The migration of health workers from developing countries to the developed world has remained pertinent for decades now. In this report, ROYAL IBEH writes on what must be done to change the tide in the nation’s health sector amidst dilapidated infrastructure, other pull factors.
Brain drain in the Nigeria health sector is not new as doctors, nurses, physiotherapists, and laboratory technicians are subscribing to application processes to relocate to the United Kingdom (UK), Saudi Arabia, Canada, and other High-Income Countries (HIC on a daily basis, a move, which has further been exacerbated by the economic impact of the COVID-19 pandemic.
Besides, the shortage of health personnel, poor infrastructure, and lack of awareness among others, many Nigerian elites have lost their confidence in the public health system due to dilapidated infrastructure, lack of medical equipment, and brain drain.
In fact, when the Secretary to the Government of the Federation, Boss Mustapha, who is also the chairman of the Presidential Taskforce (PTF) on COVID-19, was appointed to head the team while speaking during a meeting with the leadership of the National Assembly said: “I can tell you for sure, I never knew that our entire healthcare infrastructure was in the state in which it is. Until I was appointed to do this work.”
Putting a figure to the brain drain in the Nigerian health sector, the National Institute for Policy and Strategic Studies (NIPSS), recently disclosed that the long-running depletion of Nigeria’s health workforce has taken a turn for the worse with the doctor-to-patient ratio in the country now 1:10,000 as against the World Health Organisation (WHO) recommendation of 1:1,000.
The director-general of NIPSS, Prof Ayo Omotayo, added; “Nigeria lost over 9,000 medical doctors to the United Kingdom, Canada, and the United States of America between 2016 and 2018, adding that a total of 727 medical doctors trained in Nigeria relocated to the United Kingdom alone in six months, between December 2021 and May 2022.
“The data from the Register of the Nursing and Midwifery Council (NMC) of the UK shows that the number of Nigeria-trained nurses increased by 68.4 percent from 2,790 in March 2017 to 7,256 in March 2022.”
Unravelling the reasons for the brain drain
Ninety-nine per cent of graduating medical students want to leave Nigeria to developed countries and the mindset is to get exposed to first-class training, available in the UK, USA, and Canada, a physician, Trophy Ogwezi told LEADERSHIP Weekend.
Another reason for the brain drain is the monetary value, in that the rate of dollar to naira is very high, Ogwezi revealed. “For instance, doctors in Nigeria earn like N200,000 per month, meanwhile they can get five times this figure in the USA and UK. This is fuelling the brain drain we are experiencing now,” he explained.
In the same vein, a medical doctor in Nigeria, Bukar Ali Shettima, said the routine of a physician in public facilities is one that no one should pray to experience. “There is acute manpower and equipment shortage in addition to near zero health insurance coverage of the populace. All the aforementioned teamed up to make sure a doctor spends more time trying to improvise, advocate for his patients, and tackle bureaucratic bottlenecks.
“I was once in the emergency department at the peak of insurgency in Maiduguri when the expatriate staff of a non governmental organisation visited to see how they could be of help. They were in utter shock and amazement at the various improvised yet effective means of handling emergency procedures.”
It ought not to be like this, Shettima stated, while disclosing that a doctor who cannot stand the pressure and the poor working condition of most public health facilities in Nigeria would have no option but to leave the country.
Turning Brain Drain To Brain Gain
While Nigerian medical professionals are leaving Nigeria, in search of greener pastures, the Lagos state commissioner for Health, Prof. Akin Abayomi said it is important that some of them leave to attain skills in world-class health facilities around the world. But after they must have attained the skills, it is even more important that they come back home, Abayomi added.
“I have travelled to a lot of places around the world and I have never meant any Nigerian doctors in diaspora who do not want to come back home. They really want to come back home, practice here in Nigeria, so we need to create that enabling environment and the opportunity for them to come back home,” the commissioner added.
“That is what we want to achieve with Dr. Abayomi Ajayi’s Physicians Mentoring Programme (Cohort 2). We really hope that doctors stay in Nigeria, to improve the health sector because there are lots of opportunities available to them. However, for those who want to travel, nobody is stopping them. They can travel, gain the necessary skills and come back to the country to apply the skills learnt abroad,” the managing director, Nordica Fertility Centre, Dr. Abayomi Ajayi said.
Ajayi disclosed that the mentoring programme is a six-month intensive programme, designed to broaden the perspectives and deepen professional networks of the mentees in key areas of leadership through emotional intelligence, planning, self-discovery, and decision making, adding that the focus is on young doctors that have graduated and want to develop skills to be leaders and entrepreneurs.
The cohort2, which commenced February 2022 has equipped 14 young Nigerian doctors (comprising nine females and five males, between the ages of 25-35) to explore opportunities in the Nigerian health sector and diaspora and enhanced their professional and personal abilities.
Testimonial from mentees
For instance, one of the mentees, Dr. Bilal Yahya said with the mentoring training, he has learnt how to be more patient. “I have also learnt how to think outside the box,” he added.
For Dr. Trophy Ogwezi, “The mentoring programme has given me hope and has helped me change my focus. Before now, I wanted to go for my neurosurgery programme abroad and thereafter work there. I planned to come back to Nigeria when I retire abroad. But the mentoring programme has shifted my mindset.
“With the help of my mentor, I have been able to align my strength and my tendencies, because I love taking risks. The training has also helped me to know myself and study my environment, to make a positive impact, thereby rebuilding the Nigerian health sector. So my resolve after undergoing this programme is to travel abroad to get expert training on healthcare delivery, but after acquiring the skill, come back to Nigeria, to contribute my quota in revamping the health system.”
A mentee, Dr. Babajide Abegunde, who is currently working abroad confessed, “If I had this kind of mentoring programme three years ago, there is 80 per cent chance that I would not leave the country. Though I wasn’t trained in Nigeria, I came back to the country, as a patriotic Nigerian, but what I saw on the ground was really discouraging. With the mentoring programme, however, I was able to see things differently. I must thank Dr Abayomi for making this programme available for young physicians.”
In her view, a Mentee, Dr. Bilkisu Kankia Lawal said the Mentoring Programme has been enlightening as it has helped to broaden their horizon. “It has helped me in my self-discovery and in finding my purpose in life. It has given me hope that there are many opportunities in Nigeria. I am based in the Northern part of Nigeria where we don’t have an integrated mentoring programme, and we kind of move in the dark, trying to find our roots, but the programme has given me self-realization,” Lawal averred.
Lawal disclosed that a lot of her colleagues are thinking of leaving the country because they believe there is no hope in Nigeria. “However, the mentoring programme has reshaped us in that if Nordica Fertility Clinic can be this successful if other health establishments are making it in the country, then there are lots of opportunities that are yet to be explored in the country,” she stated.
Advice To Young Physicians
The mentees have stated what they intend to do going forward, but as the saying goes, ‘it is easier said than done’, even as Ajayi has urged them and other young physicians to waste follow their dreams.
“We know the system is trying to dehumanize you, but don’t let that happen, you have to put your head high, you have one of the best certificates in the world. You should have self-worth. Don’t let the noise of others overpower your inner voice, and don’t forget to follow your heart and vision,” Ajayi averred.
The managing director/ CEO of Risk Analyst Insurance Brokers Limited, Dr. Funmi Babington-Ashaye, who is one of the Mentors of the Cohort 2, however, advised mentees to believe in themselves and their abilities. “You must have confidence in yourself and believe that there is nothing you cannot achieve. There is power in setting goals and monitoring the goals on a daily basis towards achievement. The goals must be time-bound. Take on board all you have learnt,” she advised.
Consultant Orthopaedic and trauma surgeon and chief medical director at Lagoon Hospitals, Dr. Olakunle Onakoya added, “There is no manual for life and career. You should believe in yourself, especially now that you have been equipped. You should be able to handle anything that comes your way. Failure does not necessarily mean failure, it is remaining in failure that is the problem. Learn from failure, improve on it and make a success from it. That is what life and career are all about.”
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