Worrisome dearth of doctors

The disclosure of the President of the Association of Resident Doctors operating in the Federal Capital Territory (FCT), Dr. Roland Aigbovo, that its members are being burnt out on their jobs as a result of shortage of medical personnel in the country should ruffle feathers in several quarters though it is not a surprise to close watchers of the nation’s health sector.

He explained that the burnout – a long term stress reaction marked by emotional exhaustion, depersonalisation, and lack of sense of personal accomplishment – has been linked to the pressure of clinical medicine, the pressure of life and work, the conditioning of medical education and the leadership skills of their immediate supervisors.

Dr. Aigbovo noted that resident doctors who are required to be physically present in hospitals are the worst hit, stressing that duties of physicians put them at risk of varying health challenges ranging from hypertension, anxiety, psychosis, drug substance abuse and ultimately suicide.

He said, “We are made to attend to varying numbers of patients on daily basis and work for over 24 hours straight in many instances just to get work done.

“This has a direct consequence on the quality of service rendered and makes us prone to mistakes which are avoidable if things are done well.”

He lamented that doctors in the FCT are under pressure to deal with growing patient load, with many on call duty spending up to 48 hours at a stretch at work and locum doctors paid as low as N50,000 a month, a pay the association described as “embarrassing”.

Dr. Aigbovo regretted that medical practitioners were leaving the country in droves with no replacements in sight, raising the alarm that as at September this year, only 25,000 of the 80,000 doctors registered by the Medical and Dental Council of Nigeria (MDCN) are practising in the country.

The situation in the FCT signposts what obtains in other states of the federation. It is public knowledge that the ratio of doctors to patients has degenerated to one to 2,500 patients. The ratio is a far cry from the one doctor to 600 patients’ recommendation of the World Health Organisation (WHO).

Going by the current population of Nigeria put at 180m, over 300,000 doctors would be required to meet the WHO’s recommendation. This means that Nigeria must produce at least 10,000 doctors annually for the next 10 years to join the workforce. However, findings have shown that Nigeria produces about 3,000 medical doctors annually across the medical colleges that have been given accreditation.

Unfortunately, the exodus of Nigerian doctors in search of greener pastures is alarming, a situation that was humoured by the Minister of Labour and Productivity when he argued that the nation has abundant medical personnel to spare. But the problems patients face especially in hospitals are contrary to his claim as evidenced by the burnout the FCT doctors are currently experiencing as a result of overwork. The situation becomes very pathetic when viewed against the recent report that four doctors in the nation’s capital committed suicide between January and June, this year, resulting from the burnout. 

Many factors are responsible for the frightening state of affairs. Notable among them are hostile environment, poor remunerations, lack of medical facilities or antiquated ones where they are available, sporadic trade disputes, rivalry among various cadres of healthcare givers, heavy workload due to shortage of personnel and attraction to work overseas offered by good working conditions.

A worrisome scenario was also painted sometime ago by a study conducted by the Nigerian Polling Organisation (NOIPolls) in partnership with the Nigeria Health Watch (NHW) which showed that the seekers of better deals abroad even cut across the board. They included junior and senior doctors in both public and private hospitals, resident doctors, consultants, medical directors and corps members.

The Chief Executive Officer of the NOIPolls, Dr. Bell Ihua, while advancing reasons for the ongoing brain drain in the health sector, listed among others challenges such as high tax and deductions from salaries (98%), miserable remunerations and emoluments (91%) as well as the huge knowledge gaps that existed in the medical practice at home and abroad.

He further said that the survey was intended to drive the much needed reforms aimed at redesigning a health system that would be responsive to the healthcare needs of the nation.

According to him, 87 per cent of the medical practitioners surveyed also believed that the federal and state governments were not concerned about addressing the daunting challenges facing doctors. He gave a breakdown of those desiring to practise in better climes as Britain (93%), the United States (86%), Canada (60%) and Saudi Arabia (59%), among other nations.

Given the prevailing economic situation in the country coupled with the dearth of doctors, many Nigerians now seek solutions to their health issues from quacks and unskilled trado-medics. Others resort to self-medication with grave consequences.  It is high time government at all levels stopped hiding behind their fingers, pretending that all is well. The current scenario of shortage of doctors and the lackadaisical disposition to the health sector across the board do not portray us as a nation determined to achieve the Universal Health Coverage by the year 2030.

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