The recent disclosure by the Nigerian Medical Association (NMA) that going by the statistics in Adamawa state, one doctor attends to more than 13,000 people is quite worrisome. The situation is not only undesirable and despical but also an embarrassment to the state in particular and Nigeria as a whole because the case in Adamawa state is reflective of the other 35 states of the federation and the Federal Capital Territory. Tonde Gargah, the Adamawa NMA chairman, who made this known in a speech at the Adamawa Democracy Day townhall, held recently in Yola, the state capital, emphasised the need for the government to ensure that the people have access to adequate health care services.
“The population of the doctors grossly falls short of the recommendations by the World Health Organisation (WHO) which suggests one doctor to about 600 people. The situation in the state is now one doctor catering for 13,300 people. This is grossly inadequate. But, in spite of the little number of health personnel in the state, their welfare is the least, if compared with neighbouring states in the region.”
Gargah said that the population of Adamawa state was recording rapid increase, especially in Yola south local government area, and called on the government to build more hospitals to boost healthcare delivery. In his response, the state governor, Ahmadu Fintiri, said his administration has plans to recruit more health workers.“Surely, the health sector in the state is lacking personnel; this issue deserves urgent treatment,” he said.
It is quite disheartening that while there is massive brain drainof medical doctors in the country doctors of Nigerian extraction working in other countries are either reluctant or have outrightly refused to return home. The country’s polling agency, NOI Polls, in partnership with Nigerian Health Watch in 2017, found that 88 per cent of doctors are considering work opportunities abroad.
The reasons usually advanced for emigrating include better facilities and work environment, higher salaries, career progression and improved quality of life. Nine in every10 doctors are considering work opportunities outside Nigeria, according to the Polls. With a population of over 200 million, one doctor in Nigeria attends to 10,000 patients compared to the WHO recommendation of one doctor per 600 patients. The Medical and Dental Council of Nigeria, MDCN, says there are 72,000 registered doctors with over 50 per cent practicing outside the country.
NMA President, Dr Francis Faduyile, said recently that It has been found out that if Nigeria is producing 3,000 medical doctors annually it will take the country 25 years to be able to produce the total number of doctors that will adequately take care of the populace. “So we are in serious deficit. The brain drain is not limited to doctors. Some of our nurses, pharmacists and other health workers are leaving. The most skilled individuals are leaving to contribute their expertise to the economy of another country.
“Push factors is the normal definition of brain drain, it is usually from a less developed country to a more developed country. But what we are experiencing in Nigeria is not following that trend, we have some doctors migrating to developing countries or even underdeveloped countries because we have other issues that are pushing people outside this country. One is lack of equipment. So many of our doctors are leaving because what they require to safe patients are not available and by the time they sit in their consulting room and watch patients die in their presence, such persons will be frustrated and would have to look at any other place he can intervene to help humanity. Another major push is economic underdevelopment”.
He said when President Buhari assumed office, despite the high rate of inflation, the exchange rate was around N200 to $1 but through some form of economic calculation, today it is N460 to $1. So if you were earning N200,000 and you convert to dollars, that was $1,000 but if you are still earning that same amount now, that will be around $600. “So in actual sense, the salary we are receiving has actually gone down because our purchasing power has reduced. Inter-professional disharmony is another major issue, one thing we have done as NMA is to look back at why are we in the health sector, we are in this sector for the people and the people who will call our patients include every one of us. NMA has refocused and our focus is to see the patient as centre point”.
Faduyile said the NMA has been crying every day to let the government know that the three per cent allocation to health cannot help the sector. It is sad that despite the fact that in 2001, Nigeria hosted African Heads of State and they all agreed to commit a minimum of 15 per cent of their annual budgetary allocation to health but regrettably, Nigeria has only gone beyond five per cent once.
Flowing from the above, we urge government across all levels to give priority to the Nigerian health sector by raising its budgetary allocation to the WHO benchmark. The novel coronavirus pandemic has exposed the the decay in the country’s health sector, underscoring the dire need to remedy the rot in the sector as medical tourism may no longer be an option given the global lockdown due to Covid-19.