In hypothesis, it sounds unlikely, maybe even ironic, that a medical doctor would lose her life at work on the premises of a general hospital. Yet it happened in August, at the Lagos State General Hospital, Odan.
Dr. Vwaere Diaso, like the pregnant women in Ezzagu Community, Ebonyi state, lost her life to underfunded and under-equipped healthcare in Nigeria.
Following the doctor’s demise, the Nigerian Medical Association embarked on a protest strike for justice. They reiterated what they had always demanded: a properly funded health sector. But that strike was not the first in 2023. In fact, Nigerian doctors under one association or the other have gone on strike or strongly considered it every other month in 2023.
Anozie Byran Chidi, a young medical doctor based in Kwara State, would also fall victim to underfunding in the healthcare sector. In his case, he almost lost his mother to illness because he could not afford the cost of her hospital and drug bills.
Chidi had been contracted as a National Youth Service Corps (NYSC) member by the Offa General Hospital to work full-time in 2021. In September 2023, two years after his service, the hospital had not paid Chidi for his eight months of service.
This story involves three other medical professionals, a local government chairman and the chief medical director of the hospital.
‘WE KNEW THE HOSPITAL DID NOT PAY BUT THEY PROMISED US”
In his interview with FIJ, Chidi recounted the circumstances that surrounded his posting to the general hospital in Offa. According to his account, the community, through Olabisi Abdusalam, the Chief Medical Director at the general hospital, requested and pleaded for the services of a doctor who was an NYSC member.
Chidi told FIJ that he had suspected that the general hospital might not be able to compensate him well. He wanted to request for an alternative place of primary assignment (PPA). Chidi, however, reconsidered because of the promises and pleas of the CMD.
“In 2021, we arrived Offa, Kwara State, from the camp and we were received by the management of the hospital. I remember pleading with the CMD to reject me. I wanted to go to a place that would at least compensate doctors; I had quite the bill to pay at the time,” he began.
“But, the CMD, he promised to take care of me. He told me that it was the leaders of the community through the LGA chairman who requested for doctors at the hospital. He mentioned that we were there to serve the community and that the chairman promised to pay us stipends.”
FIJ would later learn that four other medical professionals, including a pharmacist, a medical laboratory scientist, a physiotherapist and a nurse, were requested by the Offa community at the time. FIJ also learnt that these medical practitioners were also corps members.
Emmanuel Ugwu, the physiotherapist posted to the general hospital, corroborated Chidi’s account in his interview with FIJ. He told FIJ that he had heard stories prior to his posting to Offa. He, like Chidi, wanted to request for a relocation.
“When me and my colleagues arrived in Kwara State, we wanted to explore our options. Normally, there was an unwritten rule that the Local Government Area Inspector (LGI) did not hold the privilege to assign PPAs to medical practitioners. We were always assigned by the Zonal Coordinator. To my disappointment, I was rejected at the Navy College of Health,” Ugwu told FIJ.
“I was even more disappointed when I got assigned to Offa. I had heard countless stories that the general hospital at Offa did not pay corps members. The physiotherapist that was posted here prior to our arrival shared experiences of people who had been owed.
“In fact, we heard that the last set of corps members served three years before our set came. I also heard they did not give accommodation. But the reception we got suggested that things would be better.
“They promised us they would pay us when we met the LGA chairman. For the first time, for instance, we were given accommodation. All of us lodged at the accommodation they gave us except the lady among us who preferred to stay with her husband,” Ugwu explained.
Both medical practitioners told FIJ that all five corps members agreed to a remuneration that summed up to N300,000. Chidi told FIJ that he had agreed to a monthly pay of N100,000. He explained that the local government and the hospital had agreed to pay each of them based on the perceived demands in their respective units.
Ugwu provided more details on the agreed remuneration amount:
“They told us Dr. Anozie would get N100,000; the pharmacist would be paid N70,000; the medical lab scientist, N60,000; myself, being the physiotherapist, N40,000; and the nurse, N30,000 monthly.”
Three out of the five corps members who responded to FIJ explained that they struck the bargain with the local government. The CMD, from their accounts, was designated as an intermediary between the local government and the corps members.
“In our agreement, the local government was supposed to pay us through the CMD. The CMD was the mediator. The CMD also seemed so sure that the local government would pay. He promised he would take care of me,” Chidi told FIJ.
I WORKED FOR 10 MONTHS, NOT PAID A DIME
Seyi Ebenezer, the pharmacist corps member requested by the Offa local government, told FIJ that he had to alternate between the general hospital and a community hospital. This was the agreement he had with the local government.
However, for eight months out of the 10 months of his service, he was not paid any money.
“In my arrangement, I was supposed to work certain days at the general hospital and other days in the community hospitals that were newly commissioned. However, after fulfilling our own end of the deal, we were owed several months of arrears,” Ebenezer told FIJ.
In Chidi’s case, his work at the general hospital was more than demanding. In his account, the workload was draining.
“Normally, a corps member doctor wasn’t supposed to take calls but I was on the roster for calls and made to be on call every weekend. Essentially, I worked full-time in the hospital. The full-time, in Nigeria as you know, was more than tough. But I was willing to do the work provided I would get paid,” Chidi explained to FIJ.
As young corps members, responsible for themselves, Chidi and Ugwu explained how the withheld pay affected their personal and professional lives. In Chidi’s case, his mother was severely ill and the financial implication of the hospital bills were heavy. He told FIJ that he thought he could rely on his remuneration to offset the bills.
“At some point during my service, I approached the CMD who then started making excuses. I had to stop working and find alternative means to pay my mother’s hospital bills and I told him. I had to borrow a heavy loan to offset my mother’s hospital bills. I stopped work because of this. After I stopped, the CMD paid me N100,000 as that month’s payment,” Chidi narrated in his interview with FIJ.
As for Ugwu, the withheld pay set his career back by several thousands of naira.
“Yes, the payment delay affected me negatively. Some of the projects I intended doing for my personal and career growth were significantly delayed. Take for instance, getting my licence as a practising physiotherapist,” Ugwu noted.
“Even when I did, I had to make sacrifices. It cost money that would have gone into personal upkeep. Even some of the equipment I used to for treatment, I bought them with my money. I am talking about equipment worth over N800,000.”
THE HOSPITAL IS SERIOUSLY SHORT ON STAFF, ESPECIALLY MEDICAL DOCTORS
In their interviews with FIJ, Chidi and Ugwu shared another concerning revelation: the hospital they worked at was short on staff. Ugwu mentioned that while some departments, like the pharmacy, seemed adequately staffed, major departments like the medical laboratory were lacking qualified personnel.
According to Ugwu, doctors bore the brunt of the workload.
“Last I checked, there were about three doctors in the entire specialist hospital. Chidi worked full time when we were there and they worked tirelessly, even on weekends. This did not exclude the CMD. Sometimes, it appeared like they were always on duty. In fact, I was the only physiotherapist in the entire Offa. So, I was quite engaged,” Ugwu explained to FIJ.
Chidi added that the hospital initially requested corps members because it was already short-staffed to begin with.
“The hospital was short-staffed and the work can be very stressful. I took weekend calls. I worked through the evening. There were very few of us when I was there,” Chidi explained.
The World Health Organisation (WHO)’s Global Health Observatory recorded that there were only about four doctors per every 10,000 people in Nigeria. Similarly, the country was estimated to have just about one nurse per 1,660 people. These figures are below the WHO recommendation of 25 doctors and nurses per 10,000 patients.
SOMETIMES THEY IGNORE YOU, SOMETIMES THEY BEG, BUT THE PROMISES NEVER END
The ex-corps members also told FIJ that their efforts at negotiation and recovery since 2021 only paid off in promises, vows and more promises.
“They keep making promises. On some occasions, the local government chairman would ignore our texts. In other instances, they would beg and beg and make promises. They’ve been telling us to wait since 2021, how much further do we have to wait for?” Chidi quizzed.
Ugwu, during the first of his two-part interview with FIJ in August, pleaded for more time for the LGA chairman. According to him, the chairman had promised to pay unfailingly in the first week of September.
When FIJ contacted him on September 8, he explained how he only got more promises instead of payment.
“The local government wants us to be understanding. I have represented my colleagues well by mediating with the local government chairman. The CMD has tried his best. I have written letters, sent texts, made calls but we have only been getting promises. I know even Anozie must have been sending texts and making calls. I can understand their frustration,” Ugwu explained.
CMD AND LGA CHAIRPERSON’S REACTIONS
On August 7, when FIJ called and sent a text to Olabisi Abdulsalam, the CMD of the general hospital in Offa, he did not respond.
On September 12, FIJ made another attempt to reach the doctor. However, he expressed a strong disinterest in speaking on the subject.
“Please, I don’t want to hear anything about it. If he needs anything and if you need anything, they should go to the local government. The way he (one of the corps members) went about it, he has proven to be someone I cannot relate with. There was nothing hidden and I don’t want to be disturbed again, they should go to the local government,” he told FIJ.
On September 12, FIJ was also able to reach Thomas Olajere Oladotun, the Offa LGA chairman. In his response to FIJ, he claimed that he was not indebted to the corps members.
Oladotun explained that the local government did not request for the corps members. Instead, the community and the hospital had made the request for the corps members. Oladotun also told FIJ that he was only in the picture to help the corps members.
“If up till now I am not able to pay, it’s just because the local government does not have the money. I am only trying to help them. God knows I have them in mind. I have my own kids and I don’t want someone else’s to suffer,” Oladotun said.
“But note that I am not indebted. Firstly, it is a state hospital, I am a Transition Implementation Committee (TIC) chairman. I met a N50 million debt when I assumed office. The local government simply does not have money in its purse too.
“Also, it was the community and the hospital that requested for corps members not the local government. I am still promising to pay, like I did. I have not got the means, but I am not indebted. I only decided to offer assistance, they did not serve at the local government office.”
The chairman’s message to FIJ was consistent with his response to Chidi on September 11, when he reached out for the pay.
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