By Ayo Oyoze Baje
According to Professor Innocent Ujah, the President of Nigerian Medical Association (NMA) Nigeria lost over 9,000 medical doctors to the United Kingdom, Canada and the United States of America between 2016 and 2018. In fact, no fewer than 727 medical doctors trained in Nigeria relocated to the United Kingdom alone between December 2021 and May 2022.
He
made this shocking statement during the Maiden NMA Annual Lecture Series
earlier in the year. The event was held in Abuja. The theme of this year’s
lecture is ‘Brain Drain and Medical Tourism: The Twin evil in Nigeria’s Health
System.’
Are you alarmed by this saddening situation that has the best brains in the medical field jetting out to greener pastures far beyond our shores? You should be and that is because the loss left Nigeria with only 4.7 per cent of its specialists to service the healthcare needs of over 200 million people!
Quoting World Health Organisation (WHO) data, he said Nigeria has
a doctor-to-population ratio of about 1: 4000-5000, which falls far short of
the WHO recommended doctor-to-population ratio of 1:600.Ujah is worried because
the worsening menace of brain drain worsens the already depleted healthcare
resources in Nigeria. And here we are in a country currently battling the
myriad of challenges including escalating insecurity, mass youth unemployment,
hiccups in the education sector exacerbated by the ASUU strike and of course,
the highest inflation rate over the past 18 years.
The real source of concern is that it is not only in the medical
field that we are bogged with the incubus of brain drain. But first, what is it
all about? According to Wikipedia, “brain drain from Nigeria is the exodus of
middle-class and highly skilled Nigerians which has been occurring in waves
since the late 1980s to early 1990s”.
Though
this trend was initially restricted to certain professions but it has now
become free- for- all with the introduction of visa programmes in order to fill
workforce gaps in developed nations. This was sparked by an economic downturn
following a period of economic boom in the 1970s and 1980s propelled by the
discovery of oil wells in Nigeria. That reminds us of the Structural Adjustment
Program days of the military junta led by the famed IBB, General Ibrahim
Babangida.
But more importantly, we should be asking ourselves about the root
causes of brain-drain, with the salutary aim of proffering and acting on
workable solutions. The answer is not far-fetched as Persisting poor leadership
has been fingered by some researchers as a critical factor leading to mass
brain drain. For instance, the political leaders could not manage the economic
prosperity of the 1970s and 1980s which came about by the discovery of oil
wells.
Nigeria, which became a destination for economic migrants with an influx of
teachers and lecturers from Ghana and India into public secondary schools and
universities soon found itself under the economic downturn and an IMF-mandated
structural adjustment program. Austerity measures were imposed led to a
downturn in funding of the educational sector. This led to several student
uprisings which triggered a mass exodus of the expatriates and an export of
skilled Nigerian workers. Ever since, many Nigerian students have shown
increasing interest, especially in travelling to developed societies, soon
after the completion of their study.
Subsequently, significant factors such as mass unemployment, poor
working conditions, poor salary structure, political and religious crises, lack
of quality education delivery and mass poverty as Nigeria became the World
Poverty Capital (OXFAM Report, 2018) led to more brain drain.
According to Wikipedia, even the entertainment industry was not
left out as some celebrities, including Opeyemi Aiyeola, Doris Simeon, Lara
George, eLdee, Lola Alao, Regina Askia and Bayo Bankole migrated to other
countries. So, what are the telling effects of this anomaly on our dear
nation, Nigeria?
Beginning
with health sector, according to the Mo Ibrahim Foundation, it costs Nigeria
between $21,000 and $51,000 to train a single medical doctor. But the
country has lost more than $2bn since 2010 to training doctors who later
migrate. It therefore, means that countries such as the UK with10% of doctors
coming from African nations save about $2.7bn by recruiting these doctors.
Nigeria is holding the short end of the medical stick!
In retrospect, concerned health stakeholders alerted the federal government to
a looming shortage of medical doctors, with a projection of over 50,120 doctors
and 137,859 nurses in Nigeria by the year 2030. That was in July, 2021.
For instance, as at March 2020 the ratio of doctor –to- patient ratio stood at
1: 2,753. This falls far short of the one medical doctor-to-600 people as
recommended by the World Health Organization (WHO). But that is not all to
worry about.
Some other effects of brain drain identified so far “include
loss of human capital assets, lost income from the loss of tax of the migrated
manpower to foreign countries and the loss of capital invested in the
subsidised public education of migrated manpower”. So, how do clip the
widening wings of brain drain from taking our best and brightest minds outside
our shores?
We should admit that quality healthcare delivery is part of the
United Nations’ Human Rights Declaration of 1948. It is also expressly
stated ,in section 17(3)(d), of the 1999 constitution (as amended which
guarantees “adequate medical and health facilities for all persons.”
There
has to be the enabling environment of peace and security in place, to act as
catalysts to increase human resources and healthcare delivery. More budgetary
allocations should go to these sectors. It is sad to note that the country’s
budget for education as a percentage of its GDP has never surpassed a single
digit from 2016 till date. In fact, in 2021, Nigeria’s education budget of 5.6
percent has been the lowest since 1999. This falls short of the 26% as
recommended by UNESCO.
As for the health sector, finding solutions go beyond the
government setting up a Health Reform Committee geared towards reversing the
brain drain. For instance, the country’s budget in 2021 was 13.6 trillion,
and the health ministry got 514 billion, being 3.7 per cent of the budget. Now
you should understand one of the reasons behind the massive brain drain.
Notably, in a 2017 survey carried out by Nigeria’s polling agency,
NOI Polls, in conjunction with Nigerian Health Watch it was found that 88
percent of doctors were considering work opportunities abroad! Over half of the
doctors registered with the Medical and Dental Council of Nigeria (MDCN)
practice outside Nigeria.
Also, medical tourism should be banned. Shortage of medical
specialists contributes towards medical tourism as a handful of Nigerians spend
₦359.2
billion annually while seeking care abroad.
The forthcoming 2023 general election provides yet another golden
opportunity to the Nigerian electorate to choose political leaders,
wisely, especially those who understand exactly where we are currently
trapped in and have to muster the political will to do the needful. That is,
with regards to the all-important education and the health sectors.
*Baje is a commentator on public issues
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