Why Nigerian doctors are leaving

The Nigerian media is awash with a recent report that President Bola Ahmed Tinubu has approved a policy to retain medical experts within the country to provide citizens with much-needed quality healthcare. This policy may be a response to the perceived mass exodus of Nigerian doctors to other countries, especially Europe, America and Saudi Arabia, where they expect to gain job satisfaction and commensurate compensation for their services.

This policy reversal may be a departure from previous ones in which the federal government openly encouraged medical experts to seek greener pastures outside the country or in other fields of endeavour. At the peak of that policy implementation, Prof Isaac Adewole, himself a professor of medicine and former Vice Chancellor of the University of Ibadan, as minister of Health in the Muhammadu Buhari administration, had admonished Nigerian doctors to take to farming instead in reaction to complaints about unemployment among them. Then, Nigerians were justifiably scandalised.

Not yet done, the Minister of Labour and Productivity also in that administration, Dr Chris Ngige, himself a medical doctor, boasted that the country had enough doctors and some to spare for other countries. That was not exactly the actual situation in the health sector. President Buhari’s Special Adviser on Media and Publicity, Femi Adesina, lent his voice to those justifying the trend. In his opinion, nothing was wrong with it, as that move would expose the doctors to job satisfaction and experiences they would have otherwise not acquired while serving in Nigeria.

In fairness to these government officials, there is nothing wrong with trained medical personnel exploring opportunities in sectors other than their field of study. After all, a one-time President of the World Bank, Jim Yong Kim, was an accomplished medical doctor. In the Buhari administration, Okechukwu Enelamah was Minister of Industry, Trade and Investment. He was also a medical doctor who veered off to train in the field of business. The point to be noted here is that it must be out of personal choice and conviction and not driven by circumstances that place no value on medicine.

In our opinion, the assertions by government operatives referred to above beg the question of the real reason why those doctors are abandoning their stethoscopes in Nigeria. The Secretary to the Government of the Federation (SGF) in that same administration, Boss Mustapha, captured the reason succinctly during the COVID-19 pandemic when he publicly lamented that he did not know that the nation’s healthcare delivery system was so decrepit.

As with other sectors of the nation’s life, the health sector seems abandoned by the authorities, who pay little more than scant attention to the services or lack of them provided in those hospitals. This is deliberate because those policymakers are availed of medical services abroad; they and their families are taken care of by the state in what is pejoratively referred to as medical tourism, which has remained a drain on the nation’s foreign reserve.  Starting from underfunding, the sector exists only in name. As a result of pervasive corruption, the little money budgeted for health services is frittered away.

In the process, basic instruments needed for efficient service delivery are inadequate, if not altogether non-existent. Consciously, medical services have been ceded to the private sector, where the profit motive drives service delivery with the implication that the poor are deliberately out-maneuvered as the cost is beyond their reach.

It is commonplace to notice that, in some cases, doctors in public facilities buy the hand gloves they necessarily need to put on before attending to patients. This essential tool should be taken for granted but is not even available. That will give one a clear insight into what obtains in other areas of healthcare delivery system. Compounding this dreary situation, in our opinion, is the fact that doctors in the country are overworked and grossly underpaid. The working conditions in Nigerian hospitals make job offers from abroad appear very attractive and professionally fulfilling.

From this perspective, we posit that any policy restraining doctors from seeking fulfilment elsewhere is unhelpful and repugnant to the provisions of labour laws in the country and internationally, which guarantee free entry and free exit. Except for doctors trained and bonded by the government, it is improper and even illegal to stop anyone, not just doctors, from seeking professional enhancement where they are available. It is against all known tenets of natural justice, equity, and good conscience, not to mention the infringement of their fundamental rights as enshrined in the Constitution.

Instead of putting in place any such policy, the government should take a hard look at the sector and identify areas that need improvement in terms of provision of infrastructure, capacity building, remuneration and compensation.

Furthermore, the government must end the current practice of sending its officials abroad for medical treatment. The resources deployed in such wastages should be channelled towards making the healthcare system conducive to Nigerians.