Dr Sylvester Ikhisemojie
Whenever health care workers go on a strike as part of their adopted strategies to press home any particular demand, they are reminded very quickly that their work is a humanitarian occupation and so they should not go on strike. Some other people will remind them that in advanced countries, health workers do not go on strike. The two positions are false. To begin with, Nigeria is not an advanced country like those others, so the work environment is very different. Such comparison should thus be seen as unwarranted and unhelpful. Secondly, health care workers embark on strikes abroad if they calculate that such a move will advance their interests.
At least twice this year alone, junior doctors in the United Kingdom have gone on strike to press home their demand for better conditions of work. In France a couple of years ago, similar actions were used to press home certain demands relating to the number of hours doctors should spend at work per week. To a large extent, diligent negotiation was employed in dealing with the problems and it often involved the participation of very senior government officials.
A humanitarian is an individual who works to improve the social and economic well-being of a populace. It is largely volunteer work often advanced through an aid agency, a non-governmental agency or through philanthropy. Certain kinds of politicians can also fit this description when they truly see their contribution to the welfare of the people as a call to service. Humanitarianism is tailored generally to improve the welfare of a target population. Nearly all the time therefore, the philanthropist is so much wealthier than the people whose lives they seek to improve. Look at Bill Gates working through the Bill and Melinda Gates Foundation. For the work done, therefore, no payment in the form of salaries or wages can be expected and very often, none is offered. A humanitarian is a person whose characteristic is such that he works to improve the lives and living conditions of other people. From this definition, you can deduce that such a job description is far beyond what any healthcare worker is usually required to do. As a way to compare this with the key members of the health team, let us examine their various job descriptions.
A pharmacist is a trained expert who is licensed to prepare and compound medications and dispense them with the authority of his knowledge. A doctor is an expert who is licenced to administer treatment in various forms as prepared by the pharmacist or with the aid of his hands essentially to obtain cure or improvement in the physical condition of a person. A nurse is that trained expert within the health care system who is licensed to administer medications prepared by the pharmacist and prescribed by the doctor. In any given situation within the hospital environment, it is these key people who have direct relationship with the patients. Their work is therefore professional and not humanitarian.
For this professional work, they expect to be paid. And the payment should not be done with strings attached. Very simply, any society that neglects to pay its professionals what is due to them is frankly not ready for substantial advancement. Even in ages past, when our forebears still patronised the village medicine men, every surcharge was paid without equivocation. It may have been in the form of a white goat or a black cock, with some other items that made it look almost like a ransom, but it was usually paid without rancour. In our world today, it is common to hear of some family who were detained in a hospital for a period of time for failure to pay a hospital bill. It is particularly sad when it relates to something like an uncomplicated delivery for which a couple has had nine months to plan for. Now, the native doctor has been largely replaced by the evolution of science for the betterment of all, but the rules should not change when it applies to the payment of hospital bills.
It is disrespectful to deny them their income to say the least and at worst, it is cynical in the extreme. And it demoralised people who believe they have earned their pay only to be subjected to ridicule. In a situation such as that, you can never expect the best output of work from dissatisfied workers. In the final analysis, these people have needs like everyone else. They get married, have children who need to be fended for, housed, clothed and educated. Will humanitarian approach to their very important work provide them all these needs? When within a system, an unskilled worker in an oil firm can earn as much as a professor because the former works in a certain industry, there is much to be desired, while respect for his less well-paid healthcare neighbour is, of course, thrown to the dogs. Unfortunately, that is the kind of mire in which many healthcare workers are stuck today. They are thus underpaid, underfed, overworked and unable to provide well for their families. What is behind it all is the mind-set that the range of services which they provide can be classified as humanitarian. It is not. It is rather a very professional kind of work provided with the utmost responsibility. When that recognition drives policies and appropriate wages are paid for work done in a fair manner, the provision of better quality of healthcare will happen almost overnight.
Elsewhere in the world, this kind of talk is considered asinine. Quality healthcare is capital intensive. The manpower requires constant training and re-training. This aspect is given close supervision in contradistinction to what routinely happens here at home, to the extent that many people become too unbending in their ways, with sometimes disastrous results. All these problems can be solved once the will exists to do so. To be sure, there are humanitarian organisations which also pay salaries to their workers, but in the main, most of the work is voluntary and difficult. The choice is the volunteer’s own. In the health sector, there may be some humanitarianism involved but the bulk of the work is professional and ought to be paid for.
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