Medical Brain Drain and Future Effects of Covid-19 on Nigeria.
When pandemics strike there are two major demographics to look after by the rest of the world, the infected and the affected. Those infected are the people who have contracted the disease and need medical attention to treat their ailment and hopefully get a cure while those affected are those who feel the impact of the activities of the disease, or, pandemic even without ever getting infected or even ever seen a victim of the disease. This category starts from cured victims, immediate relatives of victims, business associates, neighbours, dependants and some others, the most affected being medical personnel.
It is a vow they have taken, a life they have chosen through their training and profession to fight diseases, battling sickness and death, getting between them and victims while trying to get patients back to life, not many cares to know how this impacts their personal lives or the lives of those around them, after all, they get paid for what they do.
In reality, everyone knows health workers are indispensable, we can not do away with them because we can not do without them, the sacrifices they make throughout their lives can only be imagined by some of us, the heartbreak of losing patients, getting used to watching people in pains among others, theirs is a great calling.
On the 19th of August 2014 one of the great sacrifices was made when Doctor Stellah Ameyo Adadevoh was a Nigerian physician laid down her life to save millions of Nigerians and by extension, Africans from the dreaded Ebola pandemic, Adadevoh was able to contain Nigeria’s Ebola patient Zero, becoming the first and last on her fatherland, many of her compatriot-colleagues will later be heroes leading the world to combat the disease and contain it in West Africa.
Such stories are those that can’t be hidden, for each such story numerous unsung heroes died for others to live, many dying out of stress and trauma, all the money in the world can’t pay them for that.
As of March 2020 Nigerian Medical Association have registered 74,543 certified physicians, at that stage the Federal Government of Nigeria put the country’s doctors to population ratio at 1:2,753, which means there’s one doctor only for every two thousand seven hundred and fifty-three Nigerians, that is equal to a doctor attending to about eleven patients daily throughout the year, assuming all the population only fall sick once in a year. Furthermore, while graduating about 2,500 doctors a year, Nigeria produces about 7million babies within the same period, which gives a similar ratio of one new doctor to 2,800 new Nigerians and growing. The majority of these doctors will eventually migrate out of the country in large droves. Surveys showed that, at least, 88% of Nigerian trained doctors will prefer to migrate as soon as possible. As far back as 2015, Canada alone had more than twelve thousand Nigerian physicians. Presently, of the over 72,000 registered physicians with the Medical and Dental Council of Nigeria, MDCN, less than 35,000 are still in Nigeria.
Such is the reality of the medical career in Nigeria and the above figures are only for doctors, that of the nurses will be mind-blowing.
So, why do medical personnel flee Nigeria, especially when they get huge bursaries to fund their education? The oft given reasons are as follows.
- Facilities and work environment. Nigeria generally lacks modern facilities to aid effective and safe medical practice, remember we discussed trauma as one of the burdens of medical practice, it will be very painful to know you wouldn’t have lost a patient if you had certain equipment or the ones you have were in good working condition.
- Career progression and professional advancement. Professionals will have better opportunities to grow in their chosen field abroad and, more often than not, Nigerian physicians have proven to be very creative in environments that allow them to flourish as they see their career blossom in practice and academics.
- Salaries and remuneration. Doctors in Nigeria are paid far lower than their counterparts in other countries, less than 10% of what some countries pay.
- Political climate. The political climate has not been favourable to medical practitioners for generations and the apathy of politicians to healthcare seems to have climaxed under the present administration, from a president who unrepentantly patronizes foreign medical care to ministers who are at ease with making health workers, or any essential workers at all, know they are not special, they are of no extraordinary value. Here lies the major problem, people feeling irrelevant and not valued in their country. In a recent development, some individuals actually reminded the doctors of the great favour the government had done to them by funding part of their education and didn’t stop short of pointing out that they are a bunch of ungrateful beneficiaries of such magnanimity, one person even recommended that the Federal Government detain medical graduates in the country for a minimum of ten years before they can seek opportunities abroad.
Covid-19 infection in Nigeria as we write have since crossed 193,000 patients of which almost 2,500 have been lost. Nigeria’s management of the pandemic has been quite commendable, again, like Adadevoh, physicians have been putting their lives on the line, abandoning everything and people they love to go to the pandemic battlegrounds, some, never to return. Both home and abroad Nigerian physicians have sacrificed themselves to save populations, the INFECTED, are known and can even be easily projected till the, hopefully near, end of the pandemic but the affected is yet to even be paid any attention in Nigeria, I fear the affected is going to be the 99% unprivileged Nigerians, some of whom, having survived Covid-19 itself, will die of lack of medical attention that have been neglected at home and bought over abroad. Scouts from the Americas, Europe, Middle East and even Southern Africa are head-hunting the best of Nigeria’s physicians. In one embarrassing move to save face and frustrate both foreign recruitment agents and physicians aspiring to find jobs abroad, Nigerian security agents had to disperse people at a recruitment centre at the capital, Abuja. Unless we are going to make health workers prisoners in their homeland we are going to continue to loss our best brains and hands to migration, the brain drain will continue and will be easier with prolonged strikes as we witnessed recently, unless their are favourable policies that give these professionals their worthy dues they are always going to leave. It’s not all about the renumeration, it is about being valued and respected for what you do, the government must do more to make more and more health workers choose to stay back home and help build strong, resilient, health institutions while boosting a healthy and productive populace.
We must avoid the negative effect of losing our medical personnel to countries who are determined to use all they have to fight this pandemic, we must avoid death after the death.
Saheed Olayinka Shittu is the CEO of Majestic Edifice Architects and a public affairs commentator. He can be reached on saheedolayinkas@gmail.com.
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