There seems to be no end in sight to the industrial action embarked upon by resident doctors at the University of Benin Teaching Hospital (UBTH). The hospital, which caters for patients from Edo, Delta and Ondo states, has been on lockdown since August 5, 2016, when the Association of Resident Doctors, ARD, UBTH Chapter announced that they were going on indefinite strike following a breakdown of negotiations with the hospital authorities over issues surrounding allowances and the management of the hospital. Sunday Vanguard gathered that the doctors are demanding, among other things, proper equipping of the hospital, reduction in the charges paid by patients, and transparency in the running of the facility. It was also gathered that the doctors accused the hospital management of high-handedness and laxity. However, the management insisted that they have done all that was required of them and see no reason the resident doctors should still be on strike. While the face-off lingers, patients at the hospital bear the burden. Presently, medical services are rendered by the few consultants who cannot cope with the number of patients in the wards. The wards of the hospital, once ranked among the best Federal Tertiary Health Institutions (FTHI) in the country, have been deserted. The few patients left on admission have virtually been abandoned. They are helpless and hopeless. A patient, who gave her name as Esther, said she had waited endlessly to be attended to. “Only the nurses come to look after us. The doctors that come are few and their ward rounds don’t cover all of us, “she said. This development has led to many deaths since the strike began. Among the dead is one Margaret Edobor, a fire victim admitted at the hospital a month before the industrial action commenced. According to her brother, Mr. Sunday Ogbewe, the patient was already responding to treatment before the strike started. “My sister was involved in a fire accident and was admitted at UBTH in July, and was getting better until the doctors strike started. Because they left her unattended to, she contracted an infection which led to her death,” Edobor’s brother added. Meanwhile, the aggrieved doctors said they feel the pains of patients and wish deaths would not happen if the UBTH authorities had kept their word and managed the hospital properly. According to one of the doctors who spoke anonymously to Sunday Vanguard, they tried to avoid going on strike but the management failed to be sincere. “In the first place, we embarked on this action because all other options had been exhausted. It was a painful decision but several months of dialogue with our management yielded no result. We had to give a 21-day ultimatum after six months of failed negotiations. This ultimatum was extended to 35 days; still management showed no seriousness. We are eager to suspend this action because the UBTH patients, who are at the receiving end of the lapses of the management of the hospital, are our neighbours, friends, relatives, fiancés, brothers, sisters, parents, wives and children. Our training is also suffering . We just have to do this to prevent the hospital from running to a halt,” he said. Presently, UBTH, it was learnt, has the record of being the FTHI with the highest number of strikes all over the country. This situation, the doctor alleged, started since the inception of Ibadin as the Chief Medical Director of the hospital. “The present hospital management is both insincere and incompetent, their budgeting is faulty and they leave out genuine issues and use their office to punish perceived enemies whose only fault is that they don’t boot lick the hospital management. We are trying very hard to prevent the hospital from experiencing a total collapse,” he said. While the doctors leave open all avenues to seek an end to the strike, the recent visit by the Federal Ministry of Health to FTHIs, which ought to have helped to ease the tension between the hospital management and doctors, did nothing to alleviate the situation. The Federal Government team, led by the Head, Department of Hospital Services (DHS) Dr. Wapada Balami, which had been visiting Federal Government health institutions across the country to verify the ability of the institutions to finance personnel emoluments came to UBTH with a promise to have an audience with both parties (management and doctors) but ended up leaving without meeting with the doctors to hear their complaints. “We were disappointed with the FG team and they are not helping the situation when they are one-sided and biased. The indications we are getting from the CMD is that he is untouchable,”another doctor in the hospital who spoke to Sunday Vanguard said. This, the doctor believed, explained the obvious disregard of appeals from the Ministry of Health and other stakeholders to the management of the hospital to implement government policies and agreements in the hospital to no avail. “Officials at the Ministry of Finance and even the supervisory Ministry of Health recently revealed that the management had unilaterally decided against budgeting and even appropriating due benefits for the staff even after the latitude had been provided for the institution. It is even more scandalous that the hospital’s management has been briefed by the ministries of the availability of more slots for employment into the hospital and the attendant increase in allocation; the management of the hospital was said to have turned deaf ears to the advice and insisted on continual erosion of the staff strength to its current size which unfortunately is the barest minimum that can offer some semblance of service to Nigerians,” he said. Due to the bias said to have been exhibited by the Balami committee, NARD, at its Extraordinary-National Executive Council (E-NEC) meeting held at the National Trauma Centre, National Hospital, Abuja, on September 25, came out with some resolutions which blamed 12 CMDs for the crisis in their hospitals. UBTH and deaths While the issues in contention revolve around remunerations; decay of infrastructures, insecurity and intimidation of staff, a first timer to the hospital will wonder if there is any management in place at the UBTH. According to some of the hospital doctors, over the last few years, there has been a marked decline in the materials, gadgets and equipment needed to provide care for patients in the UBTH. Patients, they said, now have to provide their own materials such as plaster, syringe, cotton wool, etc. Drugs as basic as Aspirin and Paracetamol are also said to be unavailable at the pharmacy. Investigation showed that another facility that has been allowed to decay is the Stem Cell Transplant Centre at the UBTH. The facility was established for patients with sickle cell to have their stem cell replaced. But presently the facility is alleged to be wasting. “A case in point is the stem cell centre. Billions of tax payers money is left to rot because the management has personal scores to settle with the head of the stem cell centre. Our people are once again globetrotting for care for their loved ones with sickle cell. Also, specialist manpower trained in this field with tax payers money are left to do basic things as their specialist skill is not being tapped. The situation is about same in the Department of Radiotherapy as the radiotherapy machine which government spent a fortune to buy to treat Nigerians from several states no longer functions. Our people have to be referred for such care”, one of the doctors said. Also, the Accident and Emergency Department (A &E) of the UBTH, which operated initially at world class standard to cater for Nigerians, especially travellers who travel through Benin where it is located, being a transit town, is alleged to be operating below a standard primary health care centre. A source revealed that specialists in emergency care available at the A and E are poorly catered for by the hospital management such that they hardly have what to work with. “Glucometers are not present to check sugar level; instruments to measure blood pressure are faulty and the pharmacy lacks drugs and intravenous fluids. Patients and their relatives have to cross the road to get drugs and hospital consumables. Materials for advanced care are a no- go area. Several lives which could have been saved in the University of Benin Teaching Hospital Accident and Emergency are lost daily. UBTH charges are about the highest in the country. To obtain a case file in antenatal costs N25,000 and in the accident and emergency it is N5,000. Sadly, these patients still have to go out of the hospital to get investigations done and procure drugs,” he said. Allowances and salaries Unlike many of the Federal Government hospitals in the country that have paid doctors most of their allowances and salaries, doctors at UBTH are said to still being owed salaries dating back to 2014 even when they are earning less than their colleagues in other FTHI. “The doctors of UBTH have not been paid the percentage of their salaries since January 2014; this is not the case in most Federal Government hospitals in the country. One wonders why doctors in UBTH should earn less than those in OAUTH, Ife, UCH, Ibadan, National Hospital, Abuja, UCTH, Calabar, etc. The only reason that comes to mind is that the management in these institutions is more competent. The doctors are therefore demanding for a forensic audit to ascertain the health status of the finances of the hospital as it is obvious UBTH is haemorrhaging financially due to clear mismanagement,” our source stated. Poor working condition UBTH, it was alleged, has the highest billings in fees, admission deposit and costs for services in the country, even when the services provided cannot be compared to the charges. The source went on: “Patients at UBTH are made to pay N3, 900 daily for the general wards after paying an admission deposit of N 20, 000; bed fee for specialist ward is N15, 000 daily after an admission deposit of N50, 000. Even with the worsening economic situation in the country, the management’s insistence on extorting these high fees from patients who cannot afford them has forced many Nigerians to seek alternative care, which, in effect, has grossly affected the training of medical students and doctors with the declining patient load. Patients, especially those in and around Edo State and environs, are now forced to travel to parts of the country for medical care where services are affordable. At Irrua Specialist Hospital in Edo State and University College, Ibadan in Oyo State, bed fee is N1,500 and N1,000 per day respectively; the same is applicable at Obafemi Awolowo University Teaching Hospital where bed fee is N1,000 daily.” A female doctor in UBTH, who preferred anonymity, echoed the source: “The operating theatres are collapsing with doctors at times using rechargeable lanterns to operate. The doctors call room has deteriorated badly that some of us now prefer to sleep in our cars. Food is served in unhygienic canteens. “We use white bulbs and florescent to operate due to old and faulty operating theatres. Theatre roof is collapsing, you have poor ventilation and faulty air-conditioning units, you can’t operate in the daytime because you will die of heat stroke”. The harsh environment which the doctors claimed they work in does not help them considering the fact that they are short-staffed. The workload that should have been done by 650 doctors as at 2014, according to them, is now being done by 350 doctors. Pregnant staff Further investigation by Sunday Vanguard showed that female staff of the hospital who get pregnant have to either quit the job or keep working until they deliver. Insecurity Another worrisome issue at UBTH, according to the staff, is insecurity. The hospital, they alleged, has experienced a wave of unchecked thefts and break-ins in recent times. Several cases of attacks on staff in the hospital quarters, theft of cars in the hospital premises, theft of valuables in clinics and treatment rooms were alleged to have gone unchecked while doctors and staff were reportedly assaulted. “One of the cases of theft that occurred during broad daylight is the case of car theft which happened at the Department of Family Medicine where a resident doctor parked his car in front of the department just some metres away from the security post and walked into his office only to emerge 10 minutes later to find his car gone”, one of the doctors said. He went on: “The state of our call food is also verifiable. We have some resident doctors that are still owed for 2013. These are verifiable and it is not like that in other hospitals. We earn about 70 percent of the salaries of other resident doctors in other hospitals. You can call resident doctors in Ife and OAU. This has been going on since January 2014. Check the NARD communiqué that will authenticate it and UBTH is number one in that list. Do you know when a woman is pregnant, they start deducting the call duty when she is on maternity leave? “When a female doctor is pregnant, the sad thing is that government paid this money, only for the hospital to withhold the money”. Claims are false – UBTH Efforts to reach the UBTH CMD, Prof. Ibadin, proved abortive as several calls to his telephone line were not answered. Sunday Vanguard, however, spoke to the Public Relations Officer, PRO, of the hospital, Mrs. Kehinde Ibitoye. Ibitoye said: “The management has done its best but they have not been able to come to an agreement with the doctors. The doctors claimed they are the least paid in terms of salary. Government has a scale to pay federal health workers and that is what the hospital is using to pay them. You know about the skipping problem. It is not the hospital management but from the Federal Government. The problems are not what the management can handle”. On the issue of decaying infrastructures, she said: “It is all a scam. They have tried to blackmail us, then we called a press conference and it was attended by your colleagues to debunk it. They are just trying to call a dog a bad name. Everything is okay in the hospital. All the allegations are false. If you want the CMD’s phone number, I will give you. “The patients have been on the receiving end. The few patients that are there we are taking care of them. We are not admitting new patients for now. The NHIS clinic is on because the staff are not among resident doctors.”
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