The Nigerian Medical Association once told us that of the 75,000 Nigerian doctors registered with the NMA, over 33,000 have left the country.
The General Medical Council of Britain recently revealed that 805 Nigerian doctors were licensed in the UK between July and December 2021. Overall, the number of Nigerian-trained doctors in the UK as of December 25, 2021, according to the council, was 9,189. Of course, the figure does not include the number of Nigerian doctors trained in the UK and practising there.
Similarly, the Nursing and Midwifery Council of the UK has implied that an average of eight nurses have been leaving Nigeria every day for the UK in the last five years. Specifically, the body said 15,049 nurses trained in Nigeria obtained licence to practise in the United Kingdom between March 2017 and March 2021. This makes Nigeria the third highest country with foreign nurses in England coming after the Philippines and India.
If these figures are for the UK alone, the number of Nigerian medical personnel practising abroad can better be imagined. Just this last August, Saudi Arabia representatives were in Nigeria to recruit doctors. This further shows that Nigerian doctors and nurses like other highly skilled and qualified Nigerians are moving to countries where they can work in better conditions and earn more money. The Nigerian Medical Association once told us that of the 75,000 Nigerian doctors registered with the NMA, over 33,000 have left the country. Such movement is referred to as brain drain by owners of English language!
Unfortunately, this is happening in a country where we have doctors to patients’ ratio of 4:10,000 which is far below the World Health Organisation (WHO) standard ratio of 1:600. The ‘Women and Men report 2021’ revealed that a total of 39,912 doctors were available in Nigeria as of 2017.While the number increased to 44,021 in 2018, it reduced drastically to 24,640 in 2019.
But, should anyone be surprised that doctors are leaving a country where they must always have to use diplomatic and legal means before they can be paid their hard-earned salaries? The NMA revealed recently that doctors and other health workers in Abia State were being owed 23 months salaries. The ones in Ondo and Ekiti states are owed about four months’ salaries and allowances. Up till now, Nigerian doctors and lecturers must go on strike before government can honour its agreements with them. We even hear stories of doctors being assaulted on duty by politicians. Just recently, doctors at the Ladoke Akintola Teaching Hospital (LAUTECH) withdrew their services over persistent assaults. The hospital chapter of the Medical and Dental Consultants’ Association of Nigeria (MDCAN) complained that their members were being persistently harassed by some members of the host community.
On one of such occasions, a politician was the one dictating to a doctor what should be done to a patient. The politician’s friend was on admission and he allegedly demanded that his friend should be placed on oxygen and sent to Intensive Care Unit (ICU). When the doctors explained that the patient’s oxygen saturation (level) was optimal, the politician directed his followers to deal with them. That is the level of lawlessness in this part of the world.
While reacting to the rate at which medical personnel are leaving Nigeria, the Minister of Labour and Employment, Chris Ngige, once proposed that the Federal Government should make health workers trained by the Nigerian government to sign a bond of nine years during which they cannot consider relocating to another country. Ngige argued that government-trained medical personnel including doctors should not be allowed to leave the country at will after receiving training for free at public expense.
According to him, medical education in Nigeria is almost free. “Where else in the world is it free? In London, it is 45,000 pounds a session for medical education in cheap universities. If you go to Edinburgh or Oxford, you pay 80,000 pounds. If you go to USA you pay 45,000 dollars but if you go to the Ivy leagues, you pay 90,000 dollars for only tuition, excluding lodging. You do it for six years. So, people in America take loans.
“We can make provisions for loans and you pay back. If the government will train you for free, we should bond you. You serve the country for nine years before you go anywhere,” he had argued.
The minister is right in his submission on free medical training for at least those trained in federal-government owned institutions. Not too many countries do that really. In Scandinavian countries where education is free to the tertiary level, their citizens pay heavily in taxes to finance such luxury.
As a matter of fact, the unit cost of training a doctor in the British National Health Service (NHS) according to a study by the UK Department for Health was estimated at between £269,527 and £564,112 for a Foundation Officer 1 and Consultant respectively. A medical doctor in the USA pays an average of $2,398 a month for a 30-year repayment plan. In other words, a medical doctor owes taxpayers and government $863,500, which is paid back in monthly instalments. So, it is indeed expensive to be trained as medical doctors in these countries. And that is why they will forever be eager to attract Nigerian medical personnel to their land.
But where the minister missed the point is his thinking that medical personnel should allow themselves to rot and perish in Nigeria simply because they are trained by the government. More so when there are countries that are not only willing to employ them, but give them better condition of service. You can’t hold doctors or anyone for that matter to ransom because the Nigerian government has failed to place appropriate value on its investment. If Nigeria does not value what it has, those who do will take them away.
Personally, I am still bewildered as to why a country should invest its scarce resources in training its citizens and at the end of the day allow other countries to reap the gains of its investment. I don’t understand why a country would train doctors and the doctors will end up serving other countries while your own people are dying at home due to lack of doctors to attend to them. I don’t know what is wrong with our leaders. Unfortunately, this has been a recurring decimal in the history of our nationhood. We leave our own educational institutions in decay and pump billions of dollars on yearly basis to keep universities in other countries in good shape. Nigerians spent a whopping $28.65 billion on foreign education between 2010 and 2020. We foolishly fund educational growth in other countries and kill the sector in ours. We pay heavily to maintain the high standard of education in other countries- turn them to world class institutions at the expense of ours and we come back home to grumble and complain about Nigeria’s falling standard of education. And we still use the same excuse as justification to keep pumping money abroad for educational purposes! Could it be that our leaders are so daft, blind and confused or is it just a case of wickedness?
We have become experts at importing everything including education. Some people even send their children abroad for primary and secondary education. And we come back to complain about Naira losing value. How do you shore up the value of your currency when you have only developed taste for importation and none for exportation? These countries get teachers and students from all over the world but we can neither attract foreign lecturers nor students. Meanwhile, our leaders are not ashamed to announce to the world that education is the foundation for the future. Whereas, they know that as far as education goes, there is no future for this country going by what is on ground now.
The Nigerian Association of Resident Doctors (NARD) went on a 64-day strike, between August 2 and October 2021. What were their demands? Simple things like payment of Medical Residency Training Fund (MRTF), payment of outstanding salaries to members on GIFMIS platform, payment of death-in-service benefits to members who lost their lives in the line of duty during the COVID-19 pandemic, etc. Almost 90 per cent of their demands centred round payment for services already rendered. Which sane country gives such treatment to a critical segment of its society?
I guess one of the reasons why we are where we are as a nation is because Nigerian leaders don’t really care about the health, welfare, and the general well being of the people. They don’t care because they know that they have alternatives. They don’t rely on our health care services, so all Nigerian doctors could as well relocate to the moon if they so wish. After all, there is enough money to fly them to world class hospitals to treat ordinary earache or a headache even if everybody thinks Nigeria is broke. They value their own lives but care less about others. Their children still access the best of education the world can offer with stolen funds from our treasuries, so they don’t really care.
Nigerians need to take some drastic steps if we are really serious about redeeming this country. One of them is a legislation that makes it compulsory for every government official either elected, appointed or a career civil servant to access their medical needs locally. Likewise, children of politically exposed persons should be banned from schooling in foreign countries. They must all school in Nigeria. Anybody that wants their children to school abroad should not bother to seek electoral positions. Let’s face it. Where do most civil servants, political appointees and our elected officers get the money to send their children to first class institutions abroad? Is it not through stolen fund? Until we do this, we are likely to remain in this quagmire. But, if Nigerians are courageous enough to make this demand of their leaders, I bet there would be an overnight improvement in both our health and education sectors.
No one should be deceived. Our leaders will not give up easily. Our lawmakers would not want to willingly enact laws that will cripple their excesses. So, the onus is on Nigerians to collectively mount pressure on them to do it. Honestly, this should be a major conversation ahead of 2023 elections, because as it is, every sensible country is just feasting on Nigeria’s stupidity.
Olabisi Deji-Folutile (PhD) was editor, Saturday Punch and now editor-in-chief, franktalknow.com. She is a member, Nigerian Guild of Editors. Email: [email protected]