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Steths don’t lie!

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Steths don’t lie, people do.

I glance at my stethoscope and sigh. The day is October 1st 2014 and I am sitting at an independence day program listening to one of the speakers tear to shreds the last atom of self-respect I have. I think of a thousand other places I’d rather be instead of right there lost in the crowd, sitting on the 8th row but still invisible to the one man who claims to know all about me. When did I become this villain, this hated persona whose pride in her work has been snatched away by ignorant speakers such as the man who stands before me? Men who have the crowd roaring in excitement, who know just what to say to get the mob agitated and ready to do his bidding and care less about who has to hang for the sake of a good speech! I zip up my bag hurriedly, I don’t want Mr Steths hearing such bull, it could break him…and a good Littman stethoscope costs about £150 these days.

Who gave this man the permission to perpetrate ignorance? If it was any other function, we definitely would have settled it outside (I am tougher than I look oh). I think of all the casualties of this long drawn out war between the people and doctors and sigh… (if Oliver Pope was real, this definitely would need fixing). I wish I could introduce the speaker to Mrs A, my dedicated co-worker who is now a widow responsible for three children after her husband died of HIV following a needle-stick injury while he was treating a patient. Mrs A has the virus too but you would never know as she goes about her duties cheerfully. Or maybe to  Mr B, who shed tears when he was told he wouldn’t be paid this month. His rent is due and so are his children’s school fees and contrary to what this arrogant speaker is telling the crowd, Mr B has no savings to fall back on. He barely manages to keep his head above water in the sea of middle class men. And so many other doctors share his fate yet he scuttles to the emergency room when summoned to see a new patient, his problems momentarily forgotten. How does Mr B explain to his children who rarely get to see their father that all the effort he puts into his job night and day is not enough to ensure their school fees are paid on time? How does he explain to the world that the thought of buying a brand new car is merely a fantasy he couldn’t dare to entertain? Yet he is supposed to be a doctor, a senior registrar for that matter. The world doesn’t know about this but ask Mr Steths, he hears everything.

What this speaker doesn’t know is that beneath the white coat and brisk demeanor lies a broken man. An overworked, unappreciated member of society who is expected to serve at all costs regardless of his present circumstances no better than a mere slave. His dignity long forgotten, his legacy merely an embarrassment. His pleas for better work conditions shelved in the archives of greedy employees. Nobody remembers he looks death in the face each and everyday. Nobody remembers that he handles patients and diseases that could potentially cost him his life and that he walks boldly where others fear to tread (R.I.P Dr Adedavoh). We are not afraid to die and some of us have died, unsung heroes just to save a life. We wouldn’t mind Ebola and Hepatitis if it meant our children would be well taken care of if we passed on, we wouldn’t mind HIV and Lassa fever if it meant that we would be able to afford a home of our own or a car that wasn’t ‘tokunbo’. We wouldn’t mind the stench of a diabetic foot or Fournier’s gangrene if we had great working conditions. We wouldn’t mind the gore of a burst abdomen or the vigil beside a critically ill patient if we were appreciated by the people we give our lives for each and every day. But even without these perceived luxuries we work tirelessly everyday to ensure that the lives in our care do not waste away and instead of gratitude we are painted as greedy and wicked.

Free services are demanded of us by men and women who would not dream of letting the doctor’s child go to school for free or dream of giving him merchandise without money. Men and women who would not save the doctor the littlest expense, they would smile at him and say ‘Ah ah, you be doctor na, you get all of the money’. They grumble that the doctor would dare drop his stethoscope for even a day in the name of a strike but pray do tell me if there is another way to get the government to listen and yet another way to make them stay true to their promises. Like a slave who revolts after tireless beatings, doctors have revolted refusing to suffer in silence any longer. They prayed for a voice, one to fight their battles as they focused on saving lives and who better to do that than the very patients who they had managed but these patients so easily forget help rendered and join the mob to throw stones, forgetting that those who oppress the doctors are the same ones who oppress the masses, the same ones who always seek medical help abroad and cannot be even the least bit worried about the deplorable working conditions and quality of services in the health sector. My people shouldn’t we be joining forces to fight this menace rather than fighting each other?  Don’t be deceived by false statistics, for every doctor that lives in luxury there are sixty others living in squalor. Maybe it’s time the doctor started trading by barter because the other option would be to provide his every need, to allow his children go to school for free, to make sure he didn’t have to worry about his rent or his family’s expenses so that he could focus solely on saving the lives brought before him. Let’s start with you mister car dealer who refuses to go to hospital, it’s not your right to have free consultation over the phone, it’s a favor and one good turn deserves another. How about a car at half price?

They say becoming a consultant is the peak of our career, I have seen pitiable consultants who could only be called successful within the four walls of a hospital where they wield their diminutive power over subordinates till the day closes and they drag their worn out shoes into their worn out car, praying that by some stroke of good fate it would start without pushing. Why would you even entrust your life or the life of your loved ones into the hands of a man who was depressed and disgruntled with his job? It is quite ridiculous to assume he would do his best for you when the society he lives in does not care about him, when the people he works for do not care about him. It’s hard to be a hero every blessed day, doctors don’t have the luxury of being human. And for many the future is bleak.

Ask my stethoscope, he has seen it all…He has heard the deceptive words of the medical elders as they sold us out for personal gain, he shuddered at the closed door meetings, his presence forgotten as they made plans to trample upon their own for the good of their pockets.
Mr Steths ears burned when he was roughly pushed aside by the grey haired man who eagerly advised the president on the best course of action against his own kind in exchange for a place among the ruling council. Let’s not even get started about the time he heard the management warn the doctors to not treat any patient for free as they would have the cost deducted from their salaries along with a fine. Mr Management was snoring in his house the day the woman who couldn’t afford the money for the surgery died in the waiting room. No one saw the unshed tears glistening in the doctor’s eyes, his hands tied. He pressed his empty wallet against his thigh, wishing he had the five thousand naira needed by the patient for the deposit. His colleague had been fired a week before for daring to flaunt management’s orders. He needed the job but it was costing him his soul. Ask Mr Steths about all the times doctors have had to count out precious Naira to assist a patient who desperately needed a drug or test. The deed promptly forgotten as the patient ventures back into the world, the doctor’s kindness buried along with painful hospital memories not even resurfacing during testimony time at church. Perhaps these patients see it as their right, perhaps they believe we are an elite group of cyborgs created to serve…I wonder…

This uncouth speaker talks about us knowing what we signed up for when we decided to become doctors. What ten year old knows the truth about being a doctor in Nigeria? What sixteen year old filling her JAMB form can recognize the sorrow behind the doctor’s smile?  What twenty-three year old graduating from medical school knows the dissatisfaction surrounding the practice of medicine? The old doctors are tired of fighting, their eyes cast down in defeat. The younger doctors are becoming hustlers. After all you are nothing in this country without money. Dignity doesn’t put food on the table or pay the bills. Yet we serve, for whatever reason, whether it is to earn a salary or out of human compassion or for the sake of the passion we feel for the medical profession, we serve. WE SERVE.

My steths doesn’t lie, he doesn’t need a PR agent to make him look good, he believes in the greater good of humanity but people lie…

I could be lying right now like many others before me but then again I just might be speaking the truth and perhaps I have been able to give you a little insight amidst the jumble of words. So the next time you sit down judging a doctor, think of him as a person, not necessarily a good person but a person nonetheless who doesn’t care about where you have been or what you have done, who doesn’t care about the extra hours or the unending sacrifices but is only interested in helping you the best way he can even if he has a long list of unmet needs hanging over his head. It is his job description isn’t it? He isn’t the enemy, he isn’t the oppressor. He is human just like you.

Love your doctor, it’s healthy!
A heartfelt thank you gives us the sort of high that makes unpaid bills float away…Ask Mr Steths, he has been around far longer than I have and could teach you a thing or two!

Have a great day Chutzpah fam,
Xoxoxo

 
5 Comments

Posted by on October 13, 2014 in Health

 

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When doctors weep…

The past couple of weeks have been a turbulent one for the medical profession in Nigeria as 788 doctors were issued queries and then sacked as a result of a strike action that resulted from futile dialogue with the Lagos state government over its failure to keep its side of an agreement signed by both parties more than a year ago.

We’ve heard the patients and concerned citizens air their views. Doctors have been largely misrepresented by the media according to Dr. Y who believes one of the medical association’s biggest problems is those we select to represent us (hence the losing PR battle). Doctors need to be heard and here’s what some doctors had to say:

Dr. D, an NMA spokesperson said; “Bola Ahmed Tinubu was part of the government team that signed an agreement with Lagos doctors last year, Fashola should honor the agreement. FYI, Lagos judicial workers earn more than Federal judicial workers. Fashola must be a Governor of all not a group”

Dr. IN, a Lagos state doctor has this to say: “The consolidated medical salary scale (CONMESS) was the salary structure designed by the Federal Government four years ago with the aim of providing a uniform salary scale for doctors irrespective of the state, kind of hospital and area of specialization with an annual increment denoting years of experience. Most states in the country immediately began paying CONMESS in full. Two years after this, the medical guild wrote several letters to the Lagos Government to remind them of CONMESS as they were yet to be paid. The governor then SIGNED an agreement that he would commence payment in 2011 with arrears being owed. The Federal Government made it clear that if CONMESS was paid, doctors would ignore the poor work conditions, work extended hours like they have been accustomed to (but this time they would be happy doing it) and they wouldn’t have to leave the country to work abroad. More people would be encouraged to train as doctors and the health of the people would be secured! Instead, tax was increased, CONMESS was not paid, work conditions were not improved, doctors’ lives were lost to stress related illnesses and medical hazards and call rooms were not provided for doctors on call. When Governor Fashola was reminded in January, he simply said the President couldn’t dictate how much he would pay doctors in his state and the tax increase was necessary so the doctors should get used to it! He said he couldn’t afford to pay CONMESS (but he could plan the most expensive birthday party in the World for Alhaji Tinubu). We then embarked on a legal 3-day warning strike with prior notice to sensitize the people and remind the government of the signed agreement. On resumption, all doctors were given individual query letters (for a joint action!), another one was issued, and then letters were issued for “call to panel / impending dismissal from duty”.  A week later, armored tanks were brought to all Lagos General Hospitals and Teaching Hospital Lasuth, Ikeja with doctors walked out of their clinics while seeing patients. The Med guild immediately called for an indefinite strike and the Lagos state government was sued for breach of agreement and victimization of doctors. Fake pay slips were published in the papers some weeks ago claiming doctors were being paid as much as 900,000 whereas a medical professor of 20 years has never been paid as much as 500,000. A Neurosurgeon (brain surgeon) consultant still collects 171,000 as basic salary (excluding allowances). Be informed we have only about 20 in Nigeria (Two of them with Lagos state, they trained in America and they have both been sacked!) and these are doctors who work round the clock due to the number of head injuries daily as a result of road traffic accidents. 3 days ago, we were issued sack letters and 97 doctors (not 373 like you heard) were employed as Locum doctors (doctors paid per hour). These locum doctors need residents and consultants to put them through. It takes years of experience to perform a caesarian section on a woman or a brain surgery (especially bore hole to relieve increased brain pressure or blood in the brain) or an appendectomy or treat a sick child or even to help a mentally ill patient. The Nigerian Medical Association (NMA) has made it clear that the newly appointed doctors should not & would not accept the job offer and that all doctors across the nation would join in the strike against victimization on Friday after the ongoing professional exams. The issue is now beyond CONMESS struggle – the government is aiming to devour the medical and dental profession. Be informed that doctors are not slaves, our Hippocratic oath explains that we owe an obligation to our patients and they owe an obligation to us and our services must be paid for.”

This is the Hippocratic oath that binds doctors all over the world:

‘I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:

To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art; and that by my teaching, I will impart a knowledge of this art to my own sons, and to my teacher’s sons, and to disciples bound by an indenture and oath according to the medical laws, and no others. I will prescribe regimens for the good of my patients according to my ability and my judgement and never do harm to anyone. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and similarly I will not give a woman a pessary to cause an abortion. But I will preserve the purity of my life and my arts. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all humanity and in all times; but if I swerve from it or violate it, may the reverse be my life.’

The original text of the Hippocratic Oath is usually interpreted as one of the first statements of a moral of conduct to be used by doctors. Being a doctor from ages past has always been an honorable profession. The doctors were not usually the wealthiest citizens but they and their families did not suffer untold hardship and they were revered. Many doctors in Nigeria die unsung, unable to provide for their families in their death, from diseases mostly due to medical hazards. Those alive and working can barely make ends meet and cannot substitute financial aid for the time and attention their families are deprived of. So what is a doctor’s reward in Nigeria? Or should we also join the queue for 70 virgins in heaven?

Dr. OF, a doctor working outside Lagos says: “Where I work, I have not gone on leave for 5 years because of the patients. No time to see my parents or siblings, attend burial of friends and relatives and weddings of close friends. I have lost many friends who think that I’m only pretending to be busy meanwhile I see patients every other day that can only be equated to church sessions. Many people cannot sit near a HIV positive patient, but these are the people, whose blood I put hands in everyday during surgery, and their blood splashes into my eyes, mouth and face yet I endure because I won’t abandon them to die. I risk my own life and my family’s life every day to care for others. What I get as hazard allowance monthly is only N5000!!!  If I ask my employer to keep an agreement to help me feed my family, is that too much to ask?”

Dr. B, a Nigerian medical doctor practicing in the US says; “Nigerians need to change their mindset, doctors have lost it all in Naija, from money to respect. The respect and pay of registered nurses (RN) in the US is unthinkable let alone doctors. In many instances you will have to downplay being a doctor because of the attention you get”

Dr. OO had this to say: “We live in a tribal society: ethnic tribes, religious tribes and in this case professional tribe, so I understand why non-doctors would find the fact that doctors should ever have a reason to go on strike repulsive and why doctors would find the lack of understanding from the general populace unbelievable. Like all polarized debates, people are leaning towards their gut instinct, which is hardly objective, but emotionally driven. The doctors’ association needs to get off the emotional debate because trust me statements such as “oh, I work too hard and earn so little” is never going to come out tops against sentiments like “my dad died yesterday because doctors were on strike.”  Looking at it in this manner, it becomes easier to understand why we are losing what Dr. F calls the “PR war” and why we are likely to lose future ones. As a doctor, I know first-hand what it is like to treat patients without light, giving injection drugs in the dark, putting myself at the risk of needle stick injuries far from the watching eyes of the public. I do it because, like the public, I care about your dad not dying even though I know you would never ask if a needle pricked me last night. I remember a particular incidence. We had an emergency, an unconscious pregnant woman with a blood pressure 280/220mmhg (severe hypertension) who was almost at term. She was unbooked and my call was almost over but I was available. Her husband had just 200 Naira on him. We had to operate on her within the next hour with no blood, no money and no drugs. But guess what? We did! That was the first time I had a needle stick injury because NEPA/PHCN was at their norm. Minutes later the air was filled with the cry of a pretty baby girl in the arms of a doting grandmother and father. In the background were the moans of a slowly rousing mother and then there was me with a pensive look on my face while awaiting the results of my HIV test. I was okay. Even though, I had worked overtime and had to be up to make work in the morning which was now 2 hours away, there was no complain, no feeling of accomplishment because in my “tribe” I was not unique. It is the story of 788 and thousands of other people I share a proud profession with. I got a gracious thank you from the family, a thankful smile from the now recuperating mother and a smiling appreciation from my parents when I narrated it to them. So to the “court of public opinion” we don’t just measure remunerations in cash only, we do in kind as well. I am sure I am a thousand “thank you” richer and a million “smiles” wealthier because of the job I do. Now all we are asking is that the LASG should match our generosity with trustworthiness and our patience with understanding.”

Today the punch newspaper announced that doctors in Federal Government Hospitals in Lagos State have begun an indefinite strike.

Dr. K summarizes the doctor’s plight in these words: “Back in the days the next to a nation’s president was the surgeon General…what do we have now? Back in the days doctors used to get accommodation for free or for cheaper prices now doctors are being evicted from the shams they call quarters. Back then you would never want to travel to America after medical school because you were entitled to a car and good pay but now doctors go to even Ghana where circumstances are better for doctors. Back then we had functioning hospitals but now we cancel surgeries week-in week-out because there are no sterile materials, no dependable power supply…”

Dr. T warns: “A government not sensitive to the health of its citizenry is like a walking corpse. Worse of all is the senseless approach to employ rookie doctors to fill in for consultants. I sympathize with the poor people of Lagos state, I pray for the doctors who have always left their families to take care of us despite the harsh conditions, I would advise Governor Fashola to have a rethink and reinstate the sacked doctors.”

There’s no citizen who hasn’t benefitted from health aid provided by a doctor. Doctors have served you tirelessly, thanklessly and in all manner of conditions both safe and extremely dangerous but these doctors are human too and if it has gotten to a stage where a strike is the only way the Government will pay attention to their cry then be angry with an uncaring government, be mad at a government that would frustrate one of the most important sectors of the economy while they fly their families overseas. Be mad at a government that will put the lives of its people in jeopardy. Be mad at a government that callously breaches legal agreements made with its workforce but please do not be mad at the doctors, they are the victims here. When a doctor weeps, his patients weep too…Fashola harden not your heart!

Have a great day people. xoxoxo

 
40 Comments

Posted by on May 18, 2012 in Hall of Fame, Health, Uncategorized

 

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