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Europe, Asia poach Nigeria’s medical specialists as health sector flounders

By Anietie Akpan, Deputy Bureau Chief, South South
27 January 2022   |   4:02 am
Health sector in Nigeria faces imminent collapse as Saudi Arabia, Britain and others in Europe and Asia poach Nigeria’s sub specialist doctors.

UCTH

Health sector in Nigeria faces imminent collapse as Saudi Arabia, Britain and others in Europe and Asia poach Nigeria’s sub specialist doctors.

Nigeria has specialist doctors and most of them were trained within the country by the National Post-graduate Medical College, Lagos and the West African Post-graduate Medical College in the past 20 years. Many of them finished their training as surgeons, gynecologists, pediatricians and orthopedic surgeons. Many others felt their respective sectors were too broad and so, decided to narrow it down to sub-special sectors of their various fields.

Some doctors in the University of Calabar Teaching Hospital (UCTH), who pleaded anonymity said, “now the country has neurosurgeons that can enter the brain and fix people with strokes and brain tumor without the need to travel outside the country and these are the sub-specialist doctors that are leaving Nigeria. Many of them sponsored themselves abroad and some were sponsored by the teaching hospitals and they have now come back with so much skills.”

Besides, the UCTH Laboratory Village where most laboratory tests are supposed to be done is idle. There are no materials or consumables for specific tests, and as a result, most tests are done outside, leaving the doctors and Laboratory scientists unhappy over such development.

The doctors said: “In those days, kidney failure was a death sentence, but today, we just move the patient to our dialysis centre where the fellows fluid is exchanged and he or she lives again. Those are the benefits of the sub-specialty training. In our hospital for instance, the two consultants in charge of dialysis have moved because the Saudi’s recognised that they need these sub-specialty professionals. Now in Calabar, we don’t have a sub-specialist doctor to handle dialysis. So, if you have any kidney problem, we either have to refer you to Uyo or Umuahia.

They said: “Here in Calabar, orthopedics doctors have gone for sub-specialisation. They can replace your hip with an artificial one. These are the doctors that the Saudis are fishing from us and you know the implications. If not that these two doctors doing dialysis in Calabar had trained our resident doctors, we would have shut down that unit and it means anyone with a kidney problem is gone or has to go somewhere else and even the doctors there are also leaving the country.

“All the doctors that are sub-specialists are the ones they are poaching. This has been going on for almost two years and as we speak, we have up to 1000 consultants in Saudi from Nigeria. They have their platform and they are recruiting more Nigerian specialists everyday because they need more of them. They offer N7 million to them. As they began to work, the Saudis realised that these guys are even sharper than the Canadians and Egyptians. So, the Saudis decided to give the Canadians and Egyptians a pay cut. Because of the COVID-19 affected doctors decided to go back to their countries.

“The Saudis know that they now have their health answers in the Nigerian doctors. So, they started recruiting Nigerians massively. You can see them coming to setup a recruitment areas in Nigeria. They know Nigerians are capable. The Kuwaits even refer to these Nigerian doctors as magicians because of the way we train our doctors in Nigeria. We train them to make a diagnosis without any test. By the time Nigerian doctors are done examining a patient, they will tell you the exact problem.”

One of the doctors told The Guardian that these special doctors are leaving because of the good pay. Added to that, he stated is the issue of worsening security situation in the country. He claimed that they (doctors) know some people in government understand the implications of what is happening because if the remaining special doctors leave, there will be no one to train upcoming practitioners. The implication, he said is that people with such health challenges cannot get help in Nigeria.

“And it’s not everybody who has the capability to travel abroad for such operations. The drift is that all of us are vulnerable. It means common procedures that are now ‘common’ in Nigeria will suffer because the equipment will lay waste and our people will suffer because they won’t have the benefits of this procedure. We will return back to the 1980s where we were contended with the usual basic operations,” the one of the doctors said.

The Medical and Dental Council of Nigeria (MDCN) had raised the alarm. Currently, if a consultant doctor is working purely for the teaching hospital, he earns N200, 000 more than a consultant that does the same job as him but is working as a lecturer in the university. So the doctors are urging the government to “allow them to earn the medical salary structure in the university so that they earn the same as those working in the hospital.” According to the doctors, the government is paying deaf ears to the demand. They argued that for a short-term measure, if the government corrects the disparity, some of the doctors may decide to stay, adding that with the way things are, they would not be surprised if the Chief Medical Director (CMD) of UCTH leaves too, because they are considering it seriously.

The doctors said: “We have two sets of doctors leaving Nigeria: the consultants moving to Saudi because of the pay and the Saudis won’t employ doctors that have not yet specialised and so they are taking only our specialists that are supposed to stay here, train us and improve our young doctors to take over from them. Because of government’s rules on how to employ resident doctors now, many of the resident doctors are now being employed by the British people under the guise of training, but they know after the training, they are there forever and won’t come back.

“If you come to our internal medicine department, we have only three consultants left in that department. They used to be 19 consultants, but the rest have left and it won’t be surprised if the remaining three leave. And this is happening in every department. What it means is that soon, our medical schools will not have people to teach our students. But the government is not seeing the imminent problem. If you ask the medical schools, they will tell you what is going to happen to the clinical section, which is that they are in danger of not having lecturers for 400 to 600 level students.”

Commenting, the Chairman of the Cross River State Chapter of the Nigeria Medical Association (NMA), Dr. Innocent Abang said: “It takes between seven and 10 years to train a specialist doctor after graduating from Medical school. So, losing one doctor is seven to 10 years setback. Our teaching hospital has been adversely affected as we have lost all the specialists in nephrology and now trying to get those who were in training to specialist cadre with no guarantee of their stay.

“We have also lost some obstetricians, gastroenterologists, Hepatobiliary Surgeons, Family Physicians, Anaesthetists and several others. With regards to the facilities, they are not adequate even with local efforts of the management to optimise the available ones and also partnering with some organisations through PPP to keep improved service delivery. But it doesn’t translate to adequate facilities to encourage job satisfaction.”

Abang stated that Nigerian doctors’ remuneration is in an abysmal state. According to him, it is not acceptable by any standard in the world. And in basic biology, he argued, it is natural to gravitate to an osmotic gradient by a simple movement from lower concentration to higher concentration. That, Abang said, is why they see the continuous migration of doctors.

On the way forward, he said the government must have the political will and the readiness to at least implement the African Union declaration 2001 with agreed 15 per cent budgetary allocation to health.

“Only South Africa has achieved 12 per cent budgetary allocation to health. Nigeria’s budgetary allocation of 4.34 per cent for the year 2022 is still a far cry from the AU 2001 Abuja declaration.

“The solution is very simple: A functional Health Insurance Scheme without all the attendant encumbrances in Nigeria is key to universal health coverage. Above all, health sector workers’ remuneration should be according to international best practice to discourage migration of doctors and other health workers to other better climes.

“The implementation of at least 15 per cent budgetary allocation to health cannot be over-emphasised. Poor health care will definitely affect the Gross Domestic Product (GDP) of the nation because health determines productivity,” he declared.

However, the UCTH is not taking the matter lightly. It has acquired a state of the art equipment to stem the tide of medical tourism abroad by politicians and other Nigerians. Some of the sophisticated equipment acquired are Direct Digital X-ray System, 4D Ultra Sound Scanner and a 32 Slide City Scanner for the Department of Radiology.

The Chief Medical Director of the UCTH, Prof. Ikpeme Ikpeme, had recently stated that modern equipment have been installed in various departments in the hospital to carter for patients, saying “my passion is to build, improve and upscale the level of services we render in the teaching hospital.”

He stated that with the equipment in the hospital and improved welfare package for doctors, same level of services rendered in foreign countries could also be rendered in UCTH.

He explained that patients who visit the hospital for radiology intervention don’t need to go outside the state for the service any longer and the hospital has automated its laboratories, with medical microbiology laboratory being a designated Magnetic Resonance Imaging laboratory in the state.

The CMD attributed poor funding as a major challenge for the hospital.

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