Dr. Louise Mapleh Kpoto, President, LMDA
46 doctors cut, 100 more yet to be added to payroll
Building a resilient health sector in the country for Liberians to have access to quality and affordable healthcare is challenged by yet another wave of protests and ultimatums, this time from the Liberia Medical and Dental Association (LMDA) in conjunction with the Liberia Medical and Dental Council (LMDC).
The current threat of the doctors and dentists’ ultimatum over their pending strike to lay down their tools is “life threatening” and their angers would definitely be felt.
The overall unhappiness of the entire medical staff including nurses, occupational therapists, porters, paramedics and healthcare assistants has a nose-dive effect on the health sector which has struggled to rebound since the Ebola epidemic in 2014.
On Friday, May 11, the LMDA and LMDC announced their 72-hour ultimatum which began on Thursday, May 10, over the arrears of three months incentives for 40 interned doctors and the reinstatement of 46 doctors who were deleted from the payroll and classified as ghosts.
Addressing a news conference, the President of LMDA, Dr. Louise M. Kpoto and the Chairlady of LMDC, Dr. Linda Birch expressed frustration over the removal of the licensed doctors, who have completed internship and are currently in the various counties doing their intensive Emergency Obstetric Care (EmOC).
In a special statement read by the Secretary General of LMDA, Dr. Jonathan Hart, he said more than 100 Medical Doctors are yet to be placed on payroll and about 40 interns have not been paid their their incentives for three months.
“What is even more disgusting and annoying, was that while appealing to the doctors to hold on to faith and hope as we negotiate a suitable and peaceful solution, in the same Month of March 2018, the Ministry of Health removed a significant number of doctors from both incentive/payroll and labeled them as ghosts; but they were actively working without their rightfully due salary/incentives,” Dr. Hart said.
“These actions of the government over the years (and recent actions) led to a resolution passed and adopted by the LMDA in our second bi-monthly meeting, held on the 28th day of April, 2018 in Ganta, Nimba County, calling on the Minister of Health to make immediate payment of arrears and reinstate those doctors removed from the incentive and salary within 72 hours as of Thursday, May 10 and regularize the incentive and salary structure of those doctors affected, no later than May 30.”
The LMDA urged Liberians and foreigners to brace themselves for the consequences of their ‘go-slow’, beginning Sunday, May 13.
Furthermore, the LMDA has also urged President George M. Weah on the implementation of the negotiated salary scheme of Medical Doctors and Dentists, as per the November 14, 2016 demands and upgrading of all health facilities.
The Medical Doctors and Dentists emphasized that promises made to them by then President Ellen Johnson-Sirleaf were not met and they are therefore urging President Weah to effect those promises as of July 1, 2018.
They want government fully implement the resolution of the Doctors for the improvement of their lives.
Names of some of the licensed doctors removed from the payroll in March 2018
In the resolution, the Doctors called for improved salaries, insurance and other benefits developed through a policy document and implementation of the salary scheme agreed between the government and the doctors.
The doctors also want graduates who are on intern programs to receive their full incentives, the upgrading of all health facilities to the minimum standard contained within the essential package of health services.
The doctors threatened serious consequences in case of any delay and breach of the implementation of the resolution to include a full boycott of all health facilities in July of this year.
They are therefore calling on the public to prepare for a major health crisis if the government fails to meet their demand, indicating that they are tired suffering of low income despite their services to the nation.
Mr. Sorbor George, Media Officer at the Ministry of Health, acknowledged the issue of arrears on salaries and incentives, but expressed surprised at the LMDA’s statement.
“We are shocked that the doctors will go public with their concerns,” George to the Daily Observer in a telephone interview on Saturday, May 12. “Three days ago we met with he doctors over the issue of their salaries. We promised them that we would submit the payroll to the Ministry of Finance, which we did immediately following that meeting.”
It may be recalled that, in November 2016, Doctors from across Liberia gave a 72-hour ultimatum in demand for their over three months’ salary arrears. Their arrears were fully paid but, according to them, government fails to improve the public health facilities and improve their salaries. Hart continued: “If the government does not make payment of our salaries, we will take a strike action, we will gather at the Ministry of Foreign Affairs where the President works.”
According to George, for the months of March and April 2018, the intern doctors will be paid according to their status as intern doctors. For the month of May, their salaries will be upgraded to that of licensed doctors, he said.
“The Ministry of Finance is currently processing their salaries,” George said. “As of May 2018, they will be paid as ‘licensed doctors’, compared to intern doctors as they were before.”
Sorbor George insists that the Ministry did not intentionally take doctors off payroll. The Ministry instructed the Internal Audit Agency (IAA) to conduct an audit and it was the audit that recorded some doctors and other healthcare personnel as ghosts.
“We’ve begun verifying the names and asked people who were recorded as ghosts to come forward,” Sorbor George to the Daily Observer in a telephone interview.
Shortage of Doctors in Liberia
The Liberia Medical and Dental Council said as of September 2017, there were 339 Medical Doctors responsible for the 4.5 million population making the doctor per patient ratio 1:15,000.
The field of specialty is limited
The LMDC statistics, showed that there are currently 250 general practitioners, 21 public health specialists, 16 pediatricians, 12 Obstetrician-gynecologists, , 9 internal medicine specialists, 6 dentists, 6 family medicine specialists, 6 ophthalmologists, 4 psychiatrists, 2 orthopedics, 2 emergency medicine specialists, and one of each specialist in dermatology, ENT (ear nose and throat), infectious disease, neurosurgery, occupational health and pathology.
Norwu Howard, Deputy Minister for Administration, Ministry of Health (Photo: Derek Moore)
The figures show that the number of doctors is increasing, from the 278 reported last year, but with the constrains of motivating doctors beginning with their payment during internship and subsequently placed on government’s payroll is hiccup that would drive many from the medical profession.
George said Nowu Howard, the Health Ministry’s deputy minister for administration led a nationwide performance assessment of the health sector to identify gaps in order to develop solutions. “The IAA representatives sent by the Ministry to the counties could not reach certain areas because they complained of bad roads,” George explained. “Therefore, those employees in the areas that could not be reached, the IAA representatives recorded them as ghosts.”
As a case in point, George told of a human resources officer at the government hospital in River Cess County who the health ministry team met on their excursion, dressed all in black. When asked if he was mourning, the human resources officer answered, “Yes, I am mourning my ghost that was taken off the government payroll.”