Fashola, the CON and the MESS

The case of Lagos State Government vs. doctors took a bizarre turn when 788 doctors were summarily dismissed and replaced with 373; the alarming shortfall seemingly papered over.

And, so far, there are at least three factions of reactionaries: those who support the state; those who support the doctors; and others, like me, who will not take sides.

But I am sympathetic to the doctors because of my experiences in Lagos public hospitals. In December 2009, I waited nine hours to see a doctor at the Lagos State University Teaching Hospital, Ikeja. While waiting, others in the room kept murmuring that if they had money, they would go to a private hospital. My problem was the inverse; I was seeking expertise since the doctor in the private clinic I was using didn’t appear to be up-to-date (I had read more recent research online) and so I had insisted on a referral letter.

By 9pm when I eventually saw the doctor, he skimmed the letter and said, ‘I should admit you but there are no beds. Even the corridors are full. If you can wait for a bed to be vacant, fine. Otherwise, I am sorry.’ He then called the next patient. I should have railed at his evident lack of compassion to me but the manic sight of him was pitiable: His eyes were bloodshot and it was obvious he was tired and needed a nap badly. Earlier in the day, his colleague said something about having worked for 36 hours at a stretch and there was no relief in sight.

So, today, when people complain about the number of casualties of the strike actions, I tell them to spare a thought for those who have died because they were treated by fatigued personnel.

The second time was in 2010 and, this time, at the eye clinic. I went through a friend and, according to one of the nurses, his letter helped me scale a two or three months’ wait list. I ended up waiting a mere six hours! The eye clinic that day was like an extension of Balogun market; filled to the brim with a restive crowd. While waiting in the ophthalmologist’s outer office, I overheard her telling someone that they were being overworked and in her position, she has to research, teach and still see patients. And that she gets so stressed that she herself doesn’t trust any diagnosis she makes after 4pm. I carefully looked at my wristwatch.

Given my jaundiced visits to LASUTH, I don’t know which is worse: whether Lagos, the mega state as it prides itself, has such a paltry number of doctors or the sack itself.

Both sides have accused each other of various illegalities and immorality but, note, the Hippocratic Oath may be binding but there is no part that says they should tear their human bodies apart to save lives. Two, the state government too has a binding Oath on it not to toy with the lives or welfare of the people. Three, I am against doctors’ strike, anytime, any day but the government’s move is a wrong one. Nigeria is a signatory to the International Labour Organisation’s Decent Work Agenda. The Agenda states that labour is not a commodity that can be disposed at will. As the name implies, DWA ensures decent employment and it includes not throwing people out to prove a point.

I know some people have argued that the state had to resort to mass dismissal as a way of saving the system; I disagree. The system is actually worse off by tearing away people who have been in it for long and replacing them with neophytes. And considering that even the ones you sent packing were overworked, I wonder how those who are a fraction of their number will cope. When ex-governor Bola Tinubu gave the dismissal suggestion to Fashola in February, I thought it was one of those politicalspeak until it actually happened.

But then, what makes this action of ‘dismiss and replace them all’ dangerous is that it wields power; the power to subdue. The way power works — especially when the system reposes it in the hands of one man — is that it is powerful when it is not used. We know it is there and that is enough. It is not about being weak because it is strength on its own to not use power to quell those who are, in a sense, weaker. Power becomes diminished when it is used that way and to restore some mystique to it, you keep using it to suppress. It is a process that breeds tyranny. When personal ego gets intermeshed with it, it takes another face.

I once spoke to somebody about the case of the University of Ilorin lecturers and asked why he didn’t speak to former President Olusegun Obasanjo about it on a personal level. He said, “Once you mention that topic to Obasanjo, he will abuse you, abuse your father and the rest of your lineage.” We all saw how that story ended. It is a similar path I wish Lagos State will not tread. Just a year ago, the Action Congress of Nigeria used Lagos State as its poster boy for good governance. Other South-West state governors, more or less, rode on the strength of Fashola’s popularity to power.

There is no point engaging in unalloyed propaganda about the ‘state-of-the-art’ facilities in Lagos State hospitals or that the governor goes there to check his blood pressure once in a year. The truth is, the health care system needs to be humanised and both the state and doctors are not exempt from this responsibility. There are better ways to resolve issues than showing power pass power. The already bad situation will become worse if the call for a solidarity strike by doctors in the employ of the Federal Government takes effect tomorrow.

In the long run, strikes can be avoided in the essential services sector if we devise a mechanism, one independent of both parties, that’ll govern the standard workings of the system and which will guide all parties as to what their responsibilities are. Such a mechanism, periodically reviewed, can critically and fairly examine working conditions and other aspects to preempt and prevent disputes and strikes. In the meantime, they should be less recalcitrant and seek arbitration. After all, it is lives we are talking about.