Begging, Suicide Thoughts… How Doctors at OAU Teaching Hospital Manage to Work Without Pay

Published 20th Dec, 2023


The medical professionals at a federal hospital in Ile-Ife, Osun State, who have been working without pay for months are the subject of this report by FIJ’s ABIMBOLA ABATTA. Despite having to work every day, they are left to drown in a financial crisis, feeling betrayed and with their morale destroyed, hopes dashed and dedication unrewarded.

“Words can’t explain how I feel. You know when you have got to the phase when you are now numb. I don’t know how to feel anymore. I’m the one who’s supposed to take care of my family, but I’m the one who is begging.”

Those were the words of Agege Moshin (not real name), one of the doctors at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, whose salaries have not been paid for several months.

A report published by SaharaReporters earlier this month stated that OAUTHC shut down one of its wards due to a shortage of doctors and health workers caused by migration to other countries in search of greener pastures. The PUNCH also reported on December 4 that at least 65 doctors had left OAUTHC in one year, while about three wards had stopped admitting patients due to a shortage of health workers.

FIJ understands that unpaid salaries could be one of the factors responsible for the exodus of healthcare workers from the hospital. For instance, healthcare workers at OAUTHC, both clinical and non-clinical, employed between December 2022 and June 2023, have had to endure unpaid salaries.

As a federal government-owned hospital, the profiles of the affected workers at OAUTHC ought to have been captured on the Integrated Payroll and Personnel Information System (IPPIS), which makes them eligible for salaries. But this is not the case for the affected workers at this hospital.

According to Moshin, he and a host of other affected doctors are supposed to have been captured on the platform, but no capturing has been done since their employment.

While speaking with FIJ, Moshin said, “We have no idea why those of us employed between December 2022 and early this year have not been paid. Without being captured on the IPPIS platform, your payment becomes an issue, because you are being paid by the government.

“If you have ever worked in a federal government setting or hospital as a doctor, you’ll understand most people want to get captured before they even assume work, because if you start working without the IPPIS number, you may fall into this kind of problem of not getting salaries.”

‘THE MANAGEMENT EMPLOYED EXCESS HEALTHCARE WORKERS’

While Moshin disclosed that the hospital management did not give a concrete explanation for the delay, he said the government claimed the immediate past chief medical director (CMD) employed staff beyond the quota given by the federal government.

“We learned that the hospital was given a number of people to employ. The government claimed that there was a waiver that was supposed to employ 450 clinical staff, but the then CMD employed way more than what he was to employ,” the doctor said.

“So I think that the IPPIS guys consequently refused to come and capture people. At the end of the day, they sent some people to come do some fact-finding from the Federal Ministry of Health.

“How is that our fault or business? They are not meeting the CMD or the former CMD who made those blunders. You are keeping us here without any solutions. After gathering information about the excess staff who were employed, what’s the way forward? Nothing! There are no solutions whatsoever.”

A news report published in November revealed that Moshin and other affected workers at OAUTHC were not paid because Olumuyiwa Owojuyigbe, the former CMD of the hospital, was involved in over-employment and job racketeering without provision in the personnel budget.

An investigative panel set up by the Federal Ministry of Health and Social Welfare found that Owojuyigbe employed over 1,973 staff as against the 450 vacancy waivers granted for the 2022 employment by the Office of the Head of the Civil Service of the Federation.

Following the findings by the panel, Moshin and others have undergone a series of verification exercises, yet their salaries have not been paid.

“We were asked to submit our documents. I personally don’t think any doctor will be coming to apply for work without having their certificates, licenses and NYSC certificates, among others,” Moshin told FIJ

‘WORDS CAN’T EXPLAIN HOW I FEEL’

In response to a question on how this doctor had been faring, he told FIJ that words could not explain. He said he had to depend on his family for survival, as he was unable to fulfil his filial responsibilities.

“You know when you have got to the phase when you are now numb. I don’t know how to feel anymore because I have been waiting for my salary from January, February, and now December.

“Initially, when we did not get paid for the first three months, the Association of Resident Doctors (ARD) told us to be patient. They sent out memos, messages and many other things. April came, but no salary.

“I think in June or July, we went for an internal strike before the general NARD strike came up. At the time, as it is common with the government, there were ‘no work, no pay’ threats. That’s what they do to Nigerian doctors.

“There was also the fear that the hospital might send your names to the government, telling them ‘this department has not been working’. People are already suffering. The money is not even enough. So everybody backed off.

“We’ve been hearing stories upon stories. They said the Ministry of Health would come for verification. Some people came in August or so and gathered us like sardines, tossing us here and there.

“Come and line up and do this one. Bring your forms here. It was crazy. I think I almost broke my back trying to queue up with so many other non-clinical people.

“You know how everybody wants government jobs in Nigeria, even the ones that don’t deserve it. We were given a form, where they asked for our name, address, qualification, how we got the job, who we paid, how much we paid, the phone number of the person, and other sorts of questions. Was that a verification?

“One of the officers was sharing some stories to blackmail people, stories on how during NYSC people paid for relocation and paid to get posted to good places. That was the so-called verification in August, after which they left.

“We didn’t hear anything from them. They kept saying the panel had set up an investigation panel up until, was it last month or so, when they released a memo. They were only releasing a memo three months after on how they found that over 2,700 people were employed.

“Okay, so what’s your next step? What are we going to do after you’ve found that? You have doctors and nurses and pharmacists and a clinical staff that have been working without getting paid.

“I work my ass out every day. Day in, day out, I try not to take out my hands on patients. You can’t have a doctor working shifts not getting paid. We’ve had people who I have had to borrow from.

“I’m the first child. I have siblings. I have an ageing mom. My dad is late. I’m the one who’s supposed to take care of the family, but I’m the one who is begging. They are the ones who have been giving me money, sustaining me up to this time.

“You can imagine a full-grown person begging. I’m working, not like I’m jobless, but I’m begging to even be able to pay my rent. Then how much more would I do to feed? And there are other bills. My siblings are there. I have to go to work. Am I going to trek? I walk sometimes when I can’t even afford a shuttle in the hospital. The electricity bill is there. There are a lot of things to do, but you can’t do anything.

“So, as I said, I am numb. You know, when you have stopped getting angry, you’re no longer in that phase. You’re now in the acceptance phase. You’ve moved from anger to denial, not acceptance. I’m just here, like God, whatever happens, let me just get through.”

PEOPLE ARE LEAVING BECAUSE…

Moshin also revealed that many people are leaving for other hospitals within and outside the country because of unpaid salaries, among many other reasons.

He noted that despite working for almost a year, he had not been entitled to leave and work allowances, yet he had to keep working.

Many could not continue to slave away for a government that did not care about them, so they either went to other hospitals or relocated.

“I know colleagues who have left, who have left to either private hospitals or for another government. Some have left the country, but I’ve been here,” she said.

“This is not like I haven’t thought about suicide. You’re depressed. You wake up and don’t feel like waking up from your bed and going to work. But you still go to work regardless, and someone is telling you, ‘don’t worry. They’re saving the money for you.’ Are you kidding me? That’s an insensitive remark. Sometimes, they tell you that you don’t even look like you have not got a salary.”

HOW WILL PEOPLE WORK IN A HOSPITAL THAT DOES NOT FUNCTION WELL?

“A year wasted.” That was how Moshin described his ordeal at OAUTHC. His hopes, like many of his colleagues, have been dashed against the crumbling walls of a sickly healthcare system.

He made references to a news report that claimed hospital wards were being shut down because of doctors’ migration. But he pointed out that the problem could be traced to the issues of delayed payment as well as the deteriorating health sector.

“One year is gone. They’ve wasted my entire year. Even if I was planning to japa, I can’t do so without money. I can’t write exams. I can’t do anything. And yet you go about lying, saying that all doctors are leaving.

“They keep blaming the doctors, whereas the system is failing. You don’t have manpower. You don’t have enough doctors. The ones that are even around you are not paying them. And then you blackmail them.

“They don’t shut down a ward because of doctors. It’s the nurses who man the wards. So if you’re shutting down the ward, it’s because you lack nurses, not doctors. Since June or July, a part of the emergency ward has been shut down. And that’s because they don’t have nurses.

“Even if you have one or two doctors, they will rather kill that doctor with work than shut down the hospital. That’s how it works in this country. They will rather let that one particular doctor that is working kill himself or die on the spot than shut down the hospital.

“You think this hospital is functioning? You don’t want to know the things that are going on in this place. But will they shut it down? No. They will rather keep patching and patching. There are times we don’t have light and water. There are times people in the Intensive Care Unit (ICU) die when we run out of oxygen.

“Rather than hold the system responsible, you hold the doctors because they are the prey that you can easily talk to. This country is not even ready. Doctors and nurses will leave when the whole health sector is a mess, and there’s no one who is ready to pick it up.”

He stated that the government does not care because political office holders would rather seek medical care outside of the country than use the local health facilities.

Amud Duma (real name withheld), another doctor who does not want to be named, told FIJ that without being placed on the IPPIS, he and other affected workers cannot access their salaries and other benefits.

“Your insurance, pensions, national housing funds, other allowances and perks cannot be accessed without being enrolled on the payment platform. The subsidy palliatives that everyone got, we did not get it,” he said.

Like Moshin, he learned that the hospital recruited more than the assigned number of workers.

“They somehow exceeded the waiver four to five times. So that’s the reason they haven’t come to capture. They said they wanted to do multiple audits. They’ve done multiple verifications, but none has yielded fruits anyway.”

‘IT IS HECTIC’

Duma said it is hectic, struggling to cope with unpaid salaries and a chronic shortage of manpower. Despite not being paid, he told FIJ, they are required to do the same amount of work.

FIJ understands that the workload is further compounded as these doctors often have to take on extra work since many of their colleagues have already left for better opportunities.

“You are still expected to do the same number of calls. There’s even a lot of extra work that you have to do, so it’s been very tough. You have to go and do your ward rounds, see the patients you have operated on – some we’ve planned for discharges, some that we want to further reassess or review,” he told FIJ.

“Part of what makes it worse is the chronic manpower shortage, and I don’t think anybody emphasises that enough. The workload was extreme even when we were hired. Imagine hiring people and not paying them.

“This year, a number of my colleagues left the hospital. People are not just leaving the country; they are going to other places in Nigeria, where they will get better pay and remuneration for the kind of work they are doing, or at least regular pay, so that they can take care of themselves.”

Although Duma hopes for a change, he fears the system is broken and unlikely to improve without significant intervention. He pointed out that the health sector budget has shown no significant difference.

“A government comes in and they say they will do much better. But the health budget for the coming year did not increase. The percentages are still the same. So, you now wonder how they want to improve the system. How is it going to get better if we are still doing the same thing over and over again?”