According to Professor Innocent Ujah, the President of the Nigerian Medical Association (NMA) Nigeria lost over 9,000 doctors to the UK, Canada and the United States of America between 2016 and 2018. In fact, not fewer than 727 Nigerian-trained doctors moved to the UK alone between December 2021 and May 2022.
He made the shocking statement during the annual Maiden NMA lecture series earlier this year. The event took place in Abuja. The theme of this year’s conference is “Brain Drain and Medical Tourism: The Double Evil in Nigeria’s Health System”.
Are you alarmed by this sad situation that is causing the best minds in the medical field to fly off to greener pastures far beyond our shores? You should be and that’s because the loss left Nigeria with just 4.7% of its specialists to meet the health needs of over 200 million people!
Citing data from the World Health Organization (WHO), he said Nigeria has a doctor-to-population ratio of around 1:4000-5000, which is well below the doctor-to-population ratio recommended by the WHO. WHO by 1:600. Ujah is worried because the heightened threat of brain drain is compounding Nigeria’s already stretched health care resources. And here we are in a country that is currently struggling with a myriad of challenges, including escalating insecurity, massive youth unemployment, hiccups in the education sector exacerbated by the ASUU strike and, well sure, the highest inflation rate in 18 years.
The real cause for concern is that it is not just in the medical field that we are mired in the brain drain incubus. But first, what is it? According to Wikipedia, “Nigeria’s brain drain is the exodus of middle-class and highly skilled Nigerians that occurred in waves from the late 1980s to early 1990s.”
Although this trend was initially limited to certain professions, it has now become free for all with the introduction of visa programs to fill labor shortages in developed countries. This was triggered by an economic downturn after a period of economic boom in the 1970s and 1980s, propelled by the discovery of oil wells in Nigeria. It reminds us of the era of the structural adjustment program of the military junta led by the famous BWI, General Ibrahim Babangida.
But more importantly, we should ask ourselves about the root causes of the brain drain, with the salutary aim of proposing and acting on viable solutions. The answer is not far-fetched, as the persistence of poor leadership has been singled out by some researchers as a critical factor leading to massive brain drain. For example, political leaders failed to manage the economic prosperity of the 1970s and 1980s that arose from the discovery of oil wells.
Nigeria, which has become a destination for economic migrants with an influx of teachers and lecturers from Ghana and India into secondary schools and public universities, quickly found itself under the economic downturn and a drastic program. structural adjustment mandated by the IMF. The austerity measures imposed have led to a drop in funding for the education sector. This led to several student uprisings which triggered a mass exodus of expatriates and an export of skilled Nigerian workers. Since then, many Nigerian students have shown increasing interest, especially in travel to developed societies, soon after completing their studies.
Subsequently, significant factors such as mass unemployment, poor working conditions, poor wage structure, political and religious crises, lack of quality education and mass poverty as Nigeria became the world capital of poverty (OXFAM report, 2018) have led to a brain drain.
According to Wikipedia, even the entertainment industry has not been left out as some celebrities including Opeyemi Aiyeola, Doris Simeon, Lara George, eLdee, Lola Alao, Regina Askia and Bayo Bankole have migrated to other countries. So what are the telling effects of this anomaly on our dear nation, Nigeria?
Starting with the health sector, according to the Mo Ibrahim Foundation, it costs Nigeria between $21,000 and $51,000 to train a single doctor. But the country has lost more than $2 billion since 2010 to train doctors who then migrated. This therefore means that countries like the UK with 10% of doctors coming from African countries save around $2.7 billion by recruiting these doctors. Nigeria holds the small end of the medical stick!
Looking back, concerned health actors alerted the federal government to an impending shortage of doctors, with a projection of over 50,120 doctors and 137,859 nurses in Nigeria by 2030. This was in July 2021. For example, in March 2020, the doctor-to-patient ratio was 1:2,753. This figure is well below the ratio of one doctor per 600 people recommended by the World Health Organization (WHO). But that’s not all.
Some other brain drain effects identified so far “include loss of human capital assets, loss of income due to loss of taxes from labor emigrating to foreign countries, and loss of capital invested in the public subsidized education of emigrant labour”. So how do we stop the growing wings of the brain drain from taking our best and brightest minds off our shores?
We should recognize that the provision of quality health care is part of the 1948 United Nations Declaration of Human Rights. It is also expressly stated in article 17(3)(d) of the constitution of 1999 (as amended, which guarantees “adequate medical and health care” facilities for all persons.
There must be an enabling environment of peace and security in place, to act as catalysts for increasing human resources and health care delivery. More budgetary allocations should go to these sectors. Sadly, the country’s budget for education as a percentage of its GDP has never exceeded a single figure from 2016 to date. In fact, in 2021, Nigeria’s education budget of 5.6% was the lowest since 1999. This is below the 26% recommended by UNESCO.
As for the health sector, finding solutions goes beyond the government’s creation of a health reform committee aimed at reversing the brain drain. For example, the country’s budget in 2021 was 13.6 trillion, and the Ministry of Health got 514 billion, or 3.7% of the budget. You must now understand one of the reasons for the massive brain drain.
Notably, in a 2017 survey by Nigerian polling agency, NOI Polls, in conjunction with Nigerian Health Watch, it was found that 88% of doctors were considering overseas work opportunities! More than half of the doctors registered with the Medical and Dental Council of Nigeria (MDCN) practice outside Nigeria.
Also, medical tourism should be banned. The shortage of medical specialists contributes to medical tourism, as a handful of Nigerians spend N359.2 billion a year seeking medical treatment abroad.
The upcoming general elections in 2023 present another golden opportunity for the Nigerian electorate to choose political leaders wisely, especially those who understand exactly where we are currently trapped and must muster the political will to do what is necessary. That is to say with regard to the very important sectors of education and health.