Health  Interactive with Dr Aminu Magashi

 

The Negative Attitude of Health Workers

healthinteractive@hotmail.com

 

The collapse of public hospitals across the country in terms of provision of facilities and equipments as well as adequate manpower to cater for the teaming masses trouping in to such places more or less their only succor and hope contributed a lot in the proliferation of private hospitals, nursing homes and laboratories and pharmaceutical shops which in disguise also provide hospital services. It is all part of the private sector driven economy and of course people have now come to terms with the reality that working with government establishment alone will not put enough food on the table.

 

Health sector which is no longer a social service but essential and protective service has suffered a lot of deprivation in this country, the exodus of doctors to greener posture and the attitude of combining government work and a private practice (P P) which is popularly tagged Private Practice Syndrome.  In as much as I am not discouraging neither condemning PP as a means of survival but however, what is imperative is the attitude of health workers who are neither with the PP nor with the government establishment. In essence they are combining the two work compromising one and aiding one to flourish and proliferate.

 

The impoverished common man despite what I said about the collapse of public health sector, that place still remain his only hope and a tool for survival as he cannot afford the exorbitant price of private health industry. The irony of PP in Nigeria is such that, it is the same people working in government hospitals that operate the private hospitals, and laboratories ( Labs ) too and to the bewilderment of the masses, they work in the government hospitals for only few hours with no zeal and commitment to attend to patients needs and before closing hours, rush to attend to clients at private hospitals and if they are on duty ( on call) at government hospitals, they hardly turn up because they are busy making money else where. The same people at the end of the month will queue up to collect full salary and even at times expect increment, money they have not earned, justify and deserve to have.

 

The technicians and experts in the labs will come up with bizarre laboratory findings if working in government labs, one may not be able to interpreted and make any meaning  out of that result. But visit them at private labs, where they put in their best to attend to clients. Another negative behavior is the attitude of hijacking patients from government hospitals to private health industries. One will come across a medical doctor telling a patient that he may not be able to attend to him/her because of some pressing issues else where ,  but will recommend to the patient a private hospital where his/her needs will be adequately catered for, only for the patient to go there and discover that the same doctor that attend to him/her at the government hospital own or is a partner to that private hospital in question.

 

I want to believe that part of the problem bedeviling public hospitals is not only lack of funding but non chalant attitude on the part of health workers  and combining 2 to 3 work at a time, there by compromising their main job and source of income and security. The essence of this discourse is to let health workers know that they have options available to them, they can quit government jobs and face the stark reality and competition in private health industry or they still remain in government work and attend to patients with patience, care, love and affection. I am of the belief that one can combine the two due to the prevailing economic situation in the country, but such should be exercised with decorum and in away that their responsibility at public hospitals will in no way be compromised at all.

 

Other problems being seen is for someone to engaged not in private practice but combining attending  to patients, administrative work and  field work and non governmental organizations ( NGOs ) activities. It is far more better to combine PP with public work than the later,  a medical doctor who attends to patients on daily basis will repeatedly abandon the hospitals for one to two weeks either attending a workshop, seminar or field work and the stark reality , is that what attract such fellow to such work is nothing other than the allowances paid at  the end of such exercise  not the commitment to make a difference  and of course his unattended administrative job will suffer lack of attention   there by causing delay in implementation of so many developmental work that will positively improve the life of the masses.

 

The pandemonium that always occur during National Immunizations Days ( NIDs ) of Polio Eradication leave much to be desired  and is enough to say that health workers need total reengineering . When ever NID on Polio is about to commence, health workers particularly clinicians will abandon their respective stations and lobby to be part of the NID which last at least for a week. That work is the job of health workers in primary health care departments and community physicians not clinicians. In one of the states in northern Nigeria recently during one of those NIDs, about 600 applications and Curriculum Vitaes were submitted to the state ministry  of health for consideration  in a very few limited and available spaces. Astoundingly, majority of the applicants are clinicians who are more than willing to abandon their work over few allowances attach to that work.

 

Lastly I will like comment about  health workers and strikes. It is a common phenomenon for health workers unions to lock up theaters, emergency units and send all admitted patients packing during strikes even if there are Samaritans among the health workers that are willing to stay and attend to emergencies. As I mentioned in the past on these pages that a health worker need to see himself as a savoir not a terminator, as such strikes that he will embark upon should not take the same pattern like in other sectors. Ethics and the oaths  must be put in place when embarking on strikes. One cannot lock up emergency units and discharge all patients and still claiming that the strike is done on behalf of the masses, that is a blatant lie and deception.

 

Some of those patients are operated on, some on blood transfusion, intravenous or naso- gastric tube feeding. Some women are in convulsive fits due to Eclampsia, others with obstructed labour and require urgent caesarian section  , while  some are bleeding profusely and looking at pediatric unit, many children are lying down with severe Malaria, Febrile Convulsion, Anemia and Measles and severe Malnutrition. In the adult emergency unit, many are in coma and strokes and u placed on urinary catheters. Where do we expect them to go to? In essence we are discharging them to go home and die because majority of them could not afford bills at private hospitals.

 

In conclusion, as health workers, we need to know that our responsibility is not only to our employers but to the beneficiaries and community as well, as such all our decision and actions must be guided by ethics and oath of work which we have all sworn to up hold and depend.

 

Dr Magashi Is the Executive Director of Community Health And Research Initiative, Kano , Nigeria .