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00:00Hello and welcome to Guardian Talks on Guardian TV. My name is Fadima Rachel. Today, let's
00:05talk about the ongoing strike action by the Nigerian Association of Resident Doctors which
00:11began on the 1st of November, 2025. According to the association, it has listed the 19 key
00:17demands ranging from unpaid areas to better working conditions. I am being joined via
00:23Zoom by the President of NAD, Dr. Muhammad Sulaiman, who would be shedding more light
00:28on the scenario and if Nigerians should expect an end to the strike anytime soon.
00:42It's nice to have you in Grisha's studio this morning. So, let's get right into the conversation.
00:48Yeah, let's get right into the conversation. So, for clarity purposes, can you briefly tell
00:54us what has led to this most recent strike by resident doctors?
01:00Thank you. Thank you very much for this question. 12 years ago, we had about 25,000 resident doctors
01:05in this country, about 16,000 at the federal level, 6,000 to 8,000 at the state level and
01:10then the rest are spread across different private tertiary health institutions that offer residency
01:15training. Today, we have just about 8,000, 9,000 at the federal level, just about 1,500 at
01:22the state level. And then we have just, in fact, less than 400 at the private hospitals levels in
01:28Nigeria. This is at the total extent. So, we're talking about just about 11,500 resident doctors.
01:34Now, this figure dropped over the last 10, 12 years. There are reasons for it. One is the remuneration,
01:44you know. And let me take a few things under that remuneration. For instance, in 2009, 2014,
01:50there's a collective bargaining agreement with the federal government that said whenever you review
01:54minimum wage that affects basic salary, it should affect allowances. From 2019 to the last minimum
02:00wage adjusted, the basic salaries were adjusted with just about 40,000. But that adjustment did not
02:06reflect the allowances, which means every doctor for the last seven, eight years in Nigeria is collecting
02:12just about 45% of his allowances and just about 60% of their actual salaries. Now, we approached the
02:18federal government, wrote letters. This is something that has been ongoing for years. Finally, this year,
02:24there was a sit down between the Ministry of Health, the associations, and the Salaries and Wages
02:31Commission. These adjustments were done, and there was an error in it. That error led to the withdrawal of
02:35that first circular. Now, all the corrections have been done. The tables are ready. Release these
02:40tables so that at least these injustices will be corrected. No, it has still not been released. Even
02:45in these ongoing negotiations, there are still drama as to when it will be released. It has been agreed
02:50that we will release this table, but there are dramas to it. In 2023, there was a review of the salary
02:56by about 25-35%, which other people know as peculiar allowance. Now, there were seven months
03:03areas in that 2023 that was not paid. This is one of the reasons why we have been agitating.
03:08From 2021, in fact, some hospitals 2019, some hospitals 2018, every time medical officers who are
03:14members of NAD are promoted, promotion areas are not being paid. We have pockets of centers like FMC Owo.
03:21We have O-A-U-T-H-T-H-C-I-L-E-I-F-E. We have Federal University of Health Science, O-T-U-P-O.
03:25We have U-U-T-H-U-Y-O, where salary areas are being owed. This one is not an allowance,
03:30it's a salary. People have worked. It's being owed to members from three months all the way up to 20
03:36months. These issues have been ongoing for two, three, in fact, some since 2022, and we've been
03:41calling the attention of government to that. On the commerce circular, this is a different point,
03:45on the commerce circular, there's what is known as specialist allowance. Now, the senior registrar
03:50is a specialist by certification. Now, ideally, senior registrar one who is on commerce five,
03:57that part of the commerce table has that specialist allowance, but senior registrars
04:01don't get to do it, despite being specialists, despite offering and providing specialist care
04:06across different hospitals in Nigeria. So this, all this, these are just a few remuneration issues
04:11that have fueled, for instance, Benway State University General Hospital, Benway State Government,
04:15the salary areas, what, about 18 months. For instance, in Kogi, doctors have not been promoted
04:21for well over 10 years. Promotion, promotion. The salary scale being used in that state is that of
04:272014. And this is widespread across different states. Now, that is just salary issue. When you
04:33look at the work rate, WHO said there should be one doctor to every 600 of our citizens. Nigeria's population
04:39today is probably closer to 260, 280 million, according to public health models. Now, how many,
04:45how many resident doctors do we have? Just about 11,000. How many consultants do we have? Just about
04:496,000. If you join that and you extrapolate for the population, you're talking about one doctor
04:54to about 10,000, 11,000, 12,000. Some others even say 13,000 Nigerians. What does that translate
05:00in physical work? It means that 10 years ago, wait, sorry, 10 years ago, if six doctors are managing
05:08a thousand patients per month, today, it is two doctors managing 4,000 patients per that month,
05:14which means, because of the less number, doctors are taking calls, like Victor Audu and Dr. Yomi,
05:20I keep talking about in FTA, the orthopedics department, they are on call every day, 122 days,
05:25131 days. Victor Audu is only on call for 22 days because he resigned on the 23.
05:30That's why the roster is reflecting that he's there for 22 days. My own treasurer is the only
05:35senior registrar in our hospital in plastic surgery unit. He has been on call, only him since February.
05:40So this is not tenable. As a surgeon, as a surgeon in training, you probably will give out 120,
05:46130 hours per week. I am a physician in training, a pulmonologist in training, an SR1 in pulmonology.
05:52Average in a week, someone like me will give out 102, 100 and 506 hours per that week
05:57for pay that has grossly been hit, not just by failed promises from government, but by even
06:04economic realities. When I was a house officer, my salary is less than $200,000. And in dollar
06:10terms, it's over $1,000. Today, in dollar terms, I'm just going home with about $300. So there are
06:16stark realities that push doctors out of the country. And government has promised over time and time and
06:22time. There is the issue of the membership certificate. Someone just woke up and decided,
06:26let us strip their membership certificate of his specialist status. There is the local job five.
06:31Five union leaders fighting for union activities were unjustly terminated. Terminated simply because
06:38of differences in how that aluta for those welfare packages in that center has been done.
06:43Remind you, that center has 89 consultants, but only 32 resident doctors. 32 resident doctors in a federal
06:50tertiary hospital in Nigeria. You know, so I can go on and on. The house officers have myriads of issues.
06:57You know, I can go on and on about casualization. You are given an appointment.
07:02Dr. Sulaiman, I will have to cut into your conversation at this point.
07:05Dr. Sulaiman, Out of all those demands you've made mention of, which of these would you describe as
07:11non-negotiable? You know, the association listed a 19 key demand. Which would you consider non-negotiable?
07:17Dr. Sulaiman, These 19 demands are all leading up to about 10 years.
07:23Some, the youngest on these demands is about a year. The youngest, which is the upgrade issue,
07:29which is the downgrading of the entry level of doctors from Commerce 3 to Commerce 2. It's a year now,
07:34a year old. The National Executive Council said all the 19 items are minimum demands. Let me give you
07:40a hint into the conversations with the government. None of these items on the demand has been described
07:46as not genuine, not valid, not needing attention, not needing solution in the immediate term. Even
07:53government agents agree that all these 19 must be sorted out. All right, so from your own standpoint,
08:01which is non-negotiable? Because you know, you've laid more emphasis on remuneration. So would you
08:06consider remuneration as more important than the working condition?
08:12Dr. Sulaiman, Out of all the remuneration issues reinstating the local job five is non-negotiable.
08:19The special status of the membership certificate is non-negotiable. The work schedule limiting call
08:2712 hours to only 24 hours after which the officer must go and rest is non-negotiable. The issue of
08:33the packages of the house officers and the protections from the civil service are non-negotiable.
08:39The issue of the casualization where you give a doctor an appointment letter that says you work
08:43only in this hospital, you are on duty 24 hours, you can't join any association, we can terminate
08:48the appointment. All those obnoxious, illegal casualization, these are non-negotiable things. I don't
08:56know how to put that.
08:57When you put the remuneration and you think it carries weight over the non-remuneration issues,
09:02you will fix the remuneration. And the non-remuneration issues are practical realities.
09:06Let me give you an instance. There's a power problem with hospitals in Nigeria. Sometimes you
09:11go to theater. I am a senior registrar in pulmonology, we do bronchoscopy. You do it,
09:15light goes off. You now start looking for your phone to flash light when instruments are within the
09:21body canal of a human being. Would you say remuneration issues outweigh
09:26these kinds of problems? No.
09:30All right. Well said, Doctor.
09:32In recent years, we've seen a growing number of kidnap cases, you know, from Dr. Khadijat, who spent
09:38about 10 months in captivity, and to other doctors. So, what is NAD, the Nigerian Association of
09:45Resident Doctors doing to ensure that the welfare and the security of their doctors
09:50is placed in poverty? As an association, we have engaged government agents, we have engaged
09:56security agents on this matter. What we are doing as an association, and government knows this,
10:02the moment one of our members is kidnapped, and not even at the level of kidnapping, the moment a
10:06patient relation or a police officer or any officer of any aspect of government comes into the hospital
10:14to bully or even assault doctors, that center immediately shuts down. I am sorry to be very
10:19blunt about it. For instance, I was in the air one day, and a vigilante group recognized by one
10:25of the state governments came in with accident victims, and there was no light. The next thing
10:30they did, they brought out weapons, and they were shooting into the air. I instructed every doctor
10:35and every nurse in that emergency unit, flee for your life. And the next day, there was a congress
10:39meeting to shut down the hospital. You know, those are the messages that you can't, in the process
10:45of saving lives, lose your own life. When Ghaniat was kidnapped, and we appreciate the security
10:51agents, we appreciate the Nigerian government for working tirelessly to free her. You know,
10:54it's not lost on us. We ran from pillar to post, and eventually we had to go on a stride.
11:00Now, it was after that that the association decided, you kidnap a doctor, we will shut down
11:05that hospital. Perhaps it's the only cry that we have in the Nigerian setting of today that probably
11:10treats the doctor as an appendage, as a, how will I put it, as a part of a body that if you fall off
11:18and die, you're just replaced, and you become a statistic, and then the world moves on without you.
11:25Thank you, Doctor. Well said. So, finally, we have a lot of critics saying that
11:30resident doctors go on strike too much. So, if there's one word you want to say to those critics,
11:36what would that one be? Okay, let's look at the history of that statement.
11:42The last time NAD was on a prolonged strike was in 2020, 2021. That lasted two months. After that,
11:50in June or July 2023, NAD was on a five-day or seven-day or eleven-day strike. From that time,
11:58this is the first time we're on strike, an indefinite strike like this. So, I don't know where
12:03the critics are getting their facts, you know? So, I've given you a countdown of the last five years,
12:08and I don't know. Is it incessant? Now, mind you, I have two predecessors, because our
12:14tenure is just one year, who have used their entire tenures to engage in diplomacy on all these 19 items.
12:22And in the diplomacy, there were promises upon promises upon promises to solve these issues.
12:27Yet, I took over a little over six weeks ago, and the AGM said, still run a 30-day marathon of
12:34running from pillar to post to talk to government, even at the point that government did not respond
12:39at the end of the 30 days. The next still said, extend by another one week, and the one week passed,
12:44and then we're here. So, to those critics, I would hope they would understand that doctors,
12:48too, are dying. They would understand that doctors take long, prolonged call duties,
12:53driving on their way home, they have accidents, and die. I would expect those critics will realize
12:58that doctors, after this exhausting work, collapse, look at Dr. Rotify from Rivers State University
13:04Hospital. He took a three-day call. He was very exhausted. He told his friends. He felt his body was off.
13:09I need to go and lie down and rest. He went to his call room, lied down, and Rotifer died.
13:15He never woke up till date. His parents lost their breadwinner. I know of a house officer who just
13:20started his first posting, and did a call, I think of about four days. The next thing, he collapsed.
13:26He fell unconscious. They did a CT scan. He bled in his brain. He was in the ICU for a few days,
13:31and he died. I can tell you doctors who finish call, I can call their names, but I don't want their
13:36families to revisit the pain. They did call, were driving back home, had accidents, and died.
13:41You know, baby. And what is the cost? They were sleeping on the wheel.
13:45That's quite unfortunate. That's really quite unfortunate. But then, the government said they
13:50are already engaging in talks with the NAD. I mean, from your own standpoint, from your own view,
13:57what would the response of the Federal Ministry of Health be? I mean, what are they doing regarding
14:02this ongoing strike? Thank you. Thank you for this question. You know, we're having a discussion
14:08with you now, and you've agreed with me that these things are germane. This is akin to the
14:14discussions we have with government. We have agreed that all the issues are germane. Okay,
14:18let's solve them. We're now putting timelines. Those timelines have been shifted. Gold lines have been
14:23shifted. Today, you will agree that this timeline is Monday. Tomorrow, you come, they will tell you,
14:27ah, no, no, no, we didn't agree it's Monday. We were not part of the agreement that it is Monday.
14:31So that is the back and forth happening. That is bickering. And it doesn't say well at a level,
14:37at this level of discourse. We should be able to agree on concrete timelines. Now, what cyclists can
14:43solve? Release those cyclists. What memoranda can solve? Let's agree. What actions, immediate actions
14:50can solve? Let's do it. At this juncture, I have to appreciate the Honorable Minister of Finance,
14:54the Honorable Minister of State for Finance for clearing the issues on their table or doing their
14:58best to clear it. And I must say the 25, 35%, about 60% of our members have gotten it. The
15:04accoutrement allowance is still dropping. It started dropping yesterday. We would hope that everyone
15:09will end up getting and there won't be hitches like the 25, 35% that was released earlier. But this is
15:16two out of 19. Of those, of those others, of those other 17, what is on the table, concrete has been
15:24finalized, has been implemented right now. Right now, nothing. Right now, as I'm talking to you,
15:31we have agreed, let's do this. We have put timeline. Those timelines, some of them have approached,
15:36some of them have passed. Things were agreed to be done yesterday. They've not been done as at this
15:40morning. Things have been agreed to be done this morning. It's already afternoon. There are things
15:45agreed to be done tomorrow and Friday. We're waiting to see. So these are promises that have
15:50been happening. So if I come out to the media and talk, it will be like, probably I don't believe
15:56those officers there. Like the Honorable Minister for Labor and Employment. I mean, he's a very honorable
16:01man, very passionate about solving this problem. You know, a father of doctors himself. He understands
16:06our plight. You know, and he's walking around the clock to see that these things are implemented.
16:11But bureaucrats will just make it seem as if doctors have been unreasonable. When Nigeria
16:15is producing doctors, I'm leading them to other countries. All right. Well said, Dr. Sulaiman
16:22Mohamed. Thank you very much for, you know, for this insightful conversation, for joining us,
16:27you know, in tackling this issue on ground. And we hope to have more of you in the studio. Thank you
16:32very much. Thank you for having me. Good afternoon.
16:34As discussions continue between NAD and the federal government,
16:38Nigerians are hopeful that both parties would find a common ground
16:41and restore normalcy to the hospital system in the country. I am Fadima Rachel. Thanks for joining us.
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