Doctors’ exodus and absentee President

The failure of President Muhammadu Buhari’s administration is manifestly expressed in the basket case that the healthcare profession has become. More than ever, the number of doctors, nurses and other health professionals fleeing the country daily is terrifying. Most depressing is the carefree disposition of Buhari that readily jumps on the presidential jet to seek the same quality care in London, which he has failed to provide in Nigeria.

While brain drain dated back to the 80s, it has never been this nightmarish. The malaise has shown Nigeria as one peculiar country that has aversion for its bests. It is frightening that more than half of over 72,000 locally trained and registered health personnel have left the country for greener pastures, even as more are preparing for Europe, Americas, Asia and even other African countries.

As of today, the medical profession is worst-hit and awash with stories of colleagues across sub-specialties leaving the country on a one-way trip! The complaint is the same poor working condition. It manifests as: broken health system, lack of good opportunities and basic tools, high cost of living, excess taxes and deductions from salary, poor remuneration, general insecurity, personal well-being and future of children, and more. Just like the rule that attends money, essential professionals and skill-sets will naturally flow from where they are undervalued, stressed, and unappreciated, to where they are regaled and courted with princely rewards.

The symbolism of the debacle registers more the other day when the National Primary Health Care Development Agency (NPHCDA) disclosed that only four doctors are available to every 10,000 Nigerians – that is, one doctor to 2500 Nigerians. The agency noted that 70 per cent of disease burden could be prevented and managed at primary healthcare, but only 43 per cent of the citizenry have access to quality primary healthcare services. While the new official ratio suggests an improvement in capacity, it is still a far cry from global standard and perhaps belies the disturbing reality. By the World Health Organisation’s (WHO) standard, a country should have at least a doctor for 600 citizens. As of 2020, Belgium had 61 doctors to the ratio of 10, 000 population, Germany: 44, Hungary: 61, Israel: 36, Italy: 39, New Zealand: 36, and Saudi Arabia: 27.

Interestingly, there are a lot of Nigerian personnel in foreign hospitals even as more are still sought daily. Already, there are over 9000 Nigeria-trained doctors in the UK alone. They could tell that the UK is a fortress for the medical professionals, just like the system would affirm that Nigerian doctors are some of the best in the world. The UK did introduce the ‘Health and Care Visa’ policy to attract the best healthcare talents to fill emerging gaps. Similarly, Saudi Arabia brazenly staged a poaching exercise for Nigerian doctors in Lagos and Abuja last year! A lot more recruitment is going on underground and a reason not to be fooled by official figures.

Unfortunately, the current administration is unruffled by the embarrassing exodus of health practitioners and growing deficit at home. The other day, it was reported that consultants and other health workers resigned and shunned new equipment procured for various departments by the Federal Government at the Federal Medical Centre (FMC), Makurdi. Earlier, it was at the Federal Medical Centre, Jalingo, Taraba State, where overseas jobs threatened the planned upgrade of the teaching hospital. With the President and co. freely junketing wards of foreign hospitals, why should anyone be compelled to stay at home?

The President, who just returned from medical vacation in London, has not shown a good example for the rest of the professionals. As at August 2021, Buhari has spent 201 days within six years receiving medical care in London. He is not known to have visited any Nigerian hospital in the last seven years. The health facility at the Aso Rock has raked in billions of naira from appropriation law without anything to show for it. An absconding President, who is only motivated by his personal comfort, is selfish. Such is uncharacteristic of remarkable leadership and Nigerians should be wiser at the next elections.

It is imperative that Nigeria urgently considers a health reform that keeps its best at home. The exodus of Nigerian doctors and nurses overseas reiterates the point that there is nothing wrong with our medical personnel, including those fleeing for their sanity, for family, or both. But everything is wrong with the toxic system where they operate and want to elope. The overriding problem is the less than charitable disposition of superintending ministers to palm off the problem as if it is not real. The Minister of Labour and Employment, Dr. Chris Ngige, once remarked that the doctors were at liberty to migrate as Nigeria has more than enough. It is true that they are free to migrate like other free Nigerians. But the mass exodus of your green horns; best consultants and very senior doctors, is not natural. A Nigerian health professional, like most average Nigerians, is content by nature and would not freely swap his fatherland for a second-class citizenship in Europe or America. So, such a lousy thought process of making migration look attractive has never helped the health sector and obstructing its reforms. Facing the grim realities that made migration the most compelling will be most helpful.

A better strategy out of the woods is to rally stakeholders at various levels of governance to the realities of the moment. Handlers should be clear headed and consensual over the roadmap of health system development, with deliverables broken into short, medium and long term plans. The goal is to create an enabling environment both for users and the providers. It must be such that for once, places a premium on human lives and rewards hard work. Health insurance should be most valuable at this time, to ensure functional and sustainable healthcare financing across the country. Finally, those at the helm of affairs must remember that a nation that cannot keep its best will not develop. Our leaders have a responsibility to the people and to themselves too to give proper health reform a chance, at least, for enlightened self-interest. Indeed, if the healthcare system among others gets better, made effective and efficient, a lot of doctors, with or without UK visas, will stay back and our world-famous practitioners will voluntarily return home.