Still on the exodus of health workers

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LAST week, Chief Medical Directors (CMDs) of teaching hospitals across the country drew attention to the massive emigration of health workers from the country. Despite the Federal Government’s huge investment in healthcare infrastructure, they lamented, tertiary health hospitals faced potent threats as doctors, nurses and other skilled health workers exited the country in droves following inadequate remuneration and poor pay packages. The CMD of the Lagos University Teaching Hospital (LUTH), Professor Wasiu Adeyemo and his counterpart at the University College Hospital (UCH), Ibadan, Professor Jesse Abiodun, and others raised the alarm during the 2025 budget defence session before the House of Representatives’ Committee on Health Institutions chaired by Honourable Patrick Umoh. Speaking at the session, the LUTH CMD said: “We really need to act fast to save the grim situation. People resign in droves now not even retirement. Resignation is now almost a daily affair. Yes. In the next one or two years, we are going to have all our hospitals empty. We need to do something about remuneration of all the health care workers. Otherwise, government is putting a lot of money in infrastructure, and we are going to have empty hospitals. The major reason why people leave is for economic reasons. Consultants are earning less than $1,000.”

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Last week, the Medical and Dental Consultants Association of Nigeria (MDCAN) added to the picture of gloom in the health sector, indicating that only 6,000 consultants were left in the country. Speaking during the association’s National Executive Council (NEC) meeting in Ilorin, Kwara State, the association’s president, Professor Muhammad Mohammad,  lamented that about 1,300 consultants had left Nigeria in the last five years, adding that the number would continue to dwindle as the retirement age for medical consultants is 60 years. Hear him: “About 1,700 consultants are above 55 years of age. This means that in the next five years, they are going to leave the services for retirement. So you can see that the replacement cannot keep up with the loss from japa syndrome and from retirement.”

For obvious reasons, Nigerians are willing to risk life and limb to exit the country. Plagued by bad governance, economic crisis and massive insecurity, Nigerians, including health workers, exit the country in droves. Going by the findings of a survey published by the Africa Polling Institute in 2022, a staggering 69 percent of Nigerians would relocate out of the country with their families if given the opportunity, compared to only 39 percent in 2019. Some 22,130 Nigerians reportedly left for Canada in 2022, while 44,195 left for the UK through schooling. Between 2021 and 2023, over 2,000 doctors reportedly left Nigeria’s shores, bringing the doctor-to-patient ratio to a sad 1: 9,083 instead of the 1:600 recommended by the World Health Organisation (WHO). And unless and until the government deliberately reverses the situation pragmatically, the situation is bound to worsen.

Apparently, the working conditions of Nigeria’s health workers need to be improved, and that has a lot to do with the revamping of the Nigerian economy and commensurate political will. For years, we have maintained  that the government must address the welfare of medical personnel and stop the haemorrhage of professional expertise and talent needed to drive Nigeria’s quest for development, but it has been paying lip service to the issue. It is a no-brainer that with the brain drain in the health and other sectors, Nigeria loses badly needed expertise and the economy suffers because each professional lost to the malaise represents surplus spending units. Nigeria, like most of the developing countries, confronts massive shortages in the health and other sectors due to the prospects of higher pay from abroad that health workers often cannot resist. That has left millions of Nigerians vulnerable to various health challenges. If there are scant numbers of healthcare professionals to attend to massive populations, the tendency is high for the sick to seek alternative means of care which may portend grave danger.

To be sure, the emigration of healthcare professionals to Europe, America, the Middle East and other parts of the world is not without some positive notes. Healthcare professionals are a core part of Nigeria’s vibrant diaspora community, and it is a fact that on the average, Nigerians now remit $20 billion home annually. In 2021, remittances by Nigeria’s diaspora community to the country was $19.4 billion, which was 3.3 percent of the GDP. By 2022, the remittances stood at $20.3 billion or 3.5 percent of the GDP in Nigeria. In that year, Nigeria was in fact the largest recipient of remittances in Africa and the fifth-largest recipient globally.  Diaspora remittances certainly provide a more diversified source of foreign exchange earnings and reduce Nigeria’s dependence on oil exports. In October last year, the Chief Executive Officer, Nigerians in Diaspora Commission (NIDCOM), Abike Dabiri-Erewa, claimed that diaspora remittances are the highest source of foreign exchange to Nigeria. Speaking at the 12th convocation ceremony of the Afe Babalola University, Ekiti State, Dabiri-Erewa said:“Diaspora remittances are the highest source of foreign exchange to Nigeria and contribute more to Nigeria’s Gross Domestic than oil. According to the CBN, in July 2024, Nigeria recorded $553m diaspora remittance, the highest ever.”

The value of diaspora remittances by healthcare professionals notwithstanding, the fact has to be acknowledged that workers exiting Nigeria’s shores leave yawning gaps behind. In the health sector, this is especially sad because the government actually commits a fortune into the education and training of these healthcare professionals and they ideally ought to be at the disposal of the Nigerian people instead of being snapped up by wealthier and better organised countries. The fact is that the countries harvesting Nigeria’s healthcare professionals after they have enjoyed largely subsidised training in Nigeria are not doing so for fun. Rather, they are doing so to firm up their own economies and solidify the path to economic prosperity, knowing that all other things being equal, a healthy population is a productive population. For every healthcare worker caught in the japa (emigration) syndrome, vast populations of Nigerians suffer. That is why the Federal Government should liaise with the state governments and the various unions of healthcare workers and fashion out workable solutions to the exodus of health workers.

 



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