Dr. Biodun Ogungbo is a Consultant Neurological Surgeon, Brain and Spine Surgery Consortium Abuja. He spoke to NKECHI ONYEDIKA-UGOEZE on the brain drain in the Nigerian health sector and how it can be checked.
Why are Nigerian doctors fleeing abroad?
There are many reasons for this current situation of massive unrestrained emigration of doctors to other climes. Mostly, fresh doctors do not see a bright future within the shores of Nigeria.
The road ahead to becoming a successful doctor, fully trained and fully equipped, is not bright.
For many new doctors, the system and the clinical environment are challenged by poor infrastructure. The conditions of work are poor.
The facilities are poor and the remunerations are poor. Many doctors are breadwinners in their families but are unable to deliver family expectations.
Right now, a mass exodus has started. Apparently over 100 doctors have resigned from University College Hospital, Ibadan, this year, and 100 from public hospitals in Lagos this month alone.
Similarly,[tooltip id=”4500c2f113202943ff1ae30d00c9d4ac”] [/tooltip]70 per cent of young Nigerian doctors are making plans to leave for foreign lands and are taking exams to that effect. Reports claim that 660 wrote PLAB (entry exam to practice in the U.K.) recently and over 1,000 have registered for the next PLAB exam.
The PLAB examinations are being conducted in Nigeria now and other countries are coming here to conduct interviews spiriting away our dispirited doctors.
What must be done to stop the trend?
The government needs to take healthcare seriously and make it a major priority in view of its critical importance to our lives.
The amount budgeted for health must be increased. Better financing translates to more remuneration for health workers, increased training opportunities for doctors, availability of equipment and other consumables.
Doctors are currently managing and improvising daily in carrying out their duties. This impacts on the health of the Nigerian patient and leads to bad outcomes.
There is a need for stronger public-private partnerships to drive increased investment in the healthcare industry and possibly provide better remuneration to doctors (which is also a major factor causing them to seek opportunities abroad).
There is no good statistics on the matter at hand. The World Health Organisation’s (WHO) recommendation of the number of doctors per population is one doctor per 600 patients.
We estimate that only 35,000 of the 73,000 registered Nigerian doctors are practicing in the country. The rest have travelled abroad for greener pastures.
There are 73,000 doctors on the list of the Medical and Dental Council of Nigeria (MDCN).
Countries with the lowest relative need have the highest number of health workers, while those with the greatest burden of diseases must make do with a much smaller health workforce.
The African region suffers more than 24 per cent of the global burden of diseases but has access to only 3 per cent of health workers and less than 1 per cent of the world’s financial resources.
The recommendation is one doctor to 600 patients. In Nigeria, the ratio is estimated at one doctor to 6000 patients.
So, with a population of 190 million Nigerians, the country actually needs 300,000 doctors. We have only about 35,000, which is wholly inadequate.
There are no good statistics on those that are leaving. Most of our emigrating doctors are going to the U.K. and U.S.A. Some, of course, are also trooping to Saudi Arabia and Dubai. About 5,314 Nigerian doctors are currently working in the United Kingdom.
This figure, according to the recent National Health Service (NHS) statistics on staff from overseas, indicates that of doctors of African descent working in the U.K., Nigeria has the highest number, only followed by Ghana and South Africa, whose citizens practicing medicine in the European country are 2,342 and 1,641.
Right now, many of our young doctors are frustrated and disillusioned. The reality of medical practice in Nigeria has failed to meet their expectations.
The basic terms and conditions of service are poor. Importantly, opportunities for housemanship and specialist training are limited and do not match the number of graduates finishing medical school or completing the National Youth Service. Many are roaming the streets looking for work.
The certificates confirming pass in the first part of specialist examinations, for many, expire while seeking openings or waiting to obtain training appointments in our approved teaching hospitals.
The government has no obvious or clear strategy to address these known recurring problems causing considerable distress to the affected doctors. Consequently, the doctors are feeling ‘thrown under the bus’ by their own country.
Essentially, the conditions of work and training opportunities are better in other climes. Doctors are given the appropriate materials and facilities to work with. There is little room for improvisation and management of resources, which can lead to bad outcomes.
In short, the lives of the citizens are highly valued in other countries. So, the doctors are allowed the freedom and given the materials to work with in saving lives.
We get the impression that successive Nigerian governments pay lip service to health and do not show they value human lives.
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