Following the 2020 COVID-19 pandemic, the World Health Organization, WHO, and the International Council of Nurses, ICN, issued an alert warning about global health workforce depletion.
They said that the COVID-19 virus killed over 180,000 medical personnel, and that a substantial number of health workers quit due to tiredness and frustration from the pandemic’s countless tragedies.
The ICN also stated that there is a global nursing shortage of 5.6 million nurses, with Africa being one of the continents most in need of qualified nurses. It further claimed that the European continent requires medical workers to satisfy current and future demands.
However, although other countries are responding to the appeal by taking swift action to address their shortage of health personnel, the situation is different in Nigeria, where the government appears unconcerned.
We’re Losing Our Best Hands:
With the government’s failure to effectively respond to unending complaints about poor salary and welfare packages, Nigeria’s medical talent is fleeing in droves to countries luring health workers with generous pay structures and cutting-edge hospital facilities to come in and replenish their workforce.
Countries such as Canada, the United States, the United Kingdom, Saudi Arabia, and the United Arab Emirates are aggressively looking for medical specialists to fill the void left by COVID-19.
These countries have created specific immigration schemes and hastened the recognition of foreign qualifications to make the employment process easier.
The United Kingdom, for example, will launch a ‘health and care visa’ program in 2020, while Canada has lowered language barriers and simplified the qualification recognition procedure for foreign-trained nurses. In a recent development, Germany stated its intention to hire 500,000 African nurses in order to alleviate staffing shortages in its healthcare system.
According to the UK General Medical Council, the government agency in charge of maintaining the official registration of medical practitioners, there are currently over 11,000 Nigerian-trained doctors in the UK.
After India and Pakistan, Nigeria has the third biggest number of foreign doctors working in the UK. A survey also found that 727 Nigerian medical doctors migrated to the UK between December 2021 and May 2022.
Dr. Innocent Orji, National President of the Nigerian Association of Resident Doctors (NARD), said in January that Nigeria had lost over 2800 resident doctors in the last two years.
According to Dr. Orji, this figure excludes medical consultants and other specialists who have left the country.
Uche Rowland, president of the Nigerian Medical Association (NMA), has stated that 74% of Nigerian health practitioners intend to relocate to seek greener pastures abroad.
This brain drain in the health sector has reached crisis proportions, making it difficult for Nigeria to retain skilled medical staff and develop a sustainable healthcare system.
According to the World Health Organization, Nigeria is one of the countries suffering from a severe lack of health workers, noting the country’s one of the lowest physician-to-patient ratios in the world, with only 4 physicians for every 10,000 patients.
The consequences of this shortage may make it difficult for patients to receive necessary medical treatment, particularly in rural locations where access to healthcare facilities is limited.
The WHO Director-General, Tedros Ghebreyesus, emphasized that health workers are the backbone of any health system, yet some of the world’s most fragile health systems lack them, and many are losing them to international migration.
Measures of Desperation:
The country’s increasing shortage of competent medical staff has serious ramifications for Nigeria’s healthcare system and residents’ access to quality care.
A doctor and nurse deficit exacerbates an already overburdened healthcare system, resulting in longer wait times, lower patient care, and, ultimately, poorer health outcomes. This brain drain not only jeopardizes progress in medical education and training, but it also stymies the establishment of long-term healthcare systems in Nigeria.
In an effort to prevent the outflow of medical employees, the administration of former President Muhammadu Buhari made efforts to regulate the migration of health workers by requiring them to do certain years of mandatory service in Nigeria before they could seek other employment options overseas.
The government’s move became public in December 2021, when former Labour and Employment Minister Chris Ngige proposed to the House of Representatives, in response to brain drain in the health sector, that health workers trained by the Nigerian government sign a bond to work in the country for nine years.
Ngige stated that medical staff should not be permitted to leave the country for free at the expense of the government, particularly after receiving training in Nigeria.
“In Nigeria, medical education is nearly free. Where else in the world can you get it for free? The Presidential Committee on Health should develop a strategy for bonding doctors, nurses, medical laboratory scientists, and other health workers so that they do not just carry their bags and leave their country after receiving free training.
“In London, medical education at a low-cost university costs 45,000 pounds per session.” You must pay 80,000 dollars to travel to Edinburgh or Oxford. If you go to the United States, you will pay $45,000, but if you go to the Ivy League, you will pay $90,000 for tuition only, excluding lodging. You commit to it for six years. As a result, people in America take out loans. We can set aside funds for loans that you will repay. We should bond you if the government will train you for free. “You serve your country for nine years before you leave,” he explained.
Most Nigerians dismissed Ngige’s offer with a wave of their hand.
However, fast forward to April 6th, 2023, when it was announced that a measure requiring newly qualified Nigerian doctors to work in the country for five years had passed its second reading.
Nigerians and stakeholders in the health sector were upset, accusing the bill of blatantly violating their rights to dignity and personal liberty.
Ganiyu Johnson, the member who sponsored the bill, stated, like Ngige, that doctors are trained with taxpayers’ money and should give back to their country, an argument medical practitioners have criticized as ‘weak’ and a government enslavement tactic.
The medical professionals countered that the notion that Nigerian medical doctors are taught for free is a lie. They insisted that medical students pay greater tuition than nonmedical students at most universities. Furthermore, every hired graduate repays the government subsidies by receiving considerably lower wages than their colleagues in wealthy countries.
However, in an interview with DAILY POST, health workers advised President Bola Tinubu’s administration to avoid mistakes done by his predecessors by proposing answers to the doldrums of medical labor shortage. Tinubu was charged with making aggressive attempts to address the core causes of doctor migration rather than using legislation to force doctors to return to Nigeria.
According to NARD, enhanced healthcare worker welfare remains the cure for reducing brain drain in the health industry.
“I always say that while politicians are playing politics, they should also be concerned with governance.”
“The reason doctors are leaving isn’t just remuneration; they need housing schemes, car loan schemes, and other things that the government doesn’t necessarily need to spend its money on; what it needs to do is just midwife the process and bring in private investors to fund it.”
“Poor infrastructure is another reason doctors are leaving.” It’s really upsetting when, as a doctor, you know what to do to save a patient’s life yet end up losing the patient due to a lack of infrastructure.
“If it happens over time, you will develop depression; this is not a joke, and the next step is to leave and find a better system,” Orji told DAILY POST.
Dr. Albert Iseli of Springs Dental Centre, another medical worker, encouraged the Tinubu administration to increase funds for the health sector.
“There are a variety of reasons why doctors leave the country.” These factors derive from the government’s inadequate spending in health-care systems. Brain drain is the fruit.
“Governments at all levels, including policymakers, must understand the complexities of the situation and be willing to act accordingly to resolve it.” A fire-brigade approach that suffocates liberty will not address the problem. Instead, it will make matters worse,” he told the DAILY POST.
Dr. Ejim Egba Clement, a 600-level medical student at the University of Jos and President of the Nigeria Medical Students Association (NiMSA), also backed proposals for greater pay for medical personnel.
“Brain drain cannot be addressed by forcing new medical graduates to stay,” he stated. This would encourage even more people to flee.
“We have consistently made numerous recommendations to the government on what needs to be done to encourage medical students to stay in Nigeria and practice.”
“One such recommendation is that medical practitioners’ pay should be increased. Our take-home salary does not correspond to the quantity of service they provide on the job.
“Also, the amount of energy, time, and resources they invest into learning the system. An average medical student spends at least eight years in school and earns a pittance of N180,000 or N200,000, which is little compared to what our peers in other nations make after only four years in medical school.
“Secondly, the working conditions in hospitals are deplorable. Most of the time, doctors stand helpless as patients die as a result of substandard or insufficient medical facilities at our hospital to cure ailments.
“And this situation has an impact on the psyche of medical doctors.” “Many general hospitals and PHCs lack consumables such as syringes, face masks, and so on for medical workers to use,” he told DAILY POST.