The Brain Drain on Nigeria’s Health Sector Spells Imminent Crisis

It is estimated that at least 2,000 medical doctors leave Nigeria yearly. Contrary to the recommendations of the World Health Organisation (WHO) of a ratio of one doctor to 600 patients, Nigeria has a ratio of one doctor to 6,000 patients. And due to the poor conditions of work, facilities and remunerations, many doctors are choosing a better life outside the country’s shores in order to care for themselves and their families.

Healthcare is a critical challenge and has been on a decline, unable to compete with global standards even as top public officials, including Nigeria’s president Muhammadu Buhari, continue to seek medical attention outside their own country. Habitually plagued by strike actions, workers who have for long advocated for better salaries, are overworked, or just fed up, find that there is not much to keep them in Nigeria’s healthcare clime. Western nations like the United Kingdom, United States, Canada, Australia, United Arab Emirates (UAE), and South Africa are benefiting from the mass exodus of Nigeria’s medics.

Figures released February 2018 by the British government showed over 5,000 Nigerian-trained doctors and nurses currently working with the British National Health Service (NHS) in the United Kingdom constituting 3.9 percent of the 137,000 foreign staff of 202 nationalities working alongside British doctors and nurses.

A physician in Canada is paid $260,924 ($339,000 Canadian) for clinical services by the government’s Ministry of Health per year on average, according to a report from the Canadian Institute for Health Information published in September 2017. On average, a family physician is paid $211,717 ($275,000 Canadian) for clinical services and a surgical specialist is paid $354,915 ($461,000 Canadian)

This pales drastically in comparison to an entry level doctor earning N150,000 per month ($5000/year) and consultants N500,000 per month ($17000/year).

Reuben Samuel (not his real name), a doctor currently considering joining the mass exodus, says the major culprit is poor funding. “Less than 4 percent of the annual budget goes to healthcare and every area of our health sector is suffering from inadequate manpower.

“Doctors who work in rural areas are not even provided with the basic social amenities; they are already disadvantaged by being in a rural setting. Training opportunities for doctors, availability of equipment and facilities have all suffered as a result of lack of proper funding.”

The country already faces challenges with adverse results from lack of a proper insurance policy structure and Samuel postulated to the reduced life expectancy and hikes in medical tourism if the trend continues. “Doctors have left the country, more are planning on leaving the country,” he says. “This is going to have a tremendous negative impact on Nigeria. In fact there’s a joke that very soon the country will have only two doctors: Dr Sid and Small Doctor,” he concluded. Those are in fact, monikers for two of Nigeria’s popular artistes. And the United Kingdom is already set to exclude medical staff from the government’s visa cap, according to Saffron Cordery, Deputy Chief Executive of NHS Providers.

Okoye, also a Consultant Radiologist, University of Nigeria Teaching Hospital Enugu (UNTH), explained to the Guardian, “Trained health professionals are needed in every part of the world, and so when healthcare professionals lack opportunities for professional development, enabling environment to practice and optimise their skills, and find that their quality of life and ability to train their children in the best educational institutions is gated by their poor salaries (compared to their peers in more advanced countries), they permit their brains to be drained.”

With better remuneration and appreciation, constant training and sharpening of skills with tools and top notch facilities, Samuel says many of these doctors have no intention of coming back and when he eventually leaves, he may never return.