Health workers list conditions to halt brain drain

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By Mariam Ileyemi

Nigerian healthcare workers have expressed concern over the rising number of trained and professional medical practitioners who are leaving the country for improved working conditions and security of lives and property. The healthcare personnel noted that the Nigerian system has frustrated not just doctors or nurses, but many promising professionals to consider living as second class in foreign nations.

The National President of the National Association of Nigeria Nurses and Midwives (NANNM), Michael Nnachi, said based on the statistics his office is currently compiling, not less than 50,000 nurses out of Nigeria’s less than 150,000 have exited the country within the last five years. Mr Nnachi said: “There are over 50,000 nurses who have left this country in the past maybe five to six years. I feel bad for the health sector but on the other hand, I also see them as nurses who are looking for their safety and an improved standard of living. Looking at the workforce in the health sector, nurses constitute over 50 per cent, and we are at the receiving end of the terrible situations in our health facilities because we are the first and possibly the last point of contact.”

Mr Nnachi, who said many Nigerian nurses lose their lives on the line of their duties and particularly during the coronavirus pandemic, described as unfortunate the failure to list “a single nurse for national honour” during the last national honours award. “Nobody has appreciated or celebrated what the nurses are doing. Their conditions can be very critical even as they die regularly from COVID-19, Ebola and Lassa fever. The condition of service is very poor, remuneration is nothing to write home about, the standard of living is zero and yet we are serving humanity,” he lamented.

On the nurse-patient ratio, he said with a population of between 160 million to 200 million, Nigeria now has a ratio of one nurse to about 1,160 patients instead of an average of one nurse to five patients.

The President of the Association of Resident Doctors (ARD), University of Ilorin Teaching Hospital, Dele Olaitan, said the reality is that “even the 24,000 medical doctors that are believed to currently remain in Nigeria cannot be correct because many are leaving on a daily basis.”

Mr Olaitan said: “Now in Nigeria, we are beginning to lose focus on institutions that are in the healthcare system. Naturally, we are meant to have primary, secondary and tertiary healthcare institutions but because of the shortage of workforce, we have a lot of patients that are meant to visit the primary and secondary but who are going to the tertiary healthcare institutions.”

He noted that because the conditions of work are very bad, qualified healthcare workers are not even willing to work for the public system. “Many teaching hospitals are putting out vacancies for employment and we’re not even having doctors to apply because they don’t feel the need to join the collapsing system. So, unless we find a way to increase the total number of doctors in the system, it’s quite appalling that we have such few doctors,” he said.

In his own comment, an obstetrician and gynecologist Waleola Akinboboye, noted that it is not only Nigerian doctors that are migrating but other professionals too. He said: “It is not only Nigerian doctors that are migrating. For every one Nigerian doctor that is leaving Nigeria there are about three to five nurses or even more that have also migrated. As much as the doctors are critical parts of healthcare, the nurses, laboratory scientists, and pharmacists are equally important. So we should also consider their migration. So, the question we need to ask is: why are these people migrating? And I think the simple reason is that their existence is being threatened on their own soil. So, insecurity and economic reasons are the basic ones and until we address these reasons no effort will make anyone to stay in a hostile environment.” 

The speakers also responded to rumours about the bilateral agreement between the Medical and Dental Council of Nigeria and the UK medical agency that all Nigerian doctors must practice in Nigeria for 10 years before migrating to the UK.

They said they would resist every attempt to challenge the fundamental principles of labour mobility and that if Nigeria is successful in its perceived attempt at forcing the UK to stop engaging Nigerian experts, many other nations would open their doors. The Secretary of the Association of Resident Doctors, University of Abuja Teaching Hospital, Ogunsanya Ayomide, said the doctors will still travel to other countries regardless of any restrictions.

“The fact that they may try to restrict people from moving to the UK does not mean that medical personnel of this country will not go to other places. It is not only the UK that medical personnel are going to in the world. In the last two or three years, most of the consultant professors of Medicine have been going to Saudi Arabia. And also, even young medical doctors and dentists have been moving to America. So, the fact that you block a source does not mean that other places will not open up,” he said.

While he commended the government for the increment in the 2023 budget for health, Mr Olaitan, who is the incoming National President of NARD, recommended the implementation of what is popularly known as 2001 Abuja Declaration which prescribes at least 15 per cent of budgetary allocation to health. “We have 24,000, yet we don’t have facilities that can train as many doctors as we have. And we don’t have facilities that can absorb as many doctors as we have. So, we shouldn’t let the government get away with the impression that doctors moving away from Nigeria is our major headache today,” he said.

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