The hidden costs of 28-day Nigerian doctors’ strike

The hidden costs of 28-day Nigerian doctors’ strike



On November 14, Hassan Chukwu (not his real name) lost his mother unexpectedly. She died moments before a surgery that was supposed to save her life. What later emerged as a likely medical error has stayed with him.

“My mother went into the theatre room with her two legs, only to end up dead even before the surgery commenced. I suppose an error must have occurred, because the doctors could not tell what exactly happened,” Chukwu told this reporter.

Another woman shared how she lost her friend after a fibroid surgery. “Before she was discharged, she was given a drug she wasn’t supposed to take at the time. “That was what ended her life,” she said.

Stories like these continue to occur daily as doctors grow more exhausted, with more patients dying and government negotiations stalling.

Read also: Resident Doctors’ strike: The hidden costs Nigeria can’t ignore

“When medical doctors are pushed into roles they haven’t fully trained for, the problem isn’t their competence, it’s their limited experience. Clinical judgment, surgical decision-making, and critical care expertise take years to build,” Stephanie Omoarebun, a health expert and national secretary of the Young Medical Laboratory Scientists Forum.

“When less-experienced doctors are placed in these positions, the likelihood of medical errors increases, and that’s one of the hidden consequences of both the strike and the wider doctor shortage,” Omoarebun noted.

“Beyond the clinical risks, there are economic costs that Nigerians rarely see. Families are paying more in private hospital fees. Productivity is dropping because people aren’t getting timely or adequate care. Long-term treatment becomes more expensive, and medical tourism continues to rise. All of these are silent burdens the health system is carrying,” she added.

As one health analyst noted, these hidden costs must be addressed urgently because these tragedies “could happen to anyone.”

Mohammad Suleiman, president of the Nigerian Association of Resident Doctors (NARD), explained the risks behind these errors with this reporter. “It is very dangerous to refer a patient to a doctor that is burnt-out, because sometimes you are expected to take timely, well-calculated decisions with accuracy and precision on very delicate issues of life and death on a daily basis.”

Kalabari TV recently reported slowing operations by public hospitals in many states across the country due to unpaid salaries, hazard allowances, and other unresolved welfare issues. Emergency cases were turned away. Mortuaries overflowed because there was no space left for new corpses.

A BusinessDay investigation found that while some hospitals were barely functioning, others had locked key sections, such as the pharmacies, leaving only a handful of staff to attend to long lines of patients. Many families had no choice but to move to private hospitals, where the bills were far higher.

Although the government has made attempts to negotiate, key demands remain unresolved. And while the country battles a heavy debt burden, it is ordinary Nigerians, desperate to keep loved ones alive, who bear the harshest consequences.

“When two lions fight, the grass suffers,” a popular Nigerian proverb states.

NARD’s list of grievances includes unpaid basic salaries for three to 20 months, unregulated and excessive work hours, withheld 25 percent –35 percent upward-reviewed salary arrears, and, in some cases, the dismissal of doctors who protested unsafe working conditions, among others.

Read also: FG urges doctors to end strike, approves 25%/35% CONMESS, 18 other demands

“Some of our colleagues were sacked in Lokoja for speaking out, while others at UUTH, OAU Teaching Hospital, FMC Owo, and the Federal University of Health Science Otukpo have not been paid salaries for between three and 20 months,” NARD president said.

He added that “some of our doctors on call work an average of 106 hours to 126 hours per week,” more than triple the standard 40-hour work week in many other non-health professions.

Francess Ayaebene, a chief medical director, stressed why this situation is unsafe for both doctors and patients. “It is unethical for fatigued doctors to keep working. This has become the norm within the Nigerian health system,” she said. “To protect the sanity of the doctor and the safety of patients, medical practitioners must operate within safe space and humane limits consistent with international best practices.”

She captured the reality in one question, “No one would willingly board a plane flown by an unrested pilot. Why then should patients be treated by an exhausted and unpaid doctor?”

Broken promises, angry health workers

The current strike stems from an unfulfilled promise through the Collective Bargaining Agreement (CBA), to dialogue, negotiate and sign a Memorandum of Understanding to the effect of meeting the 19-point demanded by NARD. However, as of November 18, the MoU has not been signed.

Government efforts

Following a virtual meeting on November 17, 2025, the National Executive Council of NARD confirmed in a communique shared with this reporter that the Federal Ministry of Health had issued an advisory directing hospital chief executives to prevent excessive work hours for resident doctors. As at the time of this investigation, it remains unclear whether the directive has been implemented.

The communique also noted that payment of the 25/35 percent upward-reviewed salary arrears has begun, covering up to December 2024. However, about 40 percent of members are yet to receive any payment, according to the NARD president.

The Federal Ministry of Health has also set up a committee to probe the dismissal of resident doctors who protested in Lokoja.

Despite these steps, NARD maintains that the strike may continue until all 19 of its demands are met, or, at least, until a clear MoU outlining timelines for implementation is signed.

Read also: Prioritise Nigerians welfare, Pate urges striking doctors

Recommendations

Health experts are calling for urgent, coordinated action to end the strike, combining immediate interventions with sustainable reforms. “Remedies include structured task-shifting, emergency supervision for junior doctors, retention incentives, expanded training programmes, and long-term workforce planning to address chronic shortages,” Omoarebun noted.

“In short, the strike and the ongoing workforce shortage are creating escalating human, economic, and systemic costs that demand swift, coordinated short- and long-term solutions,” she added.

The NARD president also highlighted the importance of ensuring safe work hours for resident doctors. “Safe work hours keep both patients and doctors safe,” he noted.

Dr. Faith Donatus is a climate change expert, a seasoned researcher with over 15 years of experience and a two-time award winner for contributing to research by the International Journal of Research and Scientific Innovation.

With a PhD in Environmental Pollution and Control, Faith is passionate about transforming Nigeria’s food and public health systems through deep research, data-driven analysis, deducing solution-based insights to challenges impacting Nigeria’s food and health systems.

At Businessday, she is a real sector correspondent, covering health and agricultural beats.



Source: Businessday

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