ARDDELSUTH Holds 2nd OGM, Makes Demands, Gives DTSG Two-Week Ultimatum To Fix Oxygen Plant, Others

By Daniel Dafe

The Association of Resident Doctors at Delta State University Teaching Hospital (ARDDELSUTH) on Tuesday, July 30th, 2024, convened its Second Ordinary General Meeting (OGM).

Issues deliberated on include matters affecting optimal patient care, education, and emerging issues affecting the progress of the hospital, exacerbated by the prevailing socioeconomic challenges in today’s Nigeria.

Additionally, pursuant to a directive from the national body, the National Association of Resident Doctors (NARD), local branches were tasked with formulating resolutions on the pertinent issues impacting residency training and services.

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A communiqué signed by the President, Dr. Harrison E. Adja; Ag. Secretary General, Dr. Oturu Sovereignty and Public Relations Officer, Dr. Clinton U. Erhire was released after the said congress.

While ARDDELSUTH appreciated His Excellency, Rt. Hon. Elder Sheriff O. Oborevwori, for his ongoing backing of the hospital management and the progression of the building projects for resident and intern quarters and signing and implementation of the reviewed CONMESS, the body “observed with dismay the slow pace of work at the resident doctors’ housing project’s construction site at the quarters.”

The Communiqué reads further: “The Congress extended their gratitude to the Hon. Commissioner for Health, Dr. Joseph Onojaeme, The Head of Service, Mr. Reginald Bayoko, highlighting their steady support for both the hospital and the association. Thanks were also given to his technical adviser Honourable Commissioner for Health, Dr. Omovigho Agbele, recognizing their roles in the implementation of the reviewed CONMESS. Emphasizing the harsh and uncertain times, the Congress advocated for an enhanced working relationship, understanding that unity is key to averting any potential disruption of order. They, however, noted that the arrears are yet to be paid as approved by the amiable governor.

“The Congress bemoaned the nagging issue of a lack of requisite equipment for optimal patient care and the training of residents, especially with respect to the Radiology Department, Neurosurgery, Neurology, Anaesthesia, Obstetrics and Gynecology, General Surgery, and indeed all other specialty undergoing residency training. They wondered how the hospital could still maintain the toga of a Teaching Hospital when the necessary equipment and sophistication that were once available for optimal patient care have become moribund for upward of 5 years and counting. This has led to incessant attempts to put our members in harm’s way, as they are made to accompany patients to centers where investigations that were once available in the hospital are done.

“The Congress raised concern about the moribund state of the Oxygen Plant, which had the capacity to produce 100 big cylinders of oxygen per day. They asked why it has been abandoned following the development of some faults that could be fixed, if the government (the owner of the hospital) is willing.

“The Congress expresses worries about the current state of the ICU, which has been aforetime the most sophisticated ICU with good number of specialists (though it requires some more.) in Delta State. The lack of Arterial Blood Gas (ABG) machine, an important tool to assess the adequacy of ventilation. The lack of functioning ventilators, the necessary accessories, and, of course, the invaluable need to expand the ICU bed space towards catering for the increasing numbers of critically ill patients of Delta State and environs that are brought to the hospital, who are for want of space referred in moribund state to other centers.

“The Congress noted with dismay, the rising cost of power supply and increasing load shedding in the critical sector of the hospital, despite which the hospital seems to be working for the Benin Electricity Distribution company (BEDC), as most of the internally generated revenue is used to settle BEDC bills; this has led to epileptic power supply in the hospital, necessitating the Ambu bagging of critically ill patients who require mechanical ventilation.

“The Congress expressed displeasure at the recurrent unavailability of necessary medications and materials needed to provide optimal health delivery to patients in the: theatre, intensive care unit (ICU), neonatal intensive care unit (NICU), accident and emergency (A & E), and the Wards.”

“Despite applauding the government and management’s actions thus far in pursuing full accreditation of lacking departments and re-accreditation of departments, Congress expressed concern about the pace of this, emphasizing the significant impact this has on the speed and quality of training available to residents (most of whom are forced to travelled abroad to get requisite training in their chosen sub-specialties),” the communiqué added.

The association also noted with concerns the increasing gravitation of staff away from the Hospital to seek greener pasture, forcing the remaining staff to do the work of 5-10 people with increasing burnout,” adding: “This has reduced the time available for the needed reading hours and research work.”

“Some members are doing alternate day 24-hour calls (work hours); others having to do straight one-week calls (168-hour work hours). Nurses and other staff are breaking down because of inadequate staffing,” ARDDELSUTH said.

The communiqué reads further: “The Congress emphasized the cumbersome procedures for obtaining healthcare at DELSUTH for members of the Delta State Contributory Health Scheme (DSCHS). They complained that the staff pharmacy was under stocked, forcing them to pay for medications that should have been covered by the scheme at the hospital’s pharmacy. Additionally, many lamented the difficulty of accessing these services on weekends and public holidays as significant concern, given that illness does not adhere to a schedule. They opined that it was only fair to receive the benefits promised by the scheme when in need, considering the substantial amounts deducted from their pay for this very purpose. Concerns were also raised about why the free maternal and under-five services available in other state hospitals were not operational in DELSUTH. This has led to a situation where the DELSUTH primary health care centre in Ijomi, located a few miles away from the teaching hospital, refers patients to the General Hospital Ogharefe and then to the Central Hospital Sapele before they ultimately end up back at DELSUTH in critical conditions. The Congress described this as a mockery of the scheme’s intent to reduce maternal and perinatal morbidity and mortality in the state.

“The congress expressed shock at the fact that the Teaching Hospital had no Isolation centre despite having raised similar concerns in the past, with the increasing risk of diseases of public health importance like: TUBERCULOSIS, EBOLA, LASA FEVER, CHOLERA, COVID-19, etc.

“Congress expressed their displeasure over the poor state of the call rooms and the fact that call food is still pegged at an outdated and abysmal price not worthy of mentioning. They noted that the welfare of members who rendered thankless job is been toyed with, as doctor calls (24-hour work hours) are not a punishment.

“The congress expressed dissatisfaction at the slow pace of work by the contractors handling the residents’ quarters approved by the previous government and commenced by H. E. Elder Sheriff Oborevwori Orovwedor, the Executive Governor of Delta, with the promise that it was going to be completed and handed over to the management of DELSUTH in 3 months. They noted the harassment of contractors and their workers as a setback that management and government must look into.

“The Congress raised concerns regarding the delay by the Delta State government in approving and disbursing the Advance Wage award of 35,000 naira, benefits that federal employees and staff in other states of Nigeria already enjoy. They highlighted the financial strain on resident doctors who are not privy to remote work or the 3-day work/week granted to junior staff. These doctors, residing outside Oghara, face daily commute expenses ranging from 8,000 to 15,000 naira, posing a significant economic burden against the backdrop of recent financial challenges. The Congress urges consideration of these realities to aid those struggling to manage these costs.

“The Congress noted that the President had accented to the new Minimum wage of seventy thousand naira, although not commensurate with the economic realities of the current day Nigeria, they saw it as a step towards reducing the hardship.

“The Congress raised concern about increasing harassment of Residents and House officers. They noted that optimal patient care should be the rule at all time while maintaining the dictum of the Physician oath.

“The Congress observed that the planned trauma centre is yet to be completed and furnished for use, despite its importance in the plethora of patients that throng the hospital on daily basis. They also observed that the 80 bedded Building that is yet to be completed, is getting dilapidated, whereas it was meant to serve as an expansion avenue for sub-specialization of departments

“The Congress expressed regrets as citizens of this country, that a suckling mother could be kidnapped and kept in the kidnappers den for 7 months and counting without conscientious effort by the Government of Kaduna and the Federal Government of Nigeria to secure her release. Dr. Ganiyat Popoola is one of the many reasons Nigerians are seeking greener pasture abroad.

“The congress observed that DELSUTH is the only Teaching hospital in the whole of South-South that is yet to be paid the accoutrements allowance. They noted that although NARD had given directive that all centers must give two-week ultimatum for the actualization of this, ARD DELSUTH temporized because of the current situation of the hospital. However, NARD has directed that centres get this fund not later than August ending.”

READ RESOLUTIONS BELOW-

Congress urges the Government of Delta State to provide sufficient resources and ensure timely completion of the project to minimize the daily risks faced by ARD members commuting to work. The project’s timely execution is essential to enhancing the availability of doctors during emergencies, which will be beneficial to the community’s overall health care system.

The Congress demanded improved working relationship with the Management, Ministry of Health, and the Government of Delta State to prevent unnecessary conflicts that could negatively impact the people and delivery of optimal patient care.

Congress asserted that her members would not be held responsible when patient do not receive optimal health care due to unavailability of requisite equipment. Furthermore, it resolved forthwith an immediate stoppage of its members accompanying patients to do investigations that can be done in our facility, if adequate hospital equipment is not provided. The position of Congress is that immediate upgrade and provision of required equipment for optimal patient care and training of Resident be commenced, as we will no longer accept just promises. CT scan should not be less than 64 slides for quality assessment.

Congress urge the Government to fix the Oxygen plant immediately, which will also help to increase the Internally Generated Revenue of the hospital and also use a centralized oxygen piping system for ease of accessing oxygen during emergencies, among other advantages.

Congress demanded immediate expansion of ICU bed space, provision of ABG machines, more ventilators, and their accessories for optimal patient care.

Congress insists that the Delta State government should assume responsibility for the expenses associated with the provision of electricity to the hospital, citing the exorbitant monthly charges imposed by BEDC. This request stems from the fact that a significant portion of the hospital’s internally generated revenue should be allocated towards the maintenance of equipment, and the upkeep of the facility.

Congress demanded immediate stocking of necessary medications, materials, and equipment that are needed for optimal patient care in the theatre, NICU, ICU, wards, and accident and emergency departments.

Congress encourages the management to speed up and broaden the accreditation process for departments and sub specialties in colleges lacking full accreditation. The accreditation campaign should target areas with either partial accreditation or no accreditation at all.

Congress demanded immediate employment of staff to cushion the effect of the work load on resident doctors. Specifically, House officers advert for employment must henceforth be a month before the passing away of the current batch to erode any lacunae and unnecessary burden on our members.

The Congress demands the DSCHS office and staff pharmacy in DELSUTH to operate 24/7, simplify the process for obtaining prescription drugs, and eliminate the excuse of being ‘out of stock’. They also call for the immediate implementation of free maternal and under-5 services in DELSUTH to address delays contributing to maternal and perinatal morbidity and mortality.

Congress requested the establishment of an isolation center in the hospital, which is of public health importance.

The Congress demanded the mobilization of the engineering unit to address the deteriorating condition of the call rooms due to environmental changes and increased heat. Also, an immediate increase in the call food amount is demanded following the worsening quantity and quality the old amount could afford due to the steady increase in market prices of commodities.

The Congress demanded approval and payment of the Advanced Wage Award to Deltans, highlighting its importance in showing sensitivity to the Deltans’ plight as occasioned by subsidy removal.

The Congress emphasized the urgency of implementing the project for intern/house officers’ quarters and resident doctors’ quarters, urging the Delta State Government to provide sufficient support and ensure timely completion as promised. And those involved in the harassment of the contractors and workers should be brought to book.

Congress urged the Delta State Government to immediately implement the consequential adjustment of the reviewed CONMESS based on the approved new minimum wage as it will boost the morale of staff and reduce the JAPA syndrome.

The Congress frowned at the harassment of resident doctors and House officers and demanded the cessation of any form of harassment forthwith. Training must be based on international best practices. Industrial harmony will not be guaranteed, if it happens again.

Congress demands immediate intervention on the completion of the Trauma centre and 80-bed building.

Congress agreed with directive from July NARD NEC, and gave an ultimatum of two (2) weeks for the unconditional release of our colleague held captive for 7 months, failure of which industrial harmony may not be guaranteed.

The Congress demands immediate implementation of the new accoutrements allowance circular and payment of the arrears before August ends, as directed by NARD. Failure of which industrial harmony cannot be assured.

Meanwhile, ARDDELSUTH gave the Management and the state government a two-week ultimatum to implement their demands, saying that that they may not be able to assure the state Government of industrial harmony if the conditions are not met within the stipulated time.

“Congress reiterated their desire to render uninterrupted services to the good people of Delta State and Nigeria as management and Government do their bid,” the communiqué concluded.