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NMA and unbridled doctors’ exodus



It should be worrisome that an old story of how so many developed and developing economies have been gaining brains from our brain drain in the health sector is still a recent discussion point by the Nigerian Medical Association (NMA). This is a sad commentary on our development. 

Although the migration of doctors is not new, it has been on the increase in the last two years. It is estimated that at least 2,000 doctors leave the country yearly for the United Kingdom (UK), United States, Canada, Australia, United Arab Emirates (UAE), Saudi Arabia, Kuwait, South Africa, and Europe. Specifically, reports show that 50 to 60 doctors leave Lagos hospitals every six months. Also, the NMA’s chairman in Kaduna has disclosed that out of the 33 doctors recently employed in the state, only eight reported.

This is unfortunate in that Nigeria does not have enough medical doctors to serve the population. Available statistics show that the country has a doctor/patient ratio 1:6000 and in some areas, it could be worse with 1:10,000; against the WHO’s recommendation of one doctor to 600 patients (1:600). So, it is obvious that for every 1000 people or patients, there is a shortage of 10 doctors.

Therefore, there is a deficit of doctors in this country to serve the over 200 million population. This means a doctor in Nigeria is seeing 10 times the number of patients he is supposed to see. In the UK, it is 2.8 doctors to 1000 patients while in Nigeria it is 0.2 doctors to 1000 patients. It is really unfortunate.

Furthermore, figures released on February 2018 by the British government indicate that no fewer than 5,405 Nigerian-trained doctors and nurses are currently working with the British National Health Service (NHS) in the UK. This means that medics of Nigerian extraction constitute 3.9 per cent of the 137,000 foreign staff members out of 202 nationalities working alongside British doctors and nurses.

The implication is that Nigeria’s health sector challenge has become a bad ulcer thriving on the medications of doctors’ exodus occasioned by harsh working conditions, poor remuneration, deteriorating facilities, insecurity and the harsh economic realities.

It is thus regretted that even in Africa’s so-called largest economy, doctors no longer see a bright future within the shores of the country because the conditions of work are pathetic and insufferable.

Yet, there has been no recent indication that the country’s leadership is about to address the reproach as they rather resort to medical tourism as, most of the nation’s leaders, including the president, always fly abroad for treatment, an unacceptable situation in a country that once boasted of having one of the best four teaching hospitals in the Commonwealth. It would be recalled that sometime this year, President Muhammadu Buhari lamented that the country had been losing N400 billion yearly to medical tourism. This attests to the government’s inability to address the various health challenges. 

Furthermore, the Minister of Labour and Employment, Dr. Chris Ngige, this year too, said that doctors who would like to relocate to other countries in search of greener pastures are free to do so, claiming that Nigeria has enough medical personnel to cater for the population. Another issue is the perennial low budgetary allocation to health, which has never gone beyond six per cent of the national budget in the last 18 years against the African Union Declaration in 2001, at Abuja, and WHO recommendation of at least 15 per cent.

Even, the 2019 3.4 per cent budget for the sector also seems to show that the government is not interested in the health of the populace. These validate some of the excuses for the exodus of doctors to other countries and allegations that government at all levels in the country are not interested in the welfare and health of the citizens.

The indifference of our nation’s duty bearers to Nigeria’s health sector challenge, which discounts the fact that the exodus of doctors is at the expense of the lives of Nigerians, is a paradox rolled into a tragedy. The more doctors leave this country, the higher the maternal and child deaths as well as very low lifespan and expectancy. Besides, poor disease treatment outcomes can be worrisome. This may account for Nigeria’s low ranking in global health index.

Based on the brain drain that has bedevilled the sector, it is apparent that trained health professionals are needed in every part of the world. When healthcare professionals lack opportunities for professional development, lack enabling environment to function, cannot fully use their skills and find that the quality of their lives is woeful, compared to their peers in more advanced countries, they have no choice but to flee abroad for greener pastures.

So, until Nigeria places the highest premium on healthcare, the exodus of doctors will not end. Therefore, the government needs to take healthcare seriously and make it a major priority in view of its critical importance to the citizens’ lives. As this newspaper has always noted, the value of budget proposals for health must be remarkably enhanced.

In fact, healthcare requires remarkable investment, not just increased funding. The better investment will certainly translate to more remuneration for health workers, increased training opportunities for doctors, availability of equipment and other infrastructural facilities.

As a matter of urgency, government at all levels must instill confidence in and show a willingness to improve healthcare services by enunciating necessary laws that are capable of increasing funding for the sector and ensuring that the funds are properly managed to save the nation’s health infrastructure and personnel.

Better political commitment to healthcare; better appreciation of the worth of medical personnel, along with better and competitive wages; better working conditions and inspiring work environment; better security and access to social amenities; attractive and globally respected postgraduate training programmes for health workers will not only stabilise the healthcare delivery system, it will stop the current brain drain.

It is also curious that most of our leaders who campaigned on stoppage of foreign medical tourism for public officials in the previous administration have not made good their promises by investing robustly on health facilities. Our leaders should stop lamentation, but act now to reverse this ugly trend of Nigerian doctors trooping abroad in search of greener pastures.

Specifically, as we have always noted, this nation expects President Muhammadu Buhari who has spent so much time in the United Kingdom on health grounds, to execute the change he promised on foreign medical tourism since 2015.

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