As the ongoing industrial action by the Nigerian Association of Resident Doctors (NARD) continue to deny many Nigerians access to healthcare, investigations reveal that there is a an imminent mass exodus of medical personnel out of the country, in search of greener pastures.
Medical experts warn that this will further worsen the country’s healthcare system.
Findings also reveal that many doctors are presently trooping to Abuja for an interview with the Saudi Ministry of Health
The Chief Medical Director (CMD) of the Federal Medical Centre (FMC), Makurdi, Benue State, Dr Peter Inunduh, said the situation is worrisome.
He said that government must act fast to change the trend or else the health sector of the country would be in jeopardy.
“We experienced this (migration) in the late 80s and 90s. And now it is happening. You’re aware that the Kingdom of Saudi Arabia is even conducting interview next week. What is the impact?
“For example, you have one anesthetist in the hospital and it is the anesthetist that manages the Intensive Care Unit (ICU) in an hospital, if he leaves, what do you think will happen to the ICU?
“If you have only one nephrologist who is managing the dialysis unit and if the person leaves, what do you think will happen? Something is just wrong and we do not know. The rate at which doctors are leaving this country; I’m just not comfortable.
“Mind you, these doctors leaving have experience. You can replace them but you can’t replace that experience and it is scary.”
He said this is happening at a time the country was thinking about post-COVID-19 recovery and still not out of the third wave of the pandemic.
“There is going to be a lot of challenges when you find your technocrats exiting the country. It means something is fundamentally wrong in the system that government needs to fix,” Inunduh said.
Inunduh told our correspondent that he also authored the statement, which went viral on social media last week lamenting the exit of his best hands from his facility to Saudi Arabia.
He said it summarised everything presently happening in his facility in respect to the high rate of migration of doctors to Saudi Arabia and other countries.
The statement read, “In the last two years, I have lost three orthopedic surgeons, one maxillo-facial surgeon to Saudi Arabia. Within the same period, I lost my only nephrologist, SR Anesthesia, a urologist, an orthopedic surgeon to the UK.
“There is information from the grapevine that many more consultants will leave in the coming months. Just last month, I lost an SR (Surgery) to Saudi Arabia.
“Just this morning, my only anesthetist who is the most senior in Benue State walked into my office to inform me he is leaving for Saudi.
“The situation is so serious that many just drop a letter of resignation and walk away while others just abscond.
“Except something is done urgently, many critical areas will be shut!” he warned in the statement.
‘Less than 40,000 doctors practising in the country’
President of the Nigeria Medical Association (NMA), Prof Innocent Ujah said it is difficult to say the exact number of doctors currently practising in the country as they continue to leave in droves daily.
However, he said the estimated 40,000 doctors before now “has been thoroughly depleted because they are leaving by the day.”
He said by the WHO standard, one doctor should treat 600 people, but in Nigeria one doctor treats about 4,000 people and that still depends on one’s location.
In some states such as Kano, the state government spends millions of naira to train medical doctors and most of them, it was gathered, only work in the state for the number of years indicated by the bonds they sign with the state government after which they seek greener pastures.
For instance, Dr. Fatima Damagun, a family physician in Aminu Kano Teaching Hospital (AKTH), said more than 20 doctors, most of them senior ones have left her hospital (for hospitals outside the country) in the last three years, with as many more planning to exit the country as soon as possible.
Of the many senior doctors that have left recently, she said it was more painful to see one of the two professors of neurology in the hospital depart the country for greener pastures.
Saudi Arabia, for instance, is massively recruiting and they are the easiest path for doctors, especially for those from the Northern part of the country while those from the Southern part favour the United States, she said.
Going to the United States is, however, more expensive, she said, putting into consideration that each of the exams to be taken cost about $1,500 to $1,700.
From her interaction with most of her colleagues that have left, two issues stand out among their reasons for leaving: poor job satisfaction and financial constraints.
She said the professor of neurology that left her hospital and the country left his family in a rented apartment because of all his years of working in Nigeria, he was not able to build a house of his own due to poor remuneration.
“It was when he left for Saudi a few years ago that he was able to buy a house and refurbished it to his taste”, she said.
She said it is embarrassing for them to always have to refer patients to other hospitals because major equipment needed to deliver optimal healthcare are either not functioning or not available.
An official in the Kano health ministry said the state does not have a problem with the doctors as none of them have ever defaulted on the bonds.
Reasons for mass migration of doctors – NMA
Prof Innocent Ujah said unemployment, poor working conditions and hostile working environment such as poor remuneration, overworking of doctors, poor health facilities and equipment and insecurity are the issues pushing doctors out of the country.
The NMA president said doctor’s migration is not a new phenomenon and is also a fundamental human right.
He said, “Wherever you find that the work environment or condition of service is not good or not satisfying, you look for a better place and that is called ‘mobility of labour’; that is a fundamental human right. Everybody has a right.
“Many Nigerians (aside from doctors) move to America on a daily basis because the environment in the country is not conducive. Apart from the federal government, many of the state governments are not paying salaries, not to talk about pensions.
“If you go to hospitals, the facilities are less than optimal and therefore you have to struggle so much to do so little.
“Many doctors are not employed. For those employed, the hospital environment is very hostile. Facilities are not there and we believe that the government should intervene to arrest this issue.
“Apart from the remuneration, what about insecurity? There is no part of the country where you can stay and sleep with your two eyes closed. So insecurity is also a factor. Everybody wants safety and security. So if you have an option, you move.”
Doctors in mass exodus
‘NMA cannot do anything about the situation’
He said NMA cannot do anything about the mass migration because this is guaranteed in the constitution. “You can move to anywhere you want. The only thing we are advocating to the government is to see how they can improve the condition of service of health workers, not just doctors, so that they can have good retention.
Younger doctors more problematic
He said, “The younger ones are even worse. They would leave and they don’t care about it at all. Many of them are single. Maybe when they go there, they will get married.
“I decided to come back to Nigeria in 1987 on my own. People said I shouldn’t come back and I have no regrets. But the younger ones don’t have the patience that I had, because things are really difficult,” he added.