A Few days ago, Nigerian polling organisation, NOIPolls, released the results of a survey which they conducted in partnership with Nigeria Health Watch. The research revealed that about 8 out of every 10 (88 per cent) of medical doctors in Nigeria are currently seeking work opportunities abroad. In other words, not counting those who have already left, among the very inadequate number we have, 88 percent have their eyes set on leaving at the earliest opportunity.
And this is not just among young doctors. The findings, according to media reports, cuts across junior, mid and senior level doctors in both public and private medical institutions — house officers, corps members, medical and senior medical officers, residents, registrars, consultants and medical directors.
No surprises here. The survey has only brought what has been a long known fact to the front burner of national discourse, albeit for as long as our fleeting attention span on important matters such as these can accommodate. You know we have this national habit of discussing our problems seasonally in piece meals and before we as much as arrive at a consensus or a clear path forward, we leave that issue and jump to the next one. For example, how often do you see headlines or public forums on recession these days? It used to be the order. Yet, we are still in recession. Same applies to Boko Haram, herdsmen killings, the Forex challenges, the President’s health and restructuring — the more recent craze.
But I digress. The result of the survey is a reminder of how bad things are. Indeed some will be surprised that there is actually a 12% who are happy to stay. Is this loyalty to Nigeria, lack of ambition or simply a case of ‘I really cannot be bothered anymore’? which ever it is, the real tragedy, as I had written here in the past, is that a lot of Nigerians are in a hurry to quit their country and this is not only evident in the medical profession. If the same survey were administered to everyone else, perhaps the only group who will express majority desire to remain will be our politicians and those who this rent-seeking economy has helped to have their mouths positioned very close to our revenue nozzle.
The challenge with doctors and health workers generally is particularly alarming though. Health they say is wealth. This statement holds even more value for a country where the large majority of the people live in poverty with attendant poor nutrition and hygiene, which leaves them susceptible to a wide range of communicable and incommunicable diseases. Millions of Nigerians die yearly from what has come to be known as “brief illness” — mostly a cocktail of easily treatable and avoidable diseases. A lot of our people simply cannot get to a hospital to access medical care because there is none within reach or when one exists there is no doctor or the doctor really has nothing to work with. This explains the scandalously high infant and maternal mortality rates and low life expectancy in these parts.
It should be a national tragedy that we have just 72,000 medical doctors registered with the Medical and Dental Council of Nigeria given our population, but it gets even worse when you find that only approximately 35,000 of them are practising in Nigeria. And of this number, 88% are eager to leave.
So why are they leaving?
The simple answer is that the country is not in good shape. The economy is bad, the security is horrible, infrastructure is non-existent and the system generally discourages merit, innovation and hard work. This is in line with the findings of the NOIPolls study. The reasons respondents cited for the looming brain drain in the health sector included challenges such as high taxes and deductions from salary (98 per cent), low work satisfaction (92 per cent), poor salaries and emoluments (91 per cent) and the huge knowledge gap that exists in the medical practice in the country (47 per cent), among others.
It is one thing to simply want a better life for yourself and thus aspire to be where the grass is greener. It is, however, something else when you are willing to work but the tools are simply not there. Nothing could be more frustrating. And by tools, I don’t even refer to sophisticated diagnostic equipment. We are talking about everyday hospital supplies. And as if that’s not enough, you are most of the time embroiled in an argument with your employer and the government over your pay and allowances. Nobody wants to live in such a circumstance, the Hippocratic Oath and human conscience notwithstanding.
What to do? Clearly, we cannot force them to stay as long as there are other climes ready and happy to welcome them with open arms and offer them a far better condition of practice. We also cannot afford to just fold our arms and lament while the situation gets worse. We must do something.
The NOIPolls result should be the conversation starter for government and other stakeholders in the country’s health sector to begin to seriously discuss and fashion out the much-needed reforms in the sector and redesign the health system to make it one in which our people can have a fulfilling career in and to which our poor citizens can look up to for help when they are ill.
Above all, we need to fix this economy and the structure of the country as a whole, otherwise, regardless of what else we do, we will just be kicking a can down the road.