No pause in health workers’ struggles in Nigeria

As health workers’ trade unions in Nigeria call their membership to continue strike action over bad working conditions and missed payments, attempts to limit the space for industrial action persist

February 05, 2022 by Peoples Health Dispatch
Protests by Nigerian doctors.

After almost two years of incessant industrial action by health workers in Nigeria, the Lagos State chapter of the Nigerian Union of Allied Health Professionals (NUAHP) issued an ultimatum to the government in end-January. NUAHP’s membership is composed of physiotherapists, radiographers, pharmacists, and other medical professionals, apart from physicians and nurses. The trade union has warned that they are feeling the brunt of persistent inequity between different health professions.

In a statement addressed to its members and the media in January, NUAHP has raised issues about missed payments to workers, bad working conditions, and inadequate hazard allowance, particularly for those contributing to the pandemic response. The announced industrial action was to be preceded by a warning strike in Lagos commencing on February 1. The warning strike was suspended after the government called the trade union to the negotiating table, just around the time when the Speaker of Nigeria’s House of Representatives, Femi Gbajabiamila, addressed health workers in Plateau State and praised federal attempts to improve health care in the country.

While officials boast about the health sector, health workers have criticized the federal government for allocating less than 5% of the 2022 national budget to health needs – a far cry from the recommended 15% of the 2001 Abuja Declaration. According to professional associations and trade unions, the projected amount of money will not be enough to significantly improve working conditions, which would stop, or at least slow down, the brain drain the country is facing where health workers are concerned.

Shared concerns in different States

Bad working conditions have been among the most cited reasons for protests and strikes since March 2020 when nurses in Enugu State launched one of the first workers’ actions during the pandemic. Their demands for adequate access to personal protective equipment (PPE) have been echoed by over 100,000 members of the Joint Health Workers’ Union in Kaduna State, who protested a 25% reduction of salaries for public service workers on the State level, as well as workers’ groups in other States.

However, workers’ efforts in some instances have been thwarted by the stubborn rejection by some State governments to commit to a real improvement of healthcare in their jurisdictions. According to trade union officials, a big part of the workers’ grievances across Nigeria stem from non-adherence to existing collective agreements. Throughout the pandemic, State governors and officials have been quick to dismiss the workers’ requests for decent working conditions, often criticizing them for a lack of dedication to patient care though many of them continued to work in spite of lack of PPE, uniforms, and other working equipment.

Sadly, in some cases, criticism from the side of the employers and management was echoed by the leadership of some of the larger trade unions, like the National Association of Nigeria Nurses and Midwives (NANNM) did in the case of the March 2020 nurses’ strike in Enugu. And while the cases where trade union leaders have sided with the employers did not undermine the workers’ determination to fight for their rights, some State officials have found them simply emboldening. Seeing that high-positioned trade union officials are not ready to take their members’ side, they have chosen to continue their bashing of health workers, in some cases going so far as to question their right to strike rather than admitting the legitimacy of the workers’ requests.

Denying the right to strike

This approach seems to have climbed to higher instances as well. During the same event in Plateau State, while speaking of the plans to implement a nation-wide health reform, Gbajabiamila indirectly touched upon the widespread idea of limiting the right to strike in healthcare, appealing to the health workers’ dedication and sense of blame. He said, “There is no way of telling how many lives will be lost by just one health worker embarking on strike, not to talk about a whole association.”

Shortly before his speech, the National Association of Resident Doctors (NARD) criticized a plan of the House of Representatives to pass a bill prohibiting health workers from going on strike. NARD, whose own 2021 strike had been disputed by the government in court, said in a recent press statement, “We maintain that the right to strike is a universal democratic right of all employees, regardless of where they are employed: private or public sector.”

Considering the various governments’ determination to deny health workers’ right to strike rather than approaching their requests in good faith, it seems that trade unions and professional associations have every reason to be worried about what will happen next.

It is worth repeating here that the worldwide wave of strikes and protests by health workers during the Covid-19 pandemic has been not only a call for better working conditions, but also for better care for their patients. As less than 5% of the population of Nigeria has been fully vaccinated and most remain without protection against Covid-19, providing support to health workers – beginning by upholding their basic rights – should be at the top of the agenda for both federal and State governments. Until they do so, it is to be hoped that health workers will continue to pressure them with industrial action and widespread, unified organizing.

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