It is indeed a great service to humanity to be informed so as to reform those who are already deformed due to their misinformation, insatiable creed for power and wealth, arrogance, ego as well as overconfidence. The propelling impetus for writing this few lines is nothing but to correct the abnormalities embedded in an article titled: Medical Doctors’ Strike and the Problem in Nigerian Health Sector’ written by Dr Dagba, Agwaza Maxwell, a Senior Registrar at the Dept of Obstetrics & Gynaecology (ObGyn) at the Jos University Teaching Hospital, Jos, Nigeria. I need to summarise this response within four points: Criteria for CMD/MD appointment, Academic qualification of health professionals, Abuse of Professional practice in the Health Sector and finally the way forward. Criteria for CMD/MD appointment Frankly speaking, the criteria for these leadership positions in the health sector is sacrosanctly enunciation by the law of University Teaching Hospitals (reconstruction of boards) cap U15, LFN 2004 commonly called decree 10 of 1985 stated as follow: The candidate for the post of Chief Medical Director is expected to be a person who is medically qualified and registered as such for a period of not less than 12 years, has had considerable administrative experience in matters of health and holds a post-graduate medical qualification obtained not less than 5 years prior to the date of this advert. Furthermore such a candidate:- (a) Must show evidence of high-level managerial and executive capacity in the administration of a tertiary medical institution. (b) Should hold professional and academic standing that must be sufficiently high to command national and international respect, particularly in the professional medical world, such that it would enhance the good reputation already established for the Teaching Hospital. (c) The appointee must be a person of courage who can take decisions on the merit of facts and principles, and not on the basis of pressures from individuals or groups. He/She must be also be a person of unassailable integrity. (d) The appointee should possess such personality as can attract funding from both the local and international community to supplement government subventions. The section of the above Law as distorted by Dr Dagba and those who share his school of thought that “medically qualified” means only the holders of MBBS is nothing but personal interpretation of Nigerian Law without any jurisdiction to do so. Similarly, it is your personal opinion that the phrase “post-graduate medical qualification” only means “postgraduate fellowship, which is peculiar to doctors.” The flawlessness of your supportive analogy as applied to other professions is another indication of your wrong perception; I would like to ask you sincerely which of Nigerian University that is awarding a degree certificate called legal clerk? Likewise, those in the field of engineering know that both brick laying and welding are part and parcel of civil engineer procedures and not different profession. Contrarily, what is obtainable is that a civil engineer will never claim superiority over mechanical or electrical on the field work. As a law abiding professional in the country, I expect NMA to supply court with its legal exhibits since the case instituted in the Federal High Court Awka by Comr. A. A Obi a distinguished Medical Laboratory Scientist with the suit number is FHC/AWK/CS/38/2013 on interpretation of those grey areas is on-going. NMA and Dr Dagba et. al should know that orthodox medicine is not indigenous to this country. Hence we must conform to the international best practice where the headship of health facilities is not limited to Medical Doctors rather, in most places; it is a qualified hospital/health administrator that manages hospitals. For your information, this international best practice was the norm in Nigeria when the quality of our health service was ranked 4th in Africa until 1985 when the then Military Head of States, General Ibrahim Babangida, appointed Professor Olukoye Ransome Kuti as the health minister who chased away all the health administrators among whom was Col. Austin Akobundu (rdt), the then chairman of the Board of UCH, Ibadan, in 1987 and since then there have been progressive deterioration in our health system. In 2013, Mo Ibrahim foundation ranked Nigeria health section 41st out 52 countries in Africa under the administration NMA members!!! (What a gross display of incompetence). Alas! This managerial ineptitude of NMA members formed the basis of exodus medical tourisms among the Nigerian elites with the cost of 1.7 billion US dollars, according the recent research. Academic Qualification of Health Professionals It is an incontrovertible fact that all professions have their humble beginning, MBBS holders of today started in this country with award of Licentiate Diplomas as a medical assistant in 1939 at Yaba Medical College (Lagos state) which was the first medical school in Nigeria. Likewise, medical laboratory practice had its origin in ancient Europe well documented; that medical laboratory science has been practiced in Nigeria since 1922. The same thing is applicable with other professionals in the health section not only in Nigeria even among the developed nations of the world. If NMA’s campaign of calumny against other professions can be jettisoned, others can as well quickly rise to the zenith of their career. Recently, NMA’s lobby swipe at the award of D- pharm. and tried frantically to truncate BMLS degree in Nigerian University (but God Almighty Voided its plot) using its puppet -NUC Chairman (at the seat of power). Broad –based medical knowledge mentality is another issue that needs urgent clarification. Dr Dagba and others should be informed that the practice a single man claiming to know all in health sector is only traced back to medieval era when health care delivery was at throes of birth, this is not and cannot be productive in 21st century of ours. For your information sir, WHO’s concept of health service provision puts the patient in the centre of a circle formed by healthcare professionals. The old concept of the patient belonging to the doctor is now outdated which is based on guess work and at best the practice of polypharmacy. Furthermore, this broad–based medical knowledge mentality is an insult to the Nigeria educational system that as well produced you. In fact, it is highly inconceivable that someone who spent good five years of cognate university study in pursuance of a professional couse (as it is applicable to Bsc, Nursing, MLS, PHAM., PHYSIO., Optometry) and you with the broadness of modern day clinical knowledge now claiming to be more knowledgeable than all of them just because you spent six years in the school. Nigerian physicians should learn to the difference between being trained to practice a profession and being train to have an idea so as to recognize where your own professional practice interdependent with that of others. That is why we have many borrowed courses in our university system, the fact that you did philosophy or law as a borrowed course can never make you to be a philosopher or lawyer. But Nigerian physicians want to be physicians, professional nurse, medical laboratory scientists, pharmacists, physiotherapists at the same time. Your unquenchable longing for leadership, if not checked, will soon be extended to being the head of cleaning services, security services, gardner’s services in our public hospitals. As a MLS, I have not seen a Nigerian first degree MBBS holder that can accurately crossmatch donor blood for an authoimmune patient, I challenged. Abuse of Professional Practice in the Health Sector This syndrome cut across all health workers without exception, physicians claim to be jack of all trade and master of them all, nurses are running diagnostic procedures, medical lab. Scientists want to be clerking patients and so on. As we speak now, the Nigerian doctors lead the pack in the training of Quacks because they run private clinics without complementary services of other healthcare team. As at today, they hire barely literate people and train them to be auxiliary nurse!!Where is that done in the world!! It is the statutory function of all councils present in the health sector to maintain a sustainable standard of practice among their respective members. However, Medical doctors will never allow MLSCN, PCN, Nursing council of Nigeria to inspect the laboratory, pharmaceuticals and nursing staff of their facilities to even perform these legal statutory functions in public hospital sometimes is a tug of war. JOHESU members had suffered a lot of assaults from Nigeria physicians; they abuse their position as CEO of governmental facilities against other professional members. In your facility at Jos Teaching Hospital, Dr Dagba, the physiotherapists were harassed yesterday (4/07/2014) and their patients being chased away from the hospital just because NMA members are on strike and they believed they owned the hospital. Not to talk of illegal queries, suspensions and issuance of sack letters to our members just because physicians occupy the administrative position. Thank God for effective judiciary system that provides hope for the helpless. In fact, NMA’s enslavement of other health care providers who have transcended that of slave trade era. The way forward As stated earlier, WHO’s International best practice depicts effective health service delivery as mutual contribution among all professionals. The era of seeing a nurse as an errand maid for the attending physician is no more, a Med. Lab. Scientists equally burned night candle and was issued a degree certificate that (s)he is worthy in character and learning and as well licensed to practice his profession. A physiotherapist should not be looked down upon again just because (s)he did not study medicine and surgery. All these professionals should be allowed to reach the zenith of their careers as stipulated by their respective scheme of service. International best practice in the health sector revealed that sometimes physicians issue an order to other healthcare providers while in other situation the reverse being the case, all for the benefit of the patient well being. Such an order, over there, is not seen as a display of superiority but as professionalism at the highest order. Than there at South Africa, as I was told, ward-round is not limited to the physicians and some selected nurses alone (as is the case in Nigeria), Consultant Med. Lab. Scientists, Consultant pharmacists and Nurses are part of the team. Finally, sincerity of purpose should be imbibed by our political office holder. Truth, they say, promote a nation. The government at all levels should rise up to it responsibility; the practice of promising what cannot be fulfill is gross display of irresponsibility. May God Almighty bless the health sector and our nation-Nigeria. Thanks so much, Sct Ibraheem A.O BMLS, DPM. Working at Kasina, Katsina State, Northwest Nigeria. Sina4dtop@gmail.
Posted on: Sun, 06 Jul 2014 08:30:12 +0000
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