Nigeria's healthcare system has been plagued by brain drain which translates into a very poor doctor-patient ratio. Recently, it was reported that the UK licensed 91 Nigerian doctors within 15 days, bringing the number of Nigerian-trained physicians to more than 10, 200 comprising specialists, associate specialists, general practitioners and doctors in training. This figure is quite alarming considering the fact that Nigeria, with less than 30,000 practicing doctors, currently has far less number of physicians to meet the medical demands of its citizens.
During the COVID-19 lockdown in 2020, according to the Nigerian Medical Association (NMA), about 5,000 doctors had applied for, and met the requirements to work abroad: they were only waiting for the ease of lockdown in order to leave the country to various parts of the world. Subsequently, officials from the Kingdom of Saudi Arabia were in Nigeria scouting for medical personnel to fill up available spaces in their health sector. These are doctors and other medical specialists trained in Nigeria and who were working within the country at the time.
Some of the major reasons for the continued brain drain in Nigeria's healthcare sector are poor welfare of the personnel, inadequate facilities and poor working environment.
In India, for instance, despite the multidimensional challenges associated with high population, the country has been able to develop its health sector such that there is efficient service delivery. The only challenge that most citizens may face is the ability to afford it. This implies that if the majority of the citizens can afford the cost of medical care locally, then it would save the government the cost of balancing trade due to medical tourism abroad. India is one of the favoured destinations for Nigerians seeking medical treatment abroad. At the High Commission of India in Abuja, on the one hand, one of the easiest visas to process is of seeking medical care in the country. On the other hand, when applying for a visa to study a professional course, especially in the field of medicine, the process is tedious. This could partly be because these professionals would return to train other compatriots in the field thereby reducing income to the country.
However, they are not to blame because they developed their system and their diplomats are only acting in the manner they deem as in the best national interest of their country.
The case of a serious brain drain in Nigeria is not in doubt. Every medical personnel considers working in Europe, the United States, or the Middle East unless they lack the opportunity to leave. The only way to reduce the mass exodus is by improving welfare and emoluments of the workers within the sector.
An efficient healthcare system can be a source of foreign exchange earnings as Nigeria would become a medical hub and an easier and more accessible destination to most people in need of medical care especially within West Africa and some parts of Africa as a whole.
To some extent, individual attitudes towards national development are part of the problems that hamper growth in the country. In mid-January, there was another alarming report that the Zamfara State government discovered 199 ghost doctors on the state payroll of 280 doctors. The imagination that 199 ghost doctors are on the payroll of government hospitals is alarming to any well-meaning citizen. To begin with, 280 is an appalling number for physicians in a state with a population above nine million people. How many hospitals are in the state and where are these ghost doctors located? It is more disheartening that some individuals defraud the state by including non-existent physicians on the pay-roll making the challenge of fewer doctors look less macabre than it actually is from distant observation. This is at a time when Zamfara, a major state affected by banditry, is in dire need of all the possible healthcare attention it could get.
If this is happening in Zamfara State, then how many more states could be suffering from the same challenge of ghost doctors and medical personnel in the country? Rural communities are usually the ones to bear most of the brunt as they are the places with more chances of having quacks and location of non-existent hospitals with dubious staff lists. This is devilry at its peak. These are challenges that the various state governments and policy developers must look into.
Primary healthcare is another area of concern in national health security; ensuring a very functional primary healthcare system shall greatly reduce the rate of maternal and infant mortalities which is very poor in the country. Primary healthcare reaches most of the citizens in the urban and rural areas as the first, and in most cases, the only means of affordable healthcare to many Nigerians. If the primary healthcare system can be optimised towards better service delivery, it could save the higher echelons of healthcare the burden and need to handle many health issues of primary concern and, at the same time, reduce the rate of maternal and infant mortalities ravaging the country.
Consequently, the government at the centre must endeavour to commit all resources towards upgrading the standard of healthcare. This stands as one of the major components of contemporary security. If the government is serious about economic diversification, then luring other African states towards medical tourism in Nigeria should be one key area that will definitely increase foreign exchange. In fact, if only to cut the humongous amount Nigerians spend on medical tourism abroad. Citing how Nigerian leaders flock abroad for medical tourism, how much could Nigeria save if the president and other elected officials get medical care locally? Thus, if the president is going to London, it should be strictly on holiday but not with an additional cost for healthcare.
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Having, at least, two medical structures as those frequented by the president constructed and functional within Abuja and similar ones (one) in each geopolitical zone of the country could save Nigeria a lot and earn more for the country in terms of foreign exchange. If the leaders use it, it would definitely build the confidence of other African leaders to change their preferred destinations for medical tourism abroad. These are structural policy concerns that government at all levels must take into consideration with respect to revamping the health sector in Nigeria.
Ibrahim can be reached through diejuailo@gmail.com
