Rejoinder: Of Nigerian Doctors & Other Medical Workers: Where Fejiro Oliver Got It Wrong By Kalu Theodore
I read with the utmost disgust, your article on the unfortunate strike action that hit the Nigerian health sector recently. As much as I would like to commend you for showing the courage to speak (or write as the case may be) your mind, I must state clearly that I was disappointed at the incivility a seasoned journalist like you exhibited.
Your article displayed a brazen show of hatred for doctors (or physicians, as you wish to call us), a sickeningly shallow knowledge of the modus operandi of the medical profession with no effort to find out more, and above all, was an attempt to ridicule the sacrifices made over the years by Nigerian doctors. Your article only ended up spreading a hate message and heating up the polity as evidenced by the unfortunate argument in the Comments between a medical laboratory scientist and a medical doctor on abusidiqu.com. It is based on these misguided pieces of information and ill-conceived assertions that I wish to reply in the most civil of manners.
It is insulting not just to medical doctors, but to the entire academic body that you should call our institutions of higher learning “mushroom universities”. It is the fault of no medical student of this country that he has to endure unsavoury conditions in his quest to obtain the MBBS degree. As fanciful as Harvard and her ilk may sound, medical students all over the world are taught using basically the same curriculum, and as such, are almost at par with each other. The fact that some are exposed to improved facilities should in no way make you look down on the unfortunate ones. Nigeria-trained doctors have been known to hold their own anywhere in the world and should even be praised for achieving great feats against all odds using crude methods. A doctor friend once had to take the soiled diapers of a child a considerable distance to weigh every hour for 3 days in order to monitor fluid loss because the weighing scale in the Paediatric Ward of the Federal Medical Centre where he worked was outdated and had broken down. That was a commendable act of sacrificial improvisation which I don’t expect you to understand. It would interest me to see how your Harvard-trained surgeon cousins would cope in a typically standard Nigerian hospital, not to talk of rural hospitals which are a whole different story. Based on this alone, you would agree with me that this is a clear case of misdirected anger against doctors.
It is also very disheartening that a learned fellow like you would choose to term doctors as “opportunists” who are unworthy to use the title. With all due respect to PhD holders, a medical doctor spends 6 – 8 years to acquire the MBBS or MD degree. Isn’t that enough time for one to acquire a PhD, not even taking into consideration the fact that it takes at least another 6 years to specialise in a certain area? It might also interest you to know that quite a good number of doctors still go the extra mile to acquire degrees in other academic fields, going on to become professors and authorities in those areas. It’s a big shame that you are one of many Nigerians who feel a foreign degree, or added degrees, means one is far better than his peers.
You must also realise that doctors, nurses, lab scientists, pharmacists, physiotherapists, cleaners, security guards etc. work as a team to ensure a patient receives the best care possible, not as a bunch of inferiors and superiors. No physiotherapist treats stroke or cerebral palsy as you reported, neither does a nurse treat malaria. When a patient presents to a hospital, the doctor makes a differential diagnosis based on the signs and symptoms and most times, places the patient on some form of treatment while waiting on the lab results from the samples he sends to the lab scientists. He prescribes drugs which the pharmacist dispenses while the nurse takes care of the patient based on the doctor’s plan, monitoring him for signs of improvement and/or deterioration. Bottom-line is, no one person is the other’s boss. The nurse answers to a higher placed nurse who is her superior, the lab scientist does same, just as a doctor does. This is how a team works, if you get what I mean.
The issue of who is made the CMD is something I expected you to grasp, considering your claimed knowledge of what is obtainable abroad. But then, you seem to belong to that pool of Nigerians who travel abroad, see how things are done the proper way, but come back home to advocate that we follow the wrong approach. The CMD or Chief of Staff as it is known in most Western countries, is the primary leader of all divisions and staff, including divisions that have chiefs as well, such as, leadership over chief of surgery, chief of obstetrics, chief of orthopaedics, etc. as divisions that each are headed by a leader in that specialty; and is inevitably a physician. However, the administrator known as the Director of Administration (DA) in most hospitals here, or the Chief Administrator abroad, is a trained, seasoned administrator who takes charge of the day-to-day running of the hospital as a business. Furthermore, it is only the doctor’s role in patient care that allows him the freedom to supervise the work of the other components of the team, since he sees the patient and gives directions for further care; that is if you are not advocating that nurses leave the wards, lab scientists leave the laboratories, pharmacists leave the pharmacies/dispensaries to vie for the role of CMD. And if this were to be so, I wonder to whom you would suggest that those roles and offices be left.
I would like to advise at this point that you endeavour to be objective in carrying out your duties as a journalist. If you have a score to settle with the persons of the Minister of Health and the NMA Chairman, do so out of the full glare of the public. If you wish to state your displeasure at some of their utterances and policies, do so objectively and politely. It is uncivil and unprofessional to attack their persons under the guise of journalism. Faceless written words can never fully transmit the nuances of verbal conversation. As such, it is imperative that the writer chooses his words carefully and wisely. An uncivil remark can escalate spirited discussion into a personal argument that no longer focuses objectively on the problem at hand (abusidiqu.com in view). Such exchanges waste our efforts and undermine a positive, productive working environment. It is a shame how professionals in the field of medicine have allowed themselves to be brainwashed by elements like you who do not have the slightest inkling of how things work within that sector. We must band together to fight the common enemy; the government that has systematically supervised the deterioration of the health sector.
On this note, I strongly believe it would be in order if you tendered unreserved apologies to doctors for raining unwarranted abuses on them, nurses, pharmacists, lab scientists, physiotherapists, cleaners, security guards etc. for attempting to mislead them, academicians for bringing the reputation of universities to question and the entire populace for misinforming them. You will also do well to retract the unkind words directed at the persons of the Minister of Health and the NMA Chairman and attack their policies alone. I also stand to be corrected if I have put forward misguided facts.
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