The National Universities Commission’s recent concern about the enormity of the deficit in medical personnel currently being suffered in Nigeria has once again brought to the fore the daunting challenges the country faces in the health sector. It has also revealed that, to attain the level of global best practice in health care delivery, Nigeria still has a mountain to climb.
According to the NUC Executive Secretary, Abubakar Rasheed, Nigeria, with a population currently estimated at a little over 200 million, still needs additional 300,000 doctors to reach the level recommended by the World Health Organisation. This, he reckons, puts Nigeria’s doctor-patient ratio at 1:3,500. This is a far cry from the ideal, given that the WHO standard is 1:600.
This, perhaps, explains why patients have to queue for hours on end, sometimes even days, before they can see a doctor in a public hospital. It is even worse if a patient is seeking an audience with a consultant. Such consultants could be available only once in a week, by which time something unbecoming may have befallen the patient.
Lamenting the situation recently, the Lagos State chapter of the Nigerian Medical Association said a doctor in the state, where most Nigerian doctors practise, saw up to 100 patients a day, which is quite mindboggling. In the United States, for example, in 2018, the largest percentage of doctors saw between 11 and 20 patients in a day, says Statista, a German online portal for statistics. Just 1.3 per cent of the physicians saw between 51 and 60 patients, which makes it an exceptional situation.
Researchers believe that when doctors see too many patients a day, they experience a burn-out or record a higher level of medical malpractice. It is little wonder that many Nigerians lose their lives as a result of negligence by overworked doctors. Sometimes, foreign objects are left inside patients’ bodies after surgery. To support this claim, Thomas Agan, as the Chairman of Committee of Chief Medical Directors of Federal Tertiary Hospitals in Nigeria, said in 2017 that as much as 90 per cent of deaths recorded in Nigerian hospitals were as a result of poor attitude of health workers.
Rasheed who spoke at the maiden matriculation of the Bayelsa Medical University added that only 3,000 doctors were being churned out of all the medical schools in the country annually. Juxtaposed with the 300,000 deficit in the country, it is easy to see why the health sector is in such a terrible mess. Not only does Nigeria not have enough medical doctors, the few available ones are finding their ways out of the country in droves, as a result of perceived poor working environment.
In fact, at the rate of 3,000 doctors per year, the NMA National President, Francis Faduyile, said it would take Nigeria 25 years to produce enough doctors to meet the WHO doctor-patient ratio. Yet, he was not taking into consideration the doctors that would die, those that would retire and those that would move abroad in search of greener pastures. There are also many doctors who dump their certificates and decide to go into business or the pursuit of other interests.
Reports have it that the US, the United Kingdom, Saudi Arabia and Kuwait have emerged as the most attractive destinations for Nigerian doctors. Recruitment examinations by some of these countries have become common occurrences in Nigeria. NOIPolls, a public opinion polling and research organisation, said, “Nine in every ten doctors are considering work opportunities outside Nigeria.”
It is tragic for a country with relatively poor resources like Nigeria to spend money subsidising the training of doctors only for such doctors to end up saving lives in the UK, Saudi Arabia, South Africa, Australia and other such countries that are ready to pay the kind of salary that the Nigerian economy cannot afford. A former Minister of Health, Isaac Adewole, was quoted as saying last year that half of the 72,000 doctors registered with the Medical and Dental Council of Nigeria practised abroad. Others claim the number is higher.
Unbridled migration of doctors in search of greener pastures has inevitably spawned the current crisis experienced in the Nigerian health sector. Even hospitals designated as centres of excellence have now become specialists only in giving patients referrals to hospitals abroad. In fact, India has become the destination of choice for Nigerians seeking medical care abroad. Almost 40 years since Sani Abacha referred to Nigerian hospitals as mere consulting clinics, nothing seems to have changed. If anything, the situation has become worse.
With top government officials now preferring to have treatment abroad, there is no hope that the health care situation would soon undergo any transformation. The President himself, Major General Muhammadu Buhari (retd.), has been leading the way in seeking medical treatment abroad, where he once spent more than three months at a stretch in the hospital in the UK. After boasting that he built a world-class hospital in Uyo, a former Governor of Akwa Ibom State, Godswill Akpabio, was flown abroad immediately he was involved in a minor accident.
There has to be a renewal of hope in the Nigerian health system. The recent separation of conjoined twins at the National Hospital in Abuja is an indication that there are still some very good doctors in the country. Some incentives should be given to doctors to ensure that they do not all wish to practise abroad. They may not be paid what is paid in the US, but if reasonably pampered, some of them may wish to stay and those abroad could even be lured back home.
Apart from pay, doctors also get some reasonable level of job satisfaction by working in a conducive environment. If a doctor knows that a simple surgery would not lead to the loss of life, because all the equipment needed for the procedure is available, he would not be so desperate to flee. Developing the primary health care system will also reduce the number of patients that will patronise the secondary and tertiary hospitals, and therefore reduce the burden on doctors.
The health system is in a serious state of emergency. The government has to do all within its power to save it by ensuring that doctors stay instead of fleeing the country.
