An apparent attempt by Minister of Health, Dr. Osagie Ehanire to play down the import and repercussions of the mass flight of Nigerian medical doctors to foreign countries is less than pragmatic, and certainly inappropriate as a measure of addressing a very grave situation. While it is true that migration of medical doctors, or indeed any other professional, to foreign countries is not peculiar to Nigeria, such other migration is not taking place as a mass, desperate movement typified by the Nigerian case. That is a signpost that all is not well in the country. For a country with decrepit health care system and huge population lacking adequate medical care, the last thing the country needs is exodus of her doctors, nurses and other medical personnel to other countries. Sadly enough, the very few rich Nigerians who travel abroad for medical care find themselves being attended to by the same Nigerian professionals, signifying that the problem is not with the doctors but the very poor environment and conditions in which they work here in the country. These are what should be of grave concern to the minister as it is with well-meaning Nigerians who indeed are worried not only about doctors in flight, but also other professionals ‘checking out’, as it were, from Nigeria.
In this wise, the remark on migration of medical doctors to foreign countries credited to Dr. Ehanire is not what is expected of the Minister. The remark shows that government is not seriously thinking about how to remedy the situation and this is unfortunate and disappointing. There is need to stem the tide of mass migration of medical personnel by ensuring that a conducive environment is put in place, of which Ehanire ought to play a vital role by way of policy thrust. Even if doctors in the United Kingdom and Europe are leaving for Canada, New Zealand and other countries, their reasons for the migration are not the same as Nigeria’s.
Nigeria’s awful and desperate condition is incomparable and should be placed in its proper perspective. Apart from the miserable low remuneration paid to medical personnel, other life-threatening challenges abound in Nigeria like general insecurity, kidnapping and poorly equipped medical facilities. Ehanire should be seen to use the paraphernalia of his office to come up with proactive ways to tackle the mass exodus rather than accept it as normal in a country that has acute shortage of doctors.
According to Ehanire, the Federal Government is only concerned about the experienced medical personnel who left the country, adding that it was working on how to make them still offer virtual service to the country. Is this what Nigeria needs at this time? Almost as an afterthought, he said the federal government was working towards improving the condition of service of Nigerian doctors to check the migration of medical personnel. “At a very senior level of those who have had postgraduate training, we are doing everything we can to improve the conditions of service.”
“We are also talking about engaging those who have spent many years abroad; …who are highly specialised, and who know a lot of high tech medicine, to engage them to work with us, even if it is virtually, so they can do virtual consultations…They can come here every three months or six for a few weeks and do some work hands-on so that we can gain something from their experience and knowledge.” It is doubtful if the country can reap the benefits of good healthcare through the virtual methods suggested by the minister, And at what cost to the Nigeria? How many Nigerians can benefit from such an arrangement? According to the minister, Nigeria produces about 3,000 doctors every year while the number leaving is about 1000. Surely this number is huge enough to be of concern to the minister.
Available statistics shows that in 2019, there were 24,600 doctors in Nigeria for a population of about 206 million people. Male doctors accounted for 16,000, while female doctors were about 8,600. Based on this, the current doctor-patient ratio of 1:9,083 is scandalous, and a stark contrast with the WHO’s recommendation of one doctor to 600 patients. With 218 million people to cater for, Nigeria requires at least 363,000 additional doctors to meet this target. Again, this should worry the minister.
The poor state of health care in Nigeria has a direct link with the disturbing degree of deterioration that has characterised the health sector. The sector has dropped in quality to what it was in the 1960s and 1970s. The deterioration has been due to neglect by successive administrations. In fact, the nation’s health sector is groaning and now hopelessly near a total collapse.
This dismal situation is in spite of the billions of naira expended on some tertiary hospitals during the twilight of former President Olusegun Obasanjo’s administration to equip some strategic departments in some tertiary and teaching hospitals as ‘centres of medical excellence.’ Curiously, some of the equipment installed had been reportedly tampered with and cannibalised but no one is being sanctioned. Moreover, huge amounts allocated to the health sector by successive governments have not had the expected significant impact on the sector. There is need to interrogate this anomaly.
Even the State House Clinic established to take care of the President, Vice-President, their families as well as members of staff of the Presidential Villa, Abuja joined the league of hospitals that cannot deliver quality healthcare services. This fact has been made glaring by the way the president, his family and officials of the villa have trooped to hospitals abroad at the slightest hint of ill-health. The factors hampering access to quality health care in Nigeria include obsolete equipment and the brain drain that began since 1985; not discounting the not-so-conducive operating environment.
Again, inadequacy of medical facilities, high cost of drugs, sub-standard drugs, wrong diagnosis, poor attitude of health workers occasioned by poor remuneration and resulting in the neglect of patients by medical personnel, long waiting time for patients, etc. are all responsible for the unhealthy situation in Nigeria.
On brain drain, media reports have been consistent that as the nation grapples with shortage of medics, more are fleeing the country. Besides, most of those highly educated at public expense and talented medical professionals, who are out in foreign countries are excelling, where the conditions and atmosphere are much better. Many reputable doctors all over the world are Nigerians, showing that the country has the brain, talent and the right training; but cannot just retain them at home. Nigerian doctors are competent to manage the healthcare delivery system in Nigeria if the environment can enable them.
Therefore, the continuing exodus of doctors should be a concern to people in authority. And that is why duty bearers should address the rising deficit in medical personnel occasioned by migration. Specifically, there should be conscious policy to attract health technologies and experts in the Diaspora back to Nigeria for a more effective and efficient health service delivery. Government ought to recognise that the country is in trouble if there are no adequate healthcare personnel for its teeming population.
Health Minister's lame excuse for doctors' migration – Guardian Nigeria