Brain Drain: Stemming Migration Of Medical Personnel

Daily, highly qualified Nigerian professionals jet out of the country in search of the proverbial greener pasture. The lure to migrate out of the country to better one’s lot or seek higher pay for professional skills abroad is not restricted to any particular segment of the Nigerian society.

The medical practitioners are also not left out of the rush to ‘make hay while the sun shines, ’ as an appreciable number of them are relocating abroad, where they hope to fulfill inner yearnings, get better remunerations, as well as access an ‘ideal’ environment to peddle their trade.

The brain drain syndrome first appeared on the Nigerian scene in the 1980’s, when some notable professionals started travelling out of the country due to what they perceived as unsatisfactory working condition that was crippling their abilities and destinies. And ever since, the trend has been on the increase, contrary to what many had thought would wane with time.

While all the sectors of the economy are interwoven and fundamental for a robust development, some are even more crucial, as they impact directly on the people’s wellbeing. It is probably in this light that stakeholders are advocating that the many problems besetting the Nigerian medical sector, which are mainly responsible for medical personnel’s flight abroad, need to be urgently addressed, so as to stem the tide and restore the dignity of the profession and its practitioners.

Dr. Gabi Eitokpah, a public health physician with Isolo General Hospital, says a medical practitioner is just like any other Nigerian that desires progress and improvement in every area of his life.

“People usually travel abroad for several reasons, though they are majorly economic. So, obviously the Nigerian medical practitioner travels abroad to increase his/her fortune,” he says.

Explaining that the number of medical personnel travelling out of the country is on the increase, Eitokpah attributes this to lack of job satisfaction in the sector, which necessitates the movement.

“In many cases, these professionals travel abroad for further studies and to undertake specialist examinations because there are limited spaces in the country for those wanting to do this. There are many Nigerian doctors that are qualified for specialist training, but who cannot access this in the country. So, they have to look elsewhere to fulfill their ambition in this regard.

“This limitation does not, however, have only to do with the number of hospitals in the country. Rather, it has to do with funding because doctors have to be paid even while they are in training. But how much is the federal and state governments willing to pay doctors when they are undergoing such trainings,” he queries. “Right now, doctors in Lagos University Teaching Hospital (LUTH) are being owed salaries.”

While it is apparent that the doctors are benefitting hugely from their foreign venture, it is only natural that there would be some negative fallout, and expectedly, the public is at the receiving end.

“From what I’ve gathered, many of them are able to secure gainful employment in their host countries after the completion of their various programmes and so, many of them tend to stay put there,” says Dr. Kolade Thompson of Pristinecare Hospital, Dopemu, Lagos. “But that should not be surprising, as Nigerians are an intelligent lot and they tend to excel and put in their very best in their professions once they are out of the Nigerian shores.

“I believe it is a loss to the country and the people, when competent hands are allowed to leave the country on account of government’s inability to live up to its billing. It’s such a shame. I’m, however, not limiting this to medical personnel alone. No skilled professional in any field should be frustrated out of the country because all hands are needed on deck right now to build the nation.”

Eitokpah shares Thompson sentiments on this, as he says: “More often than not, the migrated medical personnel remain in the country they had gone for training. There must have been enough enticing attractions to make then want to settle there after their programmes.”

In what ways do all this negatively or otherwise affect Nigerians?

“In the first place, the arrangement in the Nigerian medical sector is skewed towards the urban areas,” explains Eitokpah. “A large number of professional medical personnel are concentrated in the towns and cities. This means that people in rural areas don’t have access to adequate competent medical practitioners.

“Then there is also the issue of poor healthcare delivery, since those left behind or on ground are unable to go round the number of patients needing medical attention. So, the result is that patients get exposed to a lot of quackery in their quest for necessary medical treatment.”

This scenario is particularly worrisome, when it is considered that Nigeria has never been able to meet the World Health Organisation (WHO)’s recommended ratio of one doctor to 600 patients. Presently in the country, there is only one doctor to 5, 000 patients. This discrepancy is certainly huge and is being aggravated by this development.

On the positive side, Thompson says if these medical practitioners were encouraged to come back, their wealth of experience would greatly benefit the country and the people.

“Over there, the level of exposure and technology is way above what we have in the developing countries, Nigeria included,” Thompson says. “Medical practitioners there have access to the latest equipment and methods of doing things. So, in my view, the development can still prove to be advantageous to the country and the people in spite of everything.

“For instance what if the government sets out to earnestly address many of the problems, which are making medical personnel leave the country? And after successfully tackling them, the medical practitioners in Diaspora are provided with all the requirements to comfortably practice their profession? I’m sure many of them would gladly return home.

“In any case, some of them are always undertaking one medical programme or another aimed at improving the medical condition of the people, especially in the rural areas. They come regularly to do this and in most cases, such programmes are free.”

Eitokpah echoes this call.

“Government doesn’t have to wait for doctors to go on strike before taking the necessary steps to ensure that all runs smoothly in the sector. What is really required to get things right is sincerity of purpose and commitment. There must be harmonisation of salaries. Doctors’ remuneration package also needs to be reviewed on a regular basis, just as they should tackle the issue of training for medical personnel and all that goes with it,” Eitokpah says.

In his view, there must also be advocacy at the highest level, whereby all stakeholders, including those in the medical profession regularly make recommendations and implement these for the welfare and wellbeing of all concerned. “The simple truth is that structures have not been put in place to ensure that the sector is well established, positioned and up-to-date in all its ramification. The underlying issues are simply not being addressed,” he says.

He, however, commended the Lagos State government under Governor Fashola for its efforts at equipping and providing conducive environment for medical practitioners in the state to perform adequately.

“The Fashola administration has been able to improve to an appreciable extent and do a lot to set the sector on the right path in the state. For instance, they have established Maternal and Childcare Centres (MCC) in the state. This is to align the government with the millennium development goals (MDGs) since the state is now a megacity. And this has helped in reducing maternal/child mortality rate in the state.

“Even though there is still room for improvement, but I believe if all states in the country would emulate this, a lot of improvement would be recorded in the medical sector in Nigeria,” he says.

For Thompson, seriousness and responsibility on the part of government are all it takes to straighten out the sector.

“Nigeria is blessed with the human and material resources to take adequate care of its population’s health. There is no reason whatsoever for our inability to provide all that is necessary medically for people. Just imagine, Nigerians are now trooping to such places as India, Germany, UK and the US among others to seek medical care.

“Aside from the fact that we are helping to grow the economy of these countries, which is very sad, we are also depriving our countries of the services of these qualified medical professionals, whose talents are highly sought and appreciated abroad. They are being well remunerated in these countries and don’t be surprised that many of them are occupying top positions in some of the best and world class hospitals all over the globe. Do you blame them for going to places where they are better appreciated and cared for?

“So, why can’t we just do the needful to get things moving in that sector? Within a few years, a serious-minded and focused government can tackle all the problems plaguing that sector and move it to the next level,” he says.