Treating the ill to the best of one’s ability requires a lot. It requires a lot of health equipment, facilities and support staff to save a life. Also, it requires that hospitals are not understaffed and doctors are not over-worked so that they can be in the best shape mentally to maximise their abilities. This is why the data of doctor to patient ratio is essential and the doctor to patient ratio in Nigeria is one doctor to two thousand five hundred patients, instead of the one doctor to six hundred patients’ standard of the World Health Organisation.
THE Hippocratic Oath was written by Hippocrates between 5th and 3rd centuries BC and it’s one of the oldest ethically binding documents in history. The Hippocratic Oath is ceremonially held sacred by physicians. It is not legally binding on doctors anymore, especially given the fact that the Oath was made in Greece for a certain generation and not a law by the Nigerian people. Is it not interesting that, in Nigeria, ethics belonging to over twenty centuries ago are still being referenced to make laws for people in Nigeria? That speaks of the backwardness of this government!
These points are basic contextual points against the law being proposed by the federal government and the National Assembly to make medical doctors’ strikes illegal in Nigeria. The bill is being sponsored by a member of the House representing Enugu State, Simon Atige, and it is titled “An Act to amend the Trade Disputes Act, cap T8, Laws of the Federation of Nigeria (2004)”.
It is designed to ban medical practitioners in the employment of federal, state and local governments in the essential services sectors from embarking on strike, while promising to accelerate the processes of administering doctor’s industrial disputes at the National Industrial Court.
The Minister of Labour and Employment, Chris Ngige, also told medical graduates at the University of Abuja late last month (around the same time the bill appeared in the House) that it was unethical for doctors to embark on strike based on the Hippocratic Oath. This was after the federal government had tried to use an Industrial Court order to make doctors call off their strike earlier in September last year, and now the government just brought the bar lower.
Yet, these are the issues that led to the strikes that the same federal government that is underfunding the health sector is about to outlaw. According to Dataphyte, the Nigerian government appropriated N3,453 per person for the medical care of every Nigerian in the 2022 budget. That’s less than nine (9) dollars. What will nine dollars afford? This has affected the quality of life of Nigerians and most Nigerians are just one health emergency away from death.
Before debating how wrong it is to make laws against the freedom of expression guaranteed in the right of workers to strike, let’s assume that the Hippocratic Oath was the legal “Alpha and Omega” of medical practice. Now what does it say?
The Hippocratic Oath makes doctors swear to treat the ill to the best of ability, to preserve a patient’s privacy, to teach the secrets of medicine to the next generation, and so on. We’ll pick two of the mandates of this oath that are relevant to the conversation on banning doctor’s strike; ‘treating the ill to the best of one’s ability,’ and ‘teaching the secrets of medicine to the next generation.’
Treating the ill to the best of one’s ability requires a lot. It requires a lot of health equipment, facilities and support staff to save a life. Also, it requires that hospitals are not understaffed and doctors are not over-worked so that they can be in the best shape mentally to maximise their abilities. This is why the data of doctor to patient ratio is essential and the doctor to patient ratio in Nigeria is one doctor to two thousand five hundred patients, instead of the one doctor to six hundred patients’ standard of the World Health Organisation. Treating the ill to the best of one’s ability requires that doctors are not underpaid or owed salaries and allowances. This is the only way doctors can keep their bodies and souls together enough to be able to maximise their abilities for the patients.
Yet, these are the issues that led to the strikes that the same federal government that is underfunding the health sector is about to outlaw. According to Dataphyte, the Nigerian government appropriated N3,453 per person for the medical care of every Nigerian in the 2022 budget. That’s less than nine (9) dollars. What will nine dollars afford? This has affected the quality of life of Nigerians and most Nigerians are just one health emergency away from death.
This is the same country where the sitting president has spent 201 days (as at August 2021) getting medical attention abroad out of the collective purse of the Nigerian people! It is therefore obvious that without attending to the demands of doctors for better working conditions and pay, it is impossible for them to treat the ill to the best of their ability. Based on the assumption that the Hippocratic Oath is binding, it is the federal government that is betraying this oath and should be punished for it.
According to Amnesty International, as at 2019 when Buhari completed his first four years in office, the President had flouted forty court orders. That’s an average of ten documented disobedience of the constitution by the president per year. That’s forty reasons to remove Buhari from office if we wanted to enforce oaths. How about all the agreements workers made with the government that were not fulfilled? For this same government to try to invoke the Hippocratic Oath is extremely hypocritical.
The second relevant point of the Hippocratic Oath is to teach the secrets of medicine to the next generation. Yet the federal government last year scrapped the salary for Housemanship (internship) for student doctors. Meanwhile in the same year 2021 alone, the University of Medical Sciences fees in Ondo increased by 120% to 2.245 million naira, and in Ebonyi State the new state Medical University kicked off with about five million naira as annual fees. It is therefore obvious that it is the government that does not want to keep the Hippocratic Oath by billing this huge amount of fees, especially in a country where the minimum wage of parents is still a meagre thirty thousand naira.
While we’re still speaking of oaths, should we not enforce the Oath of Office sworn by our government officials to uphold the constitution? How come the same government officials that want to make the Hippocratic Oath binding have not been arrested or sacked for breaking their oaths of office which was made here in Nigeria?
According to Amnesty International, as at 2019 when Buhari completed his first four years in office, the President had flouted forty court orders. That’s an average of ten documented disobedience of the constitution by the president per year. That’s forty reasons to remove Buhari from office if we wanted to enforce oaths. How about all the agreements workers made with the government that were not fulfilled? For this same government to try to invoke the Hippocratic Oath is extremely hypocritical.
What is to be done is simple! Since the federal government has brought the bar lower, doctors and health workers must raise their bar of struggle higher. Rather than sit at home strikes, the health workers and medical students across the country should embark on strikes supported with physical protests to the seats of government to speed up achieving results so that they can go back to saving lives. This is the only way to force the Nigerian government to provide the conditions necessary for the doctors and medical practitioners to fulfil their Hippocratic Oath.
Ibukun writes from Abuja, Nigeria and he can be contacted on 0906 027 7591
