A Naija doctor’s lamentation!
The Brain Drain of Nigerian Doctors
I cannot count how many patients I see each week who have a relative who is a doctor, but the said relative is abroad.
What is sad is nobody thinks it is a problem,
at least not until they get to the hospital and there is only one doctor covering all the units and you have to wait for hours, because they have to see the emergency cases before you.
A lot of people don’t know what is going on, until you have a critically ill relative who is rejected at other hospitals because they do not have the capacity to take in your relative.
You don’t understand what’s happening until you have an illness and no doctor can Diagnose what you’re going through because you are yet to see the right specialist.
You don’t understand what’s happening until you get admitted and the last time the consultant saw you was 72 hours ago.
One time, we had received a patient who left a famous big hospital because they didn’t like the care they were receiving from the neurosurgeon there, presented to our facility, only for us to call in the same neurosurgeon whom they had previously rejected.
The last time we checked in 2019, Nigeria only had about 24,000 registered doctors. Another recent statistics says 40,000.
Even if the number of doctors increases to a 100,000 tomorrow, we are looking at a population of over 200 million people. Going by the World Health Organisation (WHO) doctor to patient, recommendation ratio of 1:600. The total number of doctors Nigeria needs is over 300,000. This country has a long way to go in that regards.
Back to our 24,000 registered doctors, mind you, that some have become politicians, some are teachers, some farmers, some housewives , some are bakers, many have japa’d (left the country) and many more are still leaving, some have been kidnapped, some have retired, some have died.
Then we have those whom, although they are practicing, they work in a non clinical capacity.
So, if we are to really check the number of registered medical practitioners in clinical roles within the country, we would pray to never fall ill in this country.
Too few Doctors, Too few Specialists
Medicine thrives on specialization, patients who recover properly have each and everyone of their problems tended to by the right doctor.
Many patients have what we call comorbidities, what that means is that they have both hypertension and diabetes and chronic kidney disease. Such a patient should have regular follow up care with the cardiologist, endocrinologist and nephrologist.
God knows the number of cases we’ve. seen being mismanaged simply because they did not previously have access to the specialist that they needed.
So their condition worsens because they didn’t see the right doctor and so cases that should have been detected earlier, progress to have more complications because a necessary test wasn’t done. While an Echocardiography or an ECG seems to be very common place on the western world, it is not available in many parts of Nigeria.
There are probably only two rheumatologists in the Federal Capital Territory, I’m yet to see an immunologist or a geneticist.
I work in a tertiary center. So we have cardiologists and general physicians resident. All other specialists shuffle between facilities, between different hospitals, journeying from one location to another, just to see the patients that need to be seen by them, sometimes these trips are undertaken at night.
Often times I see patients throw a ruckus in the hospital, due to delays in being seen. As much I understand the fear and vulnerability of these patients and their relatives, the truth is, there are not enough hands.
You see Nigerian consultants moving from place to place,
You think it’s because they are looking for money and they need the money? If they really wanted ‘good money’ they would also leave the country!
Nigerian Doctors are not the Problem
So, you see I can never get it when people blame Nigerian doctors for not doing enough.
These same doctors have families to cater for, they work with the bare minimum resources with the one of the lowest past in the world.
So when these brilliant people get an opportunity to move to a country where their talents are appreciated with better pay, where they can afford better education health care and security for their families, why on earth should they stay back.
I currently have a very hectic work schedule, sometimes family duties are overwhelming and I do struggle to cope. Still I love where I work because it is one of the few places in this locality truly saving lives.
Not many doctors have access to such resources, they know what medications their patients need and what procedures by these are often not available.
Those who can afford travel hours by road or fly the distance to get the care that they need.
But flying is currently a luxury even for myself as a doctor, because the pay isn’t great. Many doctors in this country do not even fall into the middle class category.
Everyone one I currently work with is also just waiting for the opportunity to move.
Even those who studied abroad and returned to the country have been frustrated out of the country again.
This conversation on the exodus of a Nigerian doctors always turns out to be a lamentation of sorts.
So What’s the Solution?
1. Keep the Conversation going!
It doesn’t matter if you’re home or abroad, this is an issue that should never leave the table. Speak about it in our homes, in the classrooms, in our community groups, let everyone know that this is a problem!
One day, a conscionable leader with the power to make change could act upon it. Even if I have an opportunity to leave this country tomorrow, my duty remains because my roots are here, my parents are here.
2. Make Demands on our Leaders
The demand you need to make is not on Nigerian Doctors, these doctors have little power and little resources, let them use their brain where it ought to used.
The demand for good health and improvement in the numbers of doctors is upon the Ministry of Health, it’s upon The Federal Government.
Take a lesson from China’s history pages. How did they fight the brain drain of intelligent Chinese citizens. How has their Government lured its best exports back in to the country? How did a country with a much larger population than ours eradicate malaria? During the COVID pandemic, how did they create their own vaccine instead of waiting upon the western world to donate leftovers to them?
As Long as our leaders refuse to prioritize healthcare and the people, it will continue to be a downward spiral.
3. Appreciate the health workers who serve you
I spoke earlier about the doctors not being paid well enough. My peers in the banking or hospitality or technology industries earn far more than many consultant doctors.
Years of hardwork, sleepless nights, deprivation of quality time with families and the pay is nothing to write home about.
The dignity that doctors have in this country is one that comes from the profession, it’s not because Eid their pockets, it’s because it is truly a noble profession.
It comes from knowing that we are truly saving lives.
Many Nigerians will complain about the attitude of Nigerian health workers but when they leave the shores of this country, they are treated much worse in those health systems.
So, settle your problems at home, fix the system at home, own your system.
Be upset when you need to be, then do something to fix it.
At times like this, one is reminded of China- Achebe’s novel, ‘There was a Country’.
I wonder what really happened to the dream. Did the founding fathers ever have a vision for this country? are the current youngsters still with any hope for this country? Where are the true elites of this great nation?
Have the youths any dreams for this country?
We jokingly say that the Nigerian Dream is to leave Nigeria, but is that really the truth? For me, the Nigerian dream is that one day, Nigeria will work for the average Nigerian.
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