Chris Nwabueze Ngige, Nigeria’s minister of labour, studied medicine but he is more of a politician than a medical practitioner. That probably explains why he dismissed an obvious disastrous brain drain in Nigeria’s crippled health sector with a wave of the hand.
Ngige has been at the upper end of the social strata most of his adult life. Consequently, he knows next to nothing about the harrowing experience of 157 million poor Nigerians with a failed healthcare delivery system.
He would rather have the doctors trained with Nigeria’s lean resources migrate to Europe or North America for well paid jobs which would enable them to remit millions of dollars to their relatives in Nigeria.
Answering a question last week on brain drain in the health sector, Ngige told his interviewers in Channels Television that doctors were free to migrate to greener pastures as Nigeria had more than enough of them. The minister was either telling a lie or speaking out of gross ignorance of what is on ground. Nigeria is in dire need of doctors.
Ironically Nigeria has a penchant for importing what it has and exporting what it lacks. As Africa’s largest crude oil producer, Nigeria shamelessly imports refined petroleum products. Now it is exporting doctors that it desperately needs. Ngige might have had that irony in mind while putting up his logically incoherent argument at Channels Television.
The NMA is angry with Ngige. Its members have reeled out frightening statistics on Nigeria’s collapsing healthcare delivery system in a desperate bid to debunk the minister’s misleading claim that Nigeria had more than enough doctors and could export some. There are claims that NMA has only 40, 000 doctors in its register. Others contend that NMA actually has 70, 000 doctors in its register but that 30, 000 have migrated to greener pastures. Either way, the truth is that Nigeria needs 10 times the number of doctors in the register of NMA to meet the standard set by the World Health Organisation (WHO). The WHO standard demands a doctor-to-patient ratio of one to 600. Nigeria has a ratio of one doctor to more than 5, 000 patients. With an estimated population of 197 million, Nigeria needs 303, 333 doctors to meet the WHO standard.
Nigeria is a strange country and Ngige might have built his argument around the deceptive glut of doctors in the health sector. About 80 per cent of the medical students completing their six-year course in medicine in Nigeria have to wait for more than a year in some instances to be placed for the mandatory one year internship that would eventually qualify them as medical doctors. The internship facilities are just not there.
The situation is even worst in the labour market. There are instances where fresh medical doctors roam the streets for two years without gainful employment. Some fresh doctors stray into seemingly strange means of livelihood when nothing comes from the medical profession. Ngige probably had that deceptive glut in the industry in mind when he argued that Nigeria had enough doctors to export. It is a deceptive glut that has robbed Nigerians of effective healthcare because government is neither building hospitals nor recruiting doctors.
In some rural communities, the sick travel for 30 kilometres to the nearest hospital. Even the very few hospitals available are grossly under-staffed. Sick people leave home by 5am to pick the first 100 slots in hospitals to see the doctor. Those who arrive by 7am may have to wait a whole day to be attended to.
The NMA claims that there are some states of the federation that have less than 50 doctors in their pay roll. Zamfara state is a classic example of that. Even those who dare to employ up to 100 doctors are treating them like slaves. They are being owed several months salaries. Kwara and Osun states are classic examples of that.
Health is relegated to the background in Nigeria’s budgetary allocations. The federal government spends less than four per cent of its annual budget on health when WHO demands that governments should spend 15 per cent of their annual budgets on health.
Poor funding and inadequate number of doctors and nurses in the few hospitals have devastated Nigeria’s healthcare delivery. Nigeria is one of the most dangerous places in the world to give birth.
It has the world’s “fourth worst” maternal and infant mortality rates.
Nigeria on daily basis loses 2, 300 infants to avoidable ailments and 145 women through pregnancy and delivery related deaths.
Ngige cannot be blamed for the appalling state of Nigeria’s healthcare delivery system. He inherited it. The situation is the consequence of more than 40 years of neglect by successive governments.
The minister’s crime today is that as a trained medical doctor who doubles as minister of labour and has consequently handled simmering trade disputes in the industry, he should know more than he implied in his unguarded statement at Channels Television. The picture he has inadvertently painted is that of a man who would promptly sacrifice an efficient healthcare delivery system on the altar of bumper Diaspora remittance.
The federal government should ban Ngige and his colleagues in the federal executive council from medical tourism.
If everyone is compelled to treat all ailments in Nigeria, government would have no option than to invest in its human resources by addressing the deplorable state of the country’s health sector.
