Fatoumatta: One criticism of the members of the Association of Resident Doctors strike has been that doctors are bound to a set of responsibilities under the Hippocratic Oath, and that their work is a “calling”.
Health workers have countered this by arguing that they have responsibilities, but that they also have rights. The standoff between government and doctors that’s deprived many Gambians the inalienable right to quality health care and exposing many to extreme physical injuries and financial strain.
When doctors in the Gambia began the strike, they spelt out their demands clearly: they wanted an apology and resignation of the Health and Social Welfare minister. The government has chosen the wrong approach to end the strike. It’s attempted to coerce doctors to resume work by withholding salaries, issuing sacking letters and threatening to import foreign doctors from countries such as Cuba and India.
The members of the Association of Resident Doctor’s leaders have also been threatened with jail sentences for refusing to end the sit-down strike. These coercive machinations are intended to force doctors back to work. Instead they have strengthened their resolve. After so much sacrifice they feel there’s nothing more to lose.
The doctors’ resolve has also been strengthened by the fact that the government has refused to make any concessions, sticking to the same position that the doctors’ association turned down in the first week of the strike. The habit of using technicalities and bureaucratic red tape to frustrate the negotiations also needs to stop. And all stakeholders should be ready to come up with solutions rather than erecting roadblocks along the road to a deal.
Ultimately, the government needs to place the interests of the public first. It’s required to provide quality health care to all its citizens. Instead it is disregarding the needs of most Gambians who cannot afford private health care.
The most perturbing effect is that many patients have died or suffered disability because they could not access care. On top of this, many people have been forced to seek health care services from private hospitals, incurring catastrophic financial liability. The strike has also placed heavy workloads on private health facilities which have had to contend with higher number of patients.
This has stretched existing facilities and human resources, potentially reducing the quality of care. Doctors are bound by the Hippocratic oath not to harm patients under their care. That’s why, for instance, those who were performing surgery when the strike started didn’t abandon their patients but completed the operations first.
Secondly, the oath places special obligations on doctors towards their fellow human beings – whether they are ill or not – and charges them to take all the necessary measures to benefit the sick. In the current strike, doctors have clearly outlined the benefits of their demands to the public. If the government meets its obligations, there will be more doctors in public service and they will be better equipped, trained and motivated.
Therefore, the burden of abandoning patients is not to be borne by the doctors: the government bears the responsibility to provide health care to the people. After all Gambians pay their taxes to the government, not to the doctors, and should expect the government to provide essential services in return. Resolving the current strike positively would alleviate two major problems that bedevil the Gambia’s public health facilities – the shortage of doctors and insufficient equipment.