to seek alternative private healthcare.

Specifically on Thursday April 26th 2012, the Daily Sun newspaper reported that when it visited the medical emergency ward of the Lagos state university Teaching Hospital (LASUTH), Ikeja, the ward was deserted with two corpses found inside. A resident doctor who helped reporters gain entrance into the ward said one of the men died on Tuesday night, while the second died on Wednesday morning. The doctor who pleaded anonymity said the men were in critical conditions and needed intensive care, which could not be rendered when doctors abandoned their duties as a result of the strike.

“This is the kind of development we witness when there is strike,” the doctor said. “The same scenario is going on in other hospitals owned by the state. Scores of patients will die, it can be swept under the carpet, but that is the reality of strike.”

A closer look at the modern version of the Hippocratic Oath shows that medical doctors are obliged not to embark on an indefinite industrial if such is capable of endangering lives since the Oath is usually taken by physicians and other health care professionals swearing to practice medicine ethically.

The Hippocratic Oath was upgraded and updated by the Declaration of Geneva. There is also the modern version penned in 1964 by Dr. Louis Lasagna, former principal of the Sackler school of Graduate Biomedical sciences and Academic Dean of the school of medicine at Tuffs University and this is the widely accepted version in use now. Three stanzas come in handy for the purposes of our current piece.

The three stanzas of the modern version of the Hippocratic oath that are of relevance to this piece are as follows; “If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honoured with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot”.

The other stanza stated thus; “I will apply, for the benefit of the sick, all measures (that) are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”

Importantly, another aspect of the oath stated thus: “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.”… Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.”

But the question to be asked is why subject the working condition of those medical doctors who ought to save lives to very dehumanizing situation by the political office holders? Again, should political office holders treat medical doctors as slaves just because those politicians are aware of the possibility of using the Hippocratic Oath as a weapon of blackmail to seek to stop the aggrieved medical doctors from demanding that their labour rights be respected and for the entrenchment of better working environment?

The Lagos state medical doctors were legitimately demanding the full implementation of the consolidated medical salary structure (CONMESS) which is a national pay scale for medical doctors put in place by the Government of the Federal Republic of Nigeria to save the health sector from the effects of brain-drain whereby medical experts migrate to Europe, America and Asia in search of greener pastures because of poor working environment locally.

It is wrong that the Lagos state government failed to implement a subsisting legal agreement to pay the nationally accepted wage bill and it is even worst that the Lagos state government decided to sack the medical doctors rather than use peaceful negotiation to reach a truce.

To even think that the Personnel Management Board (PMB), the disciplinary agency of the government which met on April 11th-13th 2012, quickly established a case of misconduct including absence from duty against the striking doctors and subsequently dismissed them on May 4th, 2012, is reprehensible and a breach of the fundamental laws of equity and fair hearing because the Lagos state government cannot become the judge and the prosecutor in a matter that affects its interest without hearing from the striking doctors.

The Lagos state government's sack of the medical doctors smacks of dictatorship and arbitrary rule which are antithetical to the current democratic wind of change that has blown in Nigeria.

The letter conveying the dismissal of the Lagos State-based medical doctors looked like a letter from the late Nazi leader Adolphus Hitter to the prisoners of the Second World War shortly before he carried out the most despicable genocide of the Jews.

The letter from the Personnel Management Board of the Lagos state ministry of Health read thus; “The committee therefore recommended your dismissal from service in accordance with the provisions of the Civil Service Rules No. 04502, 04507 and 04508. The board has therefore approved your dismissal”.

The letter was signed by the Chief Medical Director of Lagos state University Teaching Hospital (LASUTH), Professor David Oke.

To demonstrate how infinitely unrepentant most Nigerian politicians are, it was reported last weekend that the Lagos state governor Mr. Babatunde Fashola sent his sick father to the united states of America for medical treatment even when other poor patients are left to die because of the impasse or the ongoing strike which the state government deliberately failed to resolve.

On May 13th 2012, the citizen platform, an online journal that reports on Nigeria carried a shocking story that Mr. Ademola Fashola, the father of Governor Babatunde Fashola of Lagos state, has been flown to the United States for medical attention for an undisclosed ailment, as the crisis rocking health sector in Lagos state continues.

The governor's father was said to be accompanied by two doctors from the state, one of who is the medical director of Ebute-Metta Health Centre, F.O. Williams.

A senior official of the Lagos state government who sought anonymity confirmed that the elder Fashola had been evacuated from the country before the strike.

The citizen platform reported that one of the affected doctors who sought anonymity claimed that the governor once stated, during one of their negotiations that “he has no need for public health hospitals”. “Fashola told us that he doesn't use facilities in the state hospital and that whatever project he carries out there is not for himself,” he said. The doctor also claimed that former Lagos state governor Chief Bola Tinubu, last year, at a meeting to broker peace between the state government and the doctors, said the state could afford to shut down all the public health facilities.

On reading the story that the Lagos state governor flew his sick dad to the United States for the best medical attention before he failed to convince the medical doctors not to embark on strike, one book immediately came to my mind namely the novel by Robert T. Kiyosaki aptly titled “Rich Dad, poor Dad”.

From the Wiki summaries, we learnt that one theme that's apparent in this book is that for an individual to be wealthy, he must aim to own the system or means of production, rather than work for another individual. The author stresses that “there is obviously something confining about being an employee; it shuts the mind to other possibilities and it stunts initiative”.

Fashola of Lagos state can afford foreign medical treatment for his dad while others can perish because he wields enormous power of control over the financial resources of Lagos state and also enjoys huge security votes while the people die from abject poverty.

Recently, the senate President David Mark traveled to Israel for medical attention when he reportedly suffered from tooth-related problem.

The Federal ministry of Health recently banned public office holders from using public fund to enjoy foreign medical attention even while they deliberately destroy the public health infrastructure.

Going by the ban on foreign medical pilgrimage as announced by the minister of health Dr. Onyebuchi Chukwu, the question that immediately comes to mind is if the almighty governors of the 36 states that behave like Emperors will comply with this directive, listen to the voice of reason and invest meaningfully in reviving the collapsing health sector?

Are these political office holders waiting for violent revolution before they do the right thing?

The Lagos state government must recall the medical doctors and meaningfully invest in the health sector and the Lagos state House of Assembly and other state houses of Assembly should pass a law banning use of public fund to pay medical bills of political office holders, their siblings and concubines.

Emmanuel Onwubiko, Head, HUMAN RIGHTS WRITERS' ASSOCATION OF NIGERIA; writes from www.huriwa.com.