Exhaustion is not the best of words. Even after hours of productive labour, the word “exhaustion” reads towards tiredness, fatigue, relapse, and a collapse. Sadly, those standing in the frontline of Nigeria’s COVID-19 battle have been forced to associate with the word in the last couple of months.
Perhaps it would have been better if frontline workers are exhausted from their commitment to service and humanity. Unfortunately, unpaid allowances, inadequate personal protective equipment (PPE), and assault from law enforcement officers have been identified as causes of exhaustion among Nigeria’s frontline workers.
A DATAPHYTE article in April attempted to imagine the thoughts of health workers standing in the frontline of the war against coronavirus. In a rather sobering reflection, the article had described the dilemma of caregivers as they battle the thought of patient management and the next paycheck.
The article explored the reality that most of Nigeria’s health workers are employed by state governments who are currently financially distressed. Thus, it suggested that healthcare workers may as well be caught in the web of delayed and non-payment of salaries and allowances.
Beyond unpaid allowances, Amnesty International’s recent report provides a saddening picturesque of Nigeria’s care to its caregivers. In a rather specific language, the report noted that frontline workers in Nigeria are being exposed, silenced, and attacked. Delayed allowances, derelict health facilities with poor sanitation options, stigmatization, and attacks from law enforcement are some of the woes of the Nigerian healthcare workers during the pandemic.
According to the Amnesty International report, healthcare workers have not been adequately provided with PPE. For instance, a doctor stated that surgical masks are not adequately available in the hospital where he works. Further, caregivers were provided with N95 masks only after they had protested.
The derelict nature of public health facilities also contributes to the danger health workers are poised with during this period of global health crises. Amnesty International documented the experience of a nurse who stated that in the government hospital where she works, the is no running water for health workers to wash their hands. On a general note, caregivers work under deplorable conditions.
Outside the unfriendly work environment, some caregivers in Nigeria have suffered discrimination and stigmatization. An example is the case of a doctor who was denied entry into a supermarket because she was wearing her medical uniform.
Security forces and law enforcement have also added to the exhaustion of caregivers in the country. During the period of lockdown and curfew, health workers were exempted from the restrictive measures in a directive by the President. However, they were faced with restrictions on movement, harassment, and intimidation by security agents during the lockdown period.
Even after showing their identity cards, health caregivers were reportedly denied movement, embarrassed, and assaulted in some cases. The series of attacks and assaults on healthcare by security agents workers forced the Lagos State branch of the Nigerian Medical Association to embark on a worker’s strike in May. Doctors at the Federal Medical Centre in Asaba, Delta State went on a similar strike over harassment of health workers by security agents.
Beside Amnesty International’s observations, some healthcare workers reportedly suffered disengagement amidst the pandemic. In Ondo state, resident doctors who had protested non-payment of salaries were sacked by the government in June. 30 doctors were also sacked in Benue State amidst the pandemic. Similarly, 25 doctors were sacked at Jos University Teaching Hospital in May. On a national scale, the Nigerian government has also threatened to sack doctors in the country.
The negative experiences of caregivers during this period reflect the need for structured changes in the commitment to frontline workers. Protective gears and other requirements for a safer discharge of duty should be provided for caregivers. Health facilities should also be improved to provide for standard sanitation practices. Nigerians at all levels should be educated on appreciating healthcare workers to eliminate discrimination and stigmatization.
In addition, standards and conventions on human rights and rights of caregivers should be upheld across the country. States should provide clear and reasoned public guidance on which workers are considered “essential” or “key” for the duration of the pandemic, and what their entitlements are, including where relevant, that they can travel despite any quarantines or curfews in place.
Further, health and safety protections at the workplace, and benefits associated with being part of the COVID-19 response, should be equally available to all health and essential workers engaged in the response. Efforts should also be made to eliminate corruption in the administration of COVID-19 fund. This would help address the core needs of caregivers at such a time.