PUBLIC primary health centres across the Federal Capital Territory (FCT) have remained shut for over two months, along with all public primary schools and the six area council secretariats. The closures are the result of an ongoing strike by workers demanding the implementation of the N70,000 minimum wage approved by the federal government in 2024, as well as other outstanding entitlements.
In this interview with The ICIR, Chairman of the National Association of Nigeria Nurses and Midwives (NANNM), FCT Council, Jama Medan, discusses the far-reaching impact of the strike and the inaction of the area council chairmen.
Excerpts:
The ICIR: Why has your union shut down all PHCs in Abuja for over two months?
Medan: You know we have been battling with this issue of primary health care centres being closed down for over two months, and it has become an issue that every Nigerian should be worried about. The death of one single person like this is a major issue of concern.
In developed countries, if one thing happens to one person, it becomes a serious thing. I’ll give you an example with the child that died in Lagos recently, a woman who died after delivery. The issue was in the news all over, but as I speak to you, all the primary health care centres in FCT have been under lock and key because of this strike for over two months, including schools and local government secretariats, and nothing is happening.
Sadly, the area council chairmen are not even bothered, they don’t care, they are not even moved.
Another thing that is making these people behave this way is the autonomy they have been granted. Ministers intervened in this matter. The minister intervened and released N4.1 billion to them to settle this issue. They said it when we were in the National Assembly, and they confirmed it. The Chairman of the House Committee on Area Councils invited us.
At the end, when they interrogated them, they said yes, money was paid, N4.1 billion. And the money that was paid was for Signature. The House of Representatives asked them, ‘What is signature money?’ They said it is called signature money. So, the House said, how can N4.1 billion be money that is not known? They then ordered that this money should be investigated. From then on, we have not heard from them again, and this is where we are.
The ICIR: When did this meeting take place at the House of Representatives?
Medan: That was last month, three weeks ago. The National Assembly passed the autonomy law and the president signed it into law. Now, they are taking the autonomy for granted. They feel they are above everybody, above the law. I think it is only the National Assembly and the Presidency that can call these people to order.
They should either stop their allocation or impeach them out of that office, or we find a way of doing it.
If we are going to see an example from anywhere in this country, it is supposed to be from the FCT. This is because FCT is being ruled by the president and also the Minister, but they want to spoil it.
I think somebody should call these people to order. They just want to sabotage the president and the minister of FCT, and if nothing is done quickly on this, the people of FCT will start losing confidence in the current administration. The minister has tried, it’s just that there is nothing he can do.
Throughout the period, we went into an agreement with them, but they never respected that agreement. Apart from that, we presented that agreement to the minister, signed by all of them, that they were going to do all these things. They failed.
We went to the National Assembly—same thing. Let me tell you the truth: the Minister of State for FCT called us for a meeting. These people did not come.
When they were invited to the National Assembly, some of them went, but some refused to go. Since then, these people have never, on their own, shown concern or invited us as a union to say, ‘Please come, let’s talk.’
The ICIR: Do you know those who didn’t go to the National Assembly?
Medan: The Kuje chairman did not come. I think another one sent his own vice. Let me just be honest with you; in every industrial dispute, negotiation must be ongoing. Usually, it is the union that would say, ‘We are not going for the negotiation.’
But in this case, they don’t even call. They don’t even care. They have never initiated anything like, ‘Come, let’s sit down. What is the problem?’
The ICIR: Would you attribute the imminent end of the chairmen’s tenure to why they are doing this?
Medan: Yes. Some of them are concluding their tenure, and some of them are going to continue. Some of them are willing to even pay some of these allowances, but they have come as a union to agree that even if you have the money, don’t pay because their allocations differ. What AMAC gets is bigger than what the Kuje Area Council will get. Even if AMAC is ready to pay, they will say no, don’t pay.
We are actually on this strike for these issues: One, we say non-implementation of the minimum wage. It is a law that everybody should pay, in every state. Even some states have gone ahead to implement something more than the N70,000 that we are talking about.
Even the FCTA has gotten their own with the arrears. We don’t have problems with the minister. It is the area councils. We have almost 14 items. With the current hardship and the cost of living in the country, anything that the federal government or the government says they should pay, they refused to pay in the FCT. They refused to implement it in the FCT.
The N70,000 minimum wage, they have refused to implement it. Even the N35,000 wage award that the government gave after the removal of the subsidy, they refused to pay.
They have given them all this money, but they refused to pay. Then, the implementation of the 25 per cent and 35 per cent salary increase, and the arrears, they have refused to also pay.
They also refuse to implement the N35,000, N25,000 CONMESS adjustments. Every level of government in this country has paid this one. Some people are even paying more than that, but the area councils have refused to implement.
The promotion arrears, since they came on board, they have not been paying the promotion arrears. No promotion, even, and for the few that have had a promotion, they are not paying them.
So, we have so many issues here. Even the pension that you know, the employer contributes, the employee contributes, but they don’t even remit their own.
The National Housing Fund and all those things that we are talking about, the hazard allowances that were paid to everybody, have not been paid. We don’t understand what is wrong with them.
FCT is supposed to be, at least, where every other person will at least copy from.
The ICIR: What happens to cold rooms where you store vaccines which are donated by partners, including Global Fund and WHO?
Medan: Let me tell you the dangers and what these people have caused this country. Tuberculosis patients are not supposed to miss even one medication because of the risk of them developing resistance to their drugs. Since we closed these facilities for the past two months, those TB patients have not been getting their drugs, and they stand the risk of infecting other people.
At the end of the day, even if they resume, that resistance will still continue, and the drugs may not work for them anymore. Similarly, all the people who were receiving their HIV drugs through this primary health care have not been getting their drugs. You can imagine those drugs are not in the market. Even if they are in the market, they cannot afford it.
Let me talk about the vaccination, like the oral polio vaccination that just happened. In our thinking, as good Nigerians, when the issue of polio vaccination came in, we met, and we went to the National Assembly. The National Assembly pleaded with us. The Mandate Secretary of Health called us and pleaded with us that please we should look at the innocent children in FCT. She urged us to give a waiver so that this vaccination against polio would take place, so that the FCT should not be the one to infect the neighbouring states.
We met at the level and said even if we are fighting the government, for the sake of these innocent children—so that someone doesn’t wake up tomorrow crippled or disabled because we went on strike—we said no. That was how we called all our colleagues, resumed work, and gave them access to all the cold chain rooms. We didn’t just permit them; we participated in the immunisation. That was how we concluded that.
The ICIR: Let’s look at the failure to utilise the vaccines, distribute TB, HIV drugs and others. What message is this sending to the donors like the WHO, Global Fund, and others supporting us?
Medan: That was why I said this issue should be dealt with at the National Assembly and the Presidency. They should not overlook it because it sends a signal that maybe the government is not serious about these diseases they claim to want to prevent. That’s exactly what these partners will think. But just because of ignorance or the selfish interests of Area Council chairmen, the whole country will now be looked down upon because the FCT Area Council chairmen refuse to comply with or pay civil servants the money the government has already provided.
So, it’s sending the wrong signal, not just in the FCT but across the entire country. If there’s a resurgence of polio and the resistance comes from here, even if we get support next time, they’ll say we’re unserious.
The ICIR: Can you estimate how many children and mothers could have died due to a lack of access to health facilities in the FCT?
Medan: We went on strike in late March. As of February, I may not share the document because it’s confidential, but I can produce it at any time if needed.
For example, there’s Karamajiji Primary Health Care near the National Stadium. As of February, 104 pregnant women delivered there. That tells you that if these women had come in March, they would have been in trouble.
Then there’s a PHC Kuchigoro, 28 women put to bed there before the strike. Kuje Health Centre had about 23. In Alu-Mamaji PHC, there were 11 deliveries in February. If these women had come in March, they wouldn’t have accessed care. You can imagine the implications.
I have statistics for over 70 primary health care centres – what happened within the past three months before the strike. You can use those figures to estimate how many women and children were at risk from March till now.
The ICIR: Do you have the number of PHCs in Abuja?
Medan: We have 270 primary healthcare centres in the FCT. As of today, we have only 117 nurses and midwives. If you share them, they can’t go round the PHCs. We’ve been complaining about the shortage of manpower.
Let me tell you the truth; the last recruitment of nurses and midwives done by the Area Councils was in 2008. Since 2008, there’s been no recruitment. People have retired, some have died, and others have left the country. That’s why the numbers have dropped.
In some places, they’ve closed down PHCs because the government doesn’t care. How can you have 270 PHCs with only 117 nurses and midwives?
The ICIR: If one goes to a PHC today in the FCT, one could see many workers wearing nurses’ and midwives’ uniforms. Who employed them?
Medan: Most likely, they are CHEW or JCHEW (community health extension workers or Junior Community Health Extension Workers). In fact, most PHCs are expected to have at least one doctor. But where there’s none, nurses should be there. And we know there’s a shortage, but at least nurses should be present.
The ICIR: Do you have the number of doctors in these PHCs?
Medan: I don’t have the doctors statistics, but call me at midnight, I’ll tell you even if one nurse or midwife retires tomorrow, I’ll know. I keep track.
That’s why I know the number of deliveries for every area council. I can give you nurses’ and midwives’ data for each area council at any time. Let me give you an example—go to Area 3. There’s a PHC there but just one nurse is posted there. That’s the city centre.
That place is big enough for deliveries and minor surgeries, but only one nurse. What can she do? Even administrative work will overwhelm her, not to mention clinical duties. There are many such examples; the manpower shortage is pervasive. It’s not that there aren’t graduates. We’ve got many nurses the government can employ.
The ICIR: From your data, do we have employable nurses and midwives?
Medan: My recent survey in the FCT showed over 3,000 unemployed nurses. I have their contacts, addresses, everything. They’re roaming the streets of Abuja jobless. If you need them, I’ll bring them for recruitment tomorrow.
The ICIR: Are they licensed?
Medan: Yes. I have their current licence numbers. Over 3,000 are still here, jobless. The last recruitment was in 2008. How many have graduated since then? Even in the FCTA, the last official recruitment was around 2015. We don’t have a shortage of nurses in Nigeria.
People leaving the country don’t affect the population of those not employed. ‘Japa’ is not affecting us, it’s because they are not recruiting.
When we did a recruitment exercise last, even at the national level, we recorded thousands of unemployed nurses – more than 50,000. So, we have the manpower. Even if you decide to recruit a large number today, we already have the nurses available.
Marcus bears the light, and he beams it everywhere. He's a good governance and decent society advocate. He's The ICIR Reporter of the Year 2022 and has been the organisation's News Editor since September 2023. Contact him via email @ mfatunmole@icirnigeria.org
Mustapha Usman is an investigative journalist with the International Centre for Investigative Reporting. You can easily reach him via: musman@icirnigeria.com. He tweets @UsmanMustapha_M