Shedding Some Light on the Rights and Roles of Nigerian Health/Medical Workers in the Battle Against the COVID-19 pandemic
According to the world health organization, in its technical
guidance circular, [1]
health workers are entitled to certain rights, as well as corresponding
responsibilities while playing their much needed and essential roles in the
eradication of the corona virus disease from the world.
Health workers in Nigeria have often complained of how poorly
they are paid for their services, when compared to what their professional
colleagues are paid in other countries, such as the USA, UK, UAE, Canada, and
many more. Many medical professionals have therefore left Nigeria to join the
workforce of these other developed countries with better working conditions.
Even at a time like this, when we need as much manpower as possible to care for
persons in danger of death from the dreaded virus, many health workers are
missing in action from the COVID 19 treatment centres, as they are afraid they
would never be properly catered for, and as such wouldn’t risk their lives over
a problem that might leave their families distraught, their children without a
parent, and the future of their dependants uncertain.
There are solid claims that the Nigerian medical heroes who
swiftly and efficiently tackled the Ebola pandemic received heaps of praise,
but were never paid. The then head of NCDC in 2014, Abdul Nasidi shamefully justified
the non-payment NCDC officials over 3 years of salary arrears by saying “even I
am owed salaries”[2]. Efforts
to address the issue and press for more pay for Nigerian medical professionals
have been trampled on and killed by the bureaucracy in the Nigerian Ministry of
health at both federal and state levels, and the reluctant attitude borne by
the Executive and Legislature when making annual budgets. The health sector has
witnessed a steady decline in the funding provided by the annual budget, since
2017
As though the health sector had not suffered enough, corruption also poses a deadly challenge as it has eaten very deep into the recruitment, administration, and finance of the health sector. For instance, appointment into the office of Minister of Health ought to be based on merit and experience, instead it has become an avenue for political compensation, putting the ministry at the mercy of fruitless policies and maladministration, which sadly is the order of the day in Nigeria. The healthcare insurance system is barely working.
It is laudable that the federal government through policies
and new structural implementation, has begun to address some issues, but rather
penny wise, pound foolish that they refuse to take precautionary measures to
protect these noble interventions from the business hawks that would eventually
find their way into the system to plunder whatever spoils they might find.
Could it be that they make these mistakes consciously? Could it be that they
are the ones reaping the fruits of these lacunae behind the scenes and expect
that nobody finds them out? Could it be that those in government are reaping
from both ends? I hope not, because no responsible government would meet an
essential sector in shambles, make policies to look good before the people and
seize the opportunity to enrich themselves and aggravate vulnerable situation
further. Is the Nigerian government truly responsible? To whom exactly?
However, let us postpone this discussion to another time, when it is convenient
to spend energy on the already over flogged subject.
Health workers, being at the forefront of the war against the
COVID 19 Pandemic, fighting frantically to save patients down with the virus
and preventing further spread of the highly contagious disease, deserve to be
protected too, especially whilst having regard to the fact that a good number
of patients who had earlier tested positive for the virus have fully recovered
and have been discharged, courtesy of these medical professionals. Also, it is
not news that over 40 medical personnel have been infected by this disease, and
are currently in danger of health complications and ultimately death, because
there is no known cure or vaccine for the virus. As a matter of truth, the
health/medical professions are noble professions and deserve the highest honour
in the land, even though nothing can equate saving human lives.
The World health organization in its circular provided the
following:
Rights, roles and responsibilities of health workers,
including occupational safety and health
Health workers are at the front line of any outbreak response
and as such are exposed to hazards that put them at risk of infection with an
outbreak pathogen (in this case COVID-19). Hazards include pathogen exposure,
long working hours, psychological distress, fatigue, occupational burnout,
stigma, and physical and psychological violence. This document highlights the
rights and responsibilities of health workers, including specific measures
needed to protect occupational safety and health.
Health workers' rights include that employers and managers in
health facilities:
i. assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks;
ii. provide information, instruction and training on occupational safety and health, including;
- refresher training on infection prevention and control (IPC) and
- use, putting on, taking off and disposal of personal protective equipment (PPE);
iii. provide adequate IPC and PPE supplies (masks, gloves, googles gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quality to healthcare or other staff caring for suspected or confirmed COVID-19 patients, such that workers do not incur expenses for occupational safety and health requirements;
iv. familiarize personnel with technical updates on COVID-19 and provide appropriate tools to assess, triage, test and treat patients and to share infection prevention and control information with patients and public;
v. as needed, provide with appropriate security measures for personal safety;
vi. provide
a blame-free environment for workers to report on incidents, such as exposures
to blood or bodily fluids from the respiratory system or to cases of violence,
and to adopt measures for immediate follow-up, including support to victims;
vii. advise
workers on self-assessment, symptom reporting and staying home when ill;
viii. maintain
appropriate working hours with breaks;
ix. consult
with health workers on occupational safety and health aspects of their work and
notify the labour inspectorate of cases of occupational diseases;
x. not
be required to return to a work situation where there is continuing or serious
danger to life or health, until the employer has taken any necessary remedial
action;
xi. allow
workers to exercise the right to remove themselves from a work situation that
they have reasonable justification to believe presents an imminent and serious
danger to their life or health. When a health worker exercises this right, they
shall be protected from any undue consequences;
xii. honour
the right to compensation, rehabilitation and curative services if infected
with COVID-19 following exposure in the workplace. This would be considered
occupational exposure and resulting illness would be considered an occupational
disease,
xiii. provide
access to mental health and counselling resources; and
xiv. enable
co-operation between management and workers and/or their representatives.
Further to this, the National Health Act 2014 summarily
accords credence to these rights in section 21 (2) par a-b which
provides that:
“Subject
to any applicable law, every health establishment shall implement measures to
minimise-
a. a. injury or
damage to the person and property of the healthcare personnel working at the establishment; and
b. b. disease
transmission”
The corresponding responsibilities include that:
Health workers should:
i. follow
established occupational safety and health procedures, avoid exposing others to
health and safety risks and participate in employer-provided occupational
safety and health training;
ii. use
provided protocols to assess, triage and treat patients;
iii. treat
patients with respect, compassion and dignity;
iv. maintain
patient confidentiality;
v. swiftly
follow established public health reporting procedures of suspect and confirmed
cases;
vi. provide
or reinforce accurate infection prevention and control and public health
information, including to concerned people who have neither symptoms nor risk;
vii. put
on, use, take off and dispose of personal protective equipment properly;
viii. self-monitor
for signs of illness and self-isolate or report illness to managers, if it
occurs;
ix. advise
management if they are experiencing signs of undue stress or mental health
challenges that require support interventions; and
x. report
to their immediate supervisor any situation which they have reasonable
justification to believe presents an imminent and serious danger to life or
health.
The Regulations issued by the President, Muhammadu Buhari,
GCFR, carefully omitted any provisions for financial incentives to encourage
medical professionals to participate in the fight against the Covid19 pandemic,
although some rumours about insurance have been mouthed and subsequently denied
by government officials. This should not be the case. Healthcare professionals
should be adequately catered for at this point in time, and a clear insurance
plan should be set in place for each of them, so that their families will be well
looked after if this pandemic should claim their lives. The federal government
should also make it a point of duty to stimulate the production of personal
protective equipment for the healthcare workers, and not merely depend on aid
donated by the international community or individuals. This is dangerous, not
only to the persons exposed to the risk of getting infected with this deadly
virus, but to the coffers of the federal and state governments, due to claims
of wrongful death that will arise in the future, and ultimately the health of
the general public if the disease spreads further due to the irresponsibility
of government.
We therefore urge healthcare professionals to speak up if
they are not being properly catered for, and not keep mum. It is no longer
business as usual, as many lives hang in the balance. The sacrosanct discussion
of developing our healthcare system and making it top priority should not be
postponed any further. It is my belief that this opinion is not coming from me
alone. In the words of Adedayo Adejobi;
“at a time the world is opening up
discussions about how the practice of healthcare could innovate, Nigeria’s
health system us struggling with the basic health issues, facilities,
technology and processes. With the Covid19 pandemic, our vulnerability has been
thrown open. The danger of neglecting healthcare has again been brought to the
fore; our leaders must be held accountable”[3].
Actions must be taken now, not tomorrow, not
when COVID-19 blows over, not when the dead have been buried, no. It must be NOW.
TODAY. However, in event, none of these is implemented, it is trite to remember
that at times like this, when volunteers are rarely paid, it is not because you
are worthless, it is because you are PRICELESS. Nobody can possibly repay
health workers and professionals for the superhero job they are currently doing
and the people they are restoring hope to
Now as we all know, every right comes with a corresponding
responsibility, and to whom much is given, much more is expected. Health
workers should take extra care to ensure that they do not put uninfected
persons at risk of contracting the deadly virus. There are other illnesses that
show similar symptoms as the COVID-19. An example of which, is Asthma. Due to
similarities in symptoms of both diseases, there is the possibility of people
suffering asthma attack being prejudiced as COVID-19 patients by hospitals.
While COVID-19 survivors are suffering stigmatization after winning the battle
to life, should asthmatic individuals and others suffering from some form of
non-communicable respiratory illnesses suffer stereotyping and possibly lose
the right to life?[4]
Care must be taken to avoid placing patients brought in on such emergency
grounds together with patients who are battling the COVID-19, until they have
been tested and confirmed positive of the virus. It is recommended that they be
treated in isolation; away from COVID-19 positive patients, and away from
patients who do not have the virus as well, until their test results are
available. Anything short of this may not only cause a plethora of lawsuits for
wrongful death, but also put several people in danger of contracting the virus.
Also, selfless, but extremely cautious devotion to service of
the public is paramount at this time. COVID-19 patients, do not only suffer
physically, they suffer emotionally as well, as this would be the loneliest of times
for them. At such a near-death point in time when they need the care and warmth
of family, they cannot be close to their family or hold their hands or
communicate their last wishes to them for obvious reasons, and health workers
are the closest persons and family they have at that point, and it would be
rather unfortunate if they were treated with disdain. Be very cautious for your
own health, but at the same time, be as kind as you possibly can, within the
confines of your duty. I call it treatment given by ear, kind words of comfort.
In the words of Brian Lee, it doesn’t take an instant more, or cost a penny
more, to be empathetic than it does to be indifferent. They may forget your
name, but they will never forget how you made them feel.[5]
About the Author-
Fred Chimezirim Ogundu-Osondu[6]
is an alumnus of the University of Nigeria Nsukka, the foremost faculty of Law
in Nigeria, where he obtained his LLB (Nig.) Honours in Law. He is a lawyer in
practice and principle, who takes very keen interest in Medical Law and
Corporate-Commercial Law. He is the Principal Attorney at Fred Ogundu &
Co.[7].
Get in touch
For further information, please contact:
Fred Ogundu-Osondu LLB (Hons) Nig. LLM Nig (In View); BL
Managing Partner, FRED OGUNDU & CO, LP - Nigeria
Tel +234 813 873 0840
fredogunduco@gmail.com
Managing Partner, FRED OGUNDU & CO, LP - Nigeria
Tel +234 813 873 0840
fredogunduco@gmail.com
[1] World
Health Organization, Coronavirus
disease (COVID-19) outbreak: rights, roles and responsibilities of health
workers, including key considerations for occupational safety and health. 13th
March 2020. Last accessed on 27 April 2020 via https://www.who.int/publications-detail/coronavirus-disease-(covid-19)-outbreak-rights-roles-and-responsibilities-of-health-workers-including-key-considerations-for-occupational-safety-and-health
[2]Adaobi
Tricia Nwaubani, BBC NEWS; Letter from Africa: Nigeria’s praised but unpaid
Ebola Heroes. 7th Sept 2017. Last accessed on Mon, 27th
April 2020 via http://www.bbc.com/news/world-africa-41147691
[3]
Adedayo Adejobi, This Day Newspaper, COVID19: Holding Govt Accountable on
Budgetary Allocations for Health. April 2020. Last Accessed on 27th
April 2020 via..
[4]
Sunday Omeike, The Cable, “Does the COVID-19 crisis pose more danger for asthma
sufferers in Nigeria”. Last accessed on 3rd May 2020 via
https://lifestyle.thecable.ng/does-the-covid-19-crisis-pose-more-danger-for-asthma-sufferers-in-nigeria/
[5]
Maya Angelou – an award-winning author, known for her acclaimed 1969 memoir, ‘I
Know Why the Caged Bird Sings’ and her numerous other collections
[6] fredogundu@gmail.com; +2348138730840.
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