For about forty-six days now, one full month and two restless weeks, non-physician health workers in federal hospitals have been on strike, and the most painful truth is that patients can hardly tell one disruption from another. To the average Nigerian standing helplessly at a hospital gate or wandering through silent corridors, there is no taxonomy of strikes, no professional distinctions to decode. What they see, feel, and suffer is simply that the hospitals are not working.
Technically, it may be correct to argue that doctors are not on strike, but in lived reality that distinction collapses. A strike is a strike, regardless of who downed tools. Nature, as the saying goes, dislikes discrimination, and illness certainly does not recognize professional boundaries. The patient counts only losses: wasted time, deepened frustration, untreated pain, avoidable harm, and the quiet breakdown of order and hope that accompanies every health-sector shutdown.
I have found myself repeatedly struggling to explain this nuance to relatives, friends, and distressed patients that doctors are present, that it is other health workers who are on strike. Their response is often a gaze heavy with confusion and disappointment, a silent question hanging in the air: what difference does it make? What comfort is it to know who is officially working when the outcome remains the same: no scans, no records, no lab results, skeletal services, and care that falls far short of what drove them to the hospital in the first place?
The sociologist Talcott Parsons once described medicine as a social system built on interdependence, and nothing exposes that interdependence more brutally than a strike. Remove one cog, and the entire machine grinds to a halt.
I witnessed this reality play out in a private hospital when I accompanied a friend to visit a patient. The patient needed a scan, but the hospital’s machine was non-functional, so they were referred outside. When my friend wondered why they had not simply gone to the Federal Medical Centre in Bida, the reply came swiftly: they are on strike. I tried to clarify that doctors were not on strike, only to be met with a look that suggested a person lost at a crossroads. Another patient nearby added that only a limited number of patients were being seen daily under skeletal services. That brief exchange captured the entire tragedy. This is why private and state hospitals are now overwhelmed, and why many people are driven to desperate alternatives or dangerous self-help from unregulated providers.
The consequences of this desperation are no longer abstract. My wife recently told me she was visiting a relative admitted in a private hospital. The woman’s baby had diarrhea, and in the absence of functional public hospital services, she relied on advice from people around her. Dose after dose of Flagyl was administered, even when the child did not respond. By the time the situation deteriorated into an emergency, the baby had to be admitted for intensive care. I asked why they had not gone to a state hospital to reduce costs, knowing admission could stretch for days. The answer was sobering: the situation was too urgent, and with state hospitals overwhelmed, they could not risk further delay.
Health systems research consistently shows that disruptions in formal care increase harmful self-medication and mortality, especially among children, and this story is a living footnote to that evidence. What becomes painfully clear is that, regardless of which group is on strike, the impact on patients is identical. Yet within the system, many health professionals still cling to the illusion that they can serve the public good effectively without genuine collaboration. Doctors may be physically present, but when other health workers are absent, the result is often failure—failure to protect life, failure to save life, and failure to translate professional commitment into meaningful outcomes.
As management scholar Peter Drucker famously observed, efficiency is doing things right, but effectiveness is doing the right things. In a fragmented hospital system, both are lost.
This fragmentation is worsened by long-standing rivalries among unions and a flawed orientation encouraged, often unintentionally, by government itself. By selectively resolving the demands of one group while treating others as inferior or expendable, authorities deepen resentment, professional disrespect, and indignity. The result is a toxic environment where cooperation is replaced by competition, and where each strike plants the seeds of the next. Health systems thrive on trust, yet ours is slowly being strangled by contempt.
It is therefore worth asking how some groups come to believe they are more entitled than others to certain titles or privileges, even when the collective failure to serve the public is glaring. How does the rigidity of identity make one strike seem less damaging than another? The irony is that ordinary people already understand what professionals often forget. In local culture, everyone working in a court may be addressed as “Your Lord,” everyone in an emir’s palace carries the dignity of royalty, and nearly all healthcare workers are simply called “doctor.” This is not ignorance; it is a social language of respect. It acknowledges hierarchy without weaponizing it and honors contribution over title. There is wisdom here. No so-called bona fide doctor can single-handedly replace the work of security staff, records officers, accountants, laboratory scientists, technicians, plant operators, and nurses. If these roles make the system function, why can they not all be “doctors” in their own right, in the sense of healers within a shared mission? What the health sector needs is collaboration, not rivalry; friendship, not competition.
Theories of teamwork in complex organizations emphasize psychological safety and mutual respect as prerequisites for high performance, and healthcare is perhaps the most complex organization of all. Sabotage born of narrow self-interest only ensures collective failure. In truth, health workers must heal themselves before they can convincingly claim to heal others, especially in a system increasingly poisoned by rivalry.
Recent events only underline this reality. Resident doctors called off their strike on November 29, 2025, after twenty-nine days of industrial action that began on November 1. Barely weeks earlier, on November 15, 2025, the Joint Health Sector Unions commenced their own strike over the long-delayed adjustment of the Consolidated Health Salary Structure, unpaid hazard allowances, promotion arrears, rural posting allowances, and broader concerns about poor working conditions and systemic inefficiencies. Services across federal teaching hospitals, specialist centres, and even some state-owned facilities were crippled, prompting the Pharmaceutical Society of Nigeria to describe the situation as a national health emergency. These repeated cycles of action and inaction have become a grim ritual, stretching back over a decade.
Unsurprisingly, this crisis has reignited debate about who is best suited to lead hospitals and the health ministry. Increasingly, evidence and experience suggest that effective leadership is less about clinical identity and more about competence in management, policy, and systems thinking. Non-physicians trained in administration, economics, or public governance often bring objectivity, neutrality, and a broader institutional perspective. Countries across the world have demonstrated that strong health outcomes do not depend on physician-led ministries alone. Even global health institutions have been shaped by leaders whose greatest strength lay not in clinical practice but in strategic coordination and reform.
Leadership, as Max Weber argued, is ultimately about legitimacy and rational organization, not professional symbolism.
This is why recent comments attributed to the national ASUU president, Professor Chris Piwuna, resonate so strongly. In calling on the federal government to hasten resolutions with other unions to ensure stability, he articulated a principle that applies perfectly to the health sector. There is no meaningful difference to patients between one strike and another, no moral hierarchy of disruption.
The way forward lies in government embracing equity, not merely equality, and intervening early, fairly, and comprehensively, before hospitals fall silent again. In healthcare, delay is never neutral; it always takes a side, and too often, it sides against the patient.
Bagudu can be reached at bagudumohammed15197@gmail.com or on 0703 494 3575.
