The steady migration of medical personnel out of Nigeria is cutting off the life out of a health system that was already in a state of coma, with the Nigerian masses bearing the brunt, says Juliet Jacob Ochenje in this article.
When Ms Jumoke Olasunkanmi’s nephew was scheduled for an emergency surgery for ventricular septal defect (hole in the heart) sometime in July, 2022, little did they know that they would wait another seven months before they could get the services they desired.
In an interview with African Health Report (AHR), Olasunkanmi said though they had been booked for November 2022 on the waiting list at Obafemi Awolowo University Teaching Hospital, Osun State, the ’emergency surgery’ took place in February 2023 due to shortage of consultants to perform it.
She said, ”My nephew was diagnosed with ventricular septal defect (hole in the heart) sometime in July and we were told he needed surgery as soon as possible. We went to Babcock but they said their pediatric cardiologist was out of the country.
”We went to Obafemi Awolowo university teaching hospital, and they said there was a waiting list, after paying for the surgery they said they’ll do it in November 2022. They had just one cardiologist because around October same year or so, they said the doctor lost his son so they stalled all surgeries until he resumed. After he resumed, they said they couldn’t get one of the equipment they needed for the surgery so we had to wait. We finally did the surgery in February 2023 of this year. So we waited for over seven months for a surgery that was supposed to be an emergency simply because the hospital was short staffed.”
Olasunkanmi’s account highlights the dire state of Nigeria’s healthcare sector. In both the private and public hospitals, there are not enough personnel needed to attend to the health needs of Nigerians seeking care because medical doctors, nurses, pharmacists, researchers and other highly skilled healthcare practitioners have left the country. While the exodus is daily, the government is not recruiting as frequently to replace them.
The brain drain, exacerbated by the poor remuneration and welfare of healthcare workers, and lack of political will to make provisions to develop the health sector by successive leaderships, has compounded the woes of the average Nigerian who cannot afford high end hospitals that can still manage a decent work force.
According to data from the Nigerian Association of Resident Doctors (NARD), between May 29, 2023 and December 1, 2023, approximately 1,197 Nigerian-trained doctors were licensed. The total number of Nigerian doctors licensed to practice in the United Kingdom (UK) now stands at 12,198, excluding those trained in other countries.
Also the Chairman of the Committee of Chief Medical Directors of Federal Tertiary Hospitals, Prof. Emem Bassey, noted that “so many people are now going to places like Sierra Leone and Gambia and the wages they earn $3000 to $4000.”
Similarly, the Nigerian Medical Association in Kano State confirmed a constant departure of members to countries like Gambia, Somalia, Rwanda, Saudi Arabia, and others.
The 2023 macroeconomic outlook report from the Nigerian Economic Summit Group (NESG) highlights a substantial health infrastructural gap, attributing it to the loss of medical professionals to brain drain. Nigeria’s health system ranks as the fourth worst globally, according to the World Health Organisation (WHO).
The exodus of doctors and healthcare workers seeking better prospects, with over 2,000 doctors leaving for Europe, Saudi Arabia, and Canada in 2022, means more Nigerians will not get the healthcare services they need to solve their problems. This signals that the already overburdened public health system will soon collapse like an avalanche. This is reflected in the 1 to 5000 doctor-patient ratio (according to 2022 data), against WHO’s recommendation of 1 to 600.
This dismal ratio also bleaks Nigeria’s chances of achieving the UN Sustainable Development Goal 3 of “ensuring healthy lives and promoting well-being for all ages.”
The impact on public health is already being felt across the country. NARD had confirmed that a ward at the Obafemi Awolowo University Teaching Hospital (OAUTH), Ile Ife, Osun State, which is the Behavioral Science/Psychiatry section was also shut down due to shortage of personnel.
Dr Bassey recommends that “japa” syndrome could be curtailed by building state-of-the-art infrastructure and making the sector attractive and rewarding to workers irrespective of their fields. This includes providing decent wages for healthcare practitioners.
The average doctor’s salary by countries, as revealed by The World of Statistics, in July 2023 via its verified Twitter handle, ranked Switzerland as the country with the highest salary for doctors at an average of $388,623 (N311,869,957).
Following in that order are the United States – $316,000 (N253,590,000); Canada – $194,777 (N156,308,542); Germany – $183,000 (N146,857,500); United Kingdom – $138,000 (N110,745,000) and Saudi Arabia – $133,320 (N106,989,300), making up the top six. Comparatively, doctors in Nigeria earn $11,573 (N9,263,257) yearly.
The Registrar of NISA Garki Hospital, Abuja, Dr Samuel Durotifa, in an interview with AHR,
“There is a looming problem in the health sector, which will become tragic sooner or later. The implications is that for average Nigerians seeking specialised care, in this regard, it is little to a total lack of it. The implications are already evident, more so in the rural communities and gradually taking hold in urban settlements as well. Health care personnel to patient ratio is at an all time low. The government needs to look into why the health personnel are relocating in the first place, which includes good working conditions and appropriate remuneration, without these being looked at the exodus would continue. Begging the doctors and health workers to come back home must be a joke, they either don’t care at all or are too insensitive to what people really suffer.”
The shortage continues to impact major teaching and general hospitals across Nigeria, leading to closures and disruptions in healthcare services. The government must treat the need for state-of-the-art infrastructure and improved working conditions to retain healthcare professionals as an urgent national issue to save the lives of the masses.
