A few days ago on Twitter, Nigerians in the United Kingdom were comparing the healthcare systems of Nigeria and the UK. Many argued that Nigerian hospitals are more accessible to patients than UK hospitals. They pointed out that a patient can walk into a Nigerian hospital and see a doctor within hours, whereas in the UK, the patient would need to call the hospital (General Practitioners – GP) ahead to book an appointment that could be days or even weeks away.
But, as with many issues discussed among Nigerians, proponents of accessible healthcare in Nigeria often fail to take into consideration the quality of healthcare patients receive. It is not enough for a sick patient to see a doctor immediately; they must also receive excellent care. Unfortunately, the Nigerian healthcare system performs poorly in this regard, not only when compared to the UK but also when compared to many other countries. Equally important is the impact of an open-door policy on healthcare workers who must keep the system running round the clock.
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This second point comes to mind as I read about the recent deaths of three Lagos doctors: Doctors Otukoya, Aluko, and Shuaib. According to the Lagos chapter of the Nigerian Medical Association (NMA), within just one week, three senior medical doctors at Alimosho General Hospital (ALGH), Igando, Lagos, passed away. The NMA, mourning the loss of its members to what they believe are stress-induced illnesses, is now sounding a call to action. They stated in a press release that the circumstances leading to the doctors’ demise “might have been related to chronic illnesses believed to be aggravated by stress.”
The NMA is in a good position to diagnose the problems facing their sector. However, one does not have to be a doctor to understand that the exodus of doctors from Nigeria in recent years will have a disastrous impact on the healthcare workers who are left behind to pick up the slack.
According to a 2022 UK immigration report, 13,609 Nigerian healthcare workers,, including doctors, were granted working visas in 2021, ranking Nigeria second only to India in exporting healthcare professionals. In October 2022, the Nigeria Medical Association revealed that there were only 24,000 licensed medical doctors available in the country. The imbalance is staggering: one doctor for every 30,000 patients in some southern states and one doctor for every 45,000 patients in the North. It is disappointing and outrageous that the Nigerian government has not taken any steps to replace the doctors and nurses it has lost in recent years.
The consequences of a healthcare worker shortage are evident, with cases like the tragic death of Dr. Michael Umoh at the Lagos University Teaching Hospital attributed to stress. Understaffing, which many doctors have publicly decried in recent years, can only impose immense pressure on the healthcare workforce, resulting in the physical and mental health deterioration of healthcare workers. This is a crisis that threatens not only the lives of healthcare professionals but also the quality of healthcare services available to the general population. As the saying goes, “Physician, heal thyself” (Luke 4:23). Doctors who don’t have time to rest are a danger to themselves and their patients.
Nigeria’s healthcare system is in a state of emergency, and it is high time that the government at all levels takes decisive action to address the devastating impact of brain drain. They should implement comprehensive support for public hospitals, work on medium-term reforms of the healthcare sector, including improving funding structures and quality control systems for hospitals. Doctors and other healthcare workers need better working conditions, competitive salaries, and opportunities for professional growth.
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We also need to immediately expand medical training facilities across the country. We can produce far more doctors than we currently do. Our country of over 200 million people produces around 3,000 doctors, while Cuba, with a smaller economy and population (just 11 million people), produces roughly 10,000 doctors.. The brain drain we face can surely be reduced by ensuring an improved welfare package for healthcare workers but this won’t fully fix the problem. In fact, our ambition should not be to fully end emigration of our healthcare workers. We should instead focus on producing more enough healthcare workers, especially doctors and nurses, for local demands as well as for exports. We have tens of thousands of qualified secondary school leavers who are interested in studying medicine and nursing but are currently denied due to limited spaces in our medical schools. It’s time to change that.
The government must prioritize the welfare of its healthcare professionals, invest in the sector to retain and attract talent, and support them to deliver excellent healthcare. The tragic deaths of the three doctors in Lagos should serve as a wakeup call, prompting immediate and sustained efforts to robustly address the brain drain and ensure the health and well-being of both healthcare professionals and the Nigerian population they serve.
