Doctor or Janitor: Who Is Of Premium Value?

By Innocent Daka

From the onset, it is important to state that doctors are important to our lives. They are always there to help us clear the cough that has been irritating us and taking away that clear vocal ability. They are able to give a name and advice on the possible cause of the sore-throat then give the right suggestion. Without them, many of us would be dying from malaria, diarrhoea and colds that are simple and curable, but left to deteriorate. 

But I do not mind on what the medical doctors will think of me or if they call for my blood for asking this question that compares their value to the lowest of workers in our society; A Doctor or Janitor: Who Is Of Premium Value?

Doctors are not the only best workers we have in this world and they should not be paid more than the janitors. This is true if one thinks of the biblical teaching of the body having many parts connected together and needing each other. None of the body parts must look down upon the others in terms of importance as the poor function of one of the parts has the potential of making the whole body malfunction.

Particularly, this argument arises from the question of how we have for a long time given no value to the Janitors, people who clean our toilets, sweep our streets, slash the waste places, unblock the drainage along our roads and unblock the sewer lines.

We have called these people all derogatory names and their job we have termed as blue collar. They are janitors, and will remain as such without hope for either horizontal or vertical upgrading.  The doctors and others other health workers we have called professionals and consider them as White collar category.

For the Blue collar, the salary is low and the conditions of services are almost next to nothing and they struggle to make ends meet. The white collar, whose dirty and rubbish the Janitors need to move far away from where it can cause their work environment contaminated and result in diseases like diarrhoea or malaria, are paid much more and the conditions of service are a bunch of luxury.

I choose the doctors in this white collar category because they are treated as essential workers more than the janitors, who are deliberately thrown out. The doctors and their fellow white collar brocks have all these conditions of service that can afford them flying to a plush location just to go and taste a variety of chicken and swim in a pool that needs a janitor at the end of the day. Their salaries are out of one’s imagination or out of this world, paid in between seven and eight digits starting from K6 million upwards, some even getting to above K100 million. 

These salaries afford the doctors to spend a chunk, equivalent to what passes for a janitor’s three months salary, on buying toys for their children or give pocket money to their primary school child.  The dogs, they call pets, even have a budget for food and expensive shampoo—enough  to pay for the college fees for a janitor’s child who languishes on the streets because the Blue-Collar-Father cannot afford.

The Cost of Poor Sanitation

Those who support huge perks for doctors have an absurd way of explaining this; doctors spent time in medical school studying and education has added that value to their profession, hence their enumeration is commensurate to their qualification.  

Yes! It is agreed. However, before medical school medicine was close to the crudeness that we have left to prevail in the Blue Collar World—the world of  a sanitary worker, a janitor. That does not need one to go on explaining, but the archive on the history of medicine easily takes off that veil. 

And just as those argue in support of the doctors, I will not be the one to stand in for the janitors but the proved facts and statistics of how costly the unhygienic conditions can be to a country when the work of the janitors is neglected, when the work of the drainage diggers and that of the street sweeper is insulted.

 

According to a report by Water and Sanitation Programme on the economic impacts of poor sanitation, poor sanitation costs Zambia K946 billion Zambian each year, equivalent to US$194 million (dwarfing the cost of mobile hospitals). This sum is the equivalent of US$16.4 per person in Zambia per year or 1.3% of the national GDP

While the large part of this amount covers for poor coverage of latrines which leads to people defecating in open places, especially among the poor families, US$167 million is lost each year due to Premature Death. Approximately 8,700 Zambians, including 6,600 children under 5, die each year from diarrhea – nearly 90% of which is directly attributed to poor water, sanitation and hygiene.

Of this amount, US$10.6 million spent each year on Health Care includes diarrheal diseases directly, and indirectly via malnutrition (and its consequences for other diseases such as respiratory infections and malaria that are all leading causes of morbidity. Costs associated with health seeking behaviour include consultation, medication, transport and in some cases hospitalisation – which place a heavy burden on households and government spending.

Most of the common communicable diseases like coughs, diarrhoea and malaria that make up the huge cases that our health personnel attend to are caused by the conditions in our environment and need more than the doctors to prevent them.

Apparently, janitors and other sanitary workers, who help to keep garbage out of our homes and streets, slash tall grass, are first line of defense in primary health care. And just as medicine has advanced from medieval times and doctors need to be in school, the demand for a health environment—sanitising our streets, homes and work places—begs for advancing of janitors’ knowledge and skills. 

Surgeon in Medieval Times:

"The surgeon would not have had university training, he would have learnt what he knew from other surgeons, from surgical texts or through operating on soldiers injured on the battlefield. The surgeon would have lots of surgical tools such as a amputation tools, arrow pullers, cauteries (hot irons) for stopping bleeding, bloodletting tools and much more, like those in the picture on the right. If the surgeon had to amputate a limb, he could not administer the modern anaesthetics we have now which knock us out and make sure we feel no pain. He was limited in what he could use. He may have used alcohol,opium or mandrake to help sedate the patient".

Janitors and street cleaners, alongside workers who unblock our drainages can go to school for a stretched period to learn all that it takes to do a better job.

Just why shouldn’t they understand the germs that are formed in conditions of our faecal matter which they clean, the chemical combination of the disinfectant or cleaning materials they use and use of microscopic instruments to identify the germs in the sink or toilet seat they are working on? This also applies to people who open up our drainages; why not learn the engineering of depth and width measurements of the drainage they need to create, best way to keep debris from flowing in, the plane of slant to ensure the water is carried away from our roads and not vice-versa, and how much deluge of running water can size of drainage carry per minute to avoid over flooding?  When the value of these jobs is raised and provided with best books that become reference, then it will be rich in knowledge and attract people who will do a good job like doctors do. It will have people who will be called doctors in their own field, seeking to construct the best sewer system that they can proclaim will last for another five hundred years without flooding.

Once that is done then Zambia, as a country, is going to have better drainages, healthy toilets that have a 99.99 percent insurance against communicable diseases, our sewerage system will ever be flowing to the right places and never cause diarrhoeal diseases, just as the drainages will also ever flow and never contribute to the damaging of our roads. Our garbage would be collected and our roads swept. They can even start providing consultancy on the DIY (Do It Yourself) of keeping garbage out of homes or turning it into manure that is clean.

My last thought

The janitor’s job has been shunned and given very low value. In the end this country has very few who yearn to start out as janitors. However, with a deeper reflection there is need to raise the value of this job and instead of making people end up just as janitors, we can raise it to primary health workers in that special category—corps of sanitary workers who raise awareness on sanitation issues and educate communities on low-cost technologies to set up latrines. That requires an education paper and a reasonable salary!

How much knowledge that I have talked to is offloaded to doctors in public health, but they hardly have time to use it? Take that out of the doctors and give it to people who need it and raise their value, too.

Environmental health technicians have hijacked that position, but are too smart to start from or do that dirty aspect of the job and so there is no one to do it.