Stakeholders in the health sector yesterday took the Minister of Labour and Employment, Dr. Chris Ngige, to the cleaners for saying he was not bothered about the mass exodus of Nigerian medical doctors to foreign countries.
Ngige had, while appearing as a guest on Sunrise Daily, a Channels TV programme, said doctors were free to seek greener pastures in other countries because Nigeria has produced medical doctors in surplus.
The minister had said: “I’m not worried. We have surplus doctors. If we have a surplus, we export. I was taught Biology and Chemistry by Indian teachers in my secondary school days.
“They are surplus in their country. We have a surplus in the medical profession in our country. I can tell you this. It is my area. We have excess. We have enough, more than enough, quote me.”
Ngige, when prodded further by his interviewers, insisted that there was nothing wrong in their choice to practice overseas, at the detriment of Nigeria’s health sector.
He said: “There is nothing wrong. They go out to sharpen their skills, earn money and send them back home here. Yes, we have foreign exchange earnings from them, not from oil.
“Those guys go there, they are better trained because of the facilities they have there. Eventually, I know a couple of them who practice abroad, but set up medical centres back home. They have CT scan and MRI scan, which even government hospitals cannot maintain. So, I don’t see any loss.
“Brain drain will only be inimical when, for instance, neurosurgeons travel and we don’t have neurosurgeons here.”
However, the minister’s position was met with anger from stakeholders in the country.
President of the Nigerian Medical Association (NMA), Dr. Francis Faduyile, told newsmen that such comments, coming from a senior medical colleague, was unfortunate, given the current doctor-to-patient ratio, which was far below the recommendations of the World Health Organisation (WHO).
Presently, he said an average of 40,000 doctors treat 200 million Nigerians.
While noting that the country was highest in the number of preventable deaths due to inadequate and poor healthcare services arising from shortage of medical personnel, he disclosed that the foreign countries where doctors were relocating had more doctors than Nigeria.
“Everybody knows that is an unfortunate statement. Any well-meaning Nigerian should be bothered because Nigeria has a low patient-to-doctor ratio and for us to get our acts right, we actually need more doctors.
“In the United States (U.S.) or in the United Kingdom (UK) where they are also going, they have an average of 2.8 doctors per 1,000 people. In Nigeria, we have 0.2 per 1,000 and you are saying you want more of our 0.2 per cent to go and join 2.8 per cent. You can see the disparity; what we have is not enough.
“In U.S., that is about 14 times the number that they have in UK, whereas WHO states that we need an average of one doctor to 500 or 600 people. Nigeria, currently with our 40,000 to 200 million, has about one doctor to 5,000 people in some parts of the country. It can be 10,000 people and what that means is that for every 1,000 people, we are short of about 10 doctors and it is unfortunate.
“Nigeria has one of the highest perinatal mortality rates, maternal mortality rates and infant mortality rates. Our average lifespan is very low and these are results of poor health management of our people,” he said.
Faduyile stressed the need for the Federal Government to honour the Abuja declaration by raising the bar on health budget from below six per cent to 15 per cent that was agreed by all African Heads of States.
“Sincerely, we have been advocating for government to put in place things that will retain doctors in this country. They are just shying away from doing that. We have advocated for them to honour the agreement they willingly entered into when, in 2001 at Abuja, all the African heads of states came and had an agreement that 15 per cent of the budget should be devoted to health every year.
“Nigeria has never had beyond six per cent, which occur only once in 19 years. We have always been less than five per cent. Currently, we are about 3.6 per cent and the one they are about to pass in 2019 is about 3.8 per cent and this is the premium our government has placed on health.
“Because, they have not put enough funding in health, maybe, we have a very wrong view that we don’t have spaces; so we have more than enough, but the populace is suffering. A lot of deaths that are highly preventable are occurring; a lot of mishaps are happening to our people and we want our people to rise up and tell government enough is enough. We need to make a change about the health of our people because one of the cardinal constitutional duties of government is to see that it provides health services to its populace,” he added.
Also speaking, the National President of Health Care Providers Association of Nigeria (HCPAN), Dr. Adeyeye Arigbabuwo, said time was rife for the federal and state governments to create enabling environment for medical doctors to retain their services in Nigeria.
Arigbabuwo noted that the current salary and remuneration of doctors was not enough, saying the statement credited to Ngige was an insult to Nigerians who are currently facing acute shortage of doctors.
While saying he foresaw an end to the on-going brain drain, he noted that as long as the environment in Nigeria was not conducive to the doctors to work, they would continue to migrate to developed countries for greener pastures.
On his part, the President, Association of Resident Doctors (ARD), Abuja chapter, Dr. Roland Aigbovo, said the calibre of doctors leaving Nigeria to practice abroad were leaving a wide gap that determines the health outcomes in the county.
He lamented that due to the rigorous process of getting placement for Nigeria postgraduate training, even after being successful in the examinations, majority of doctors prefer to write foreign examinations, which were easier and faster.
“Even if doctors are being mass produced in this country, they need to take a statistics to know the calibre of doctors that are leaving. We have a situation whereby young consultants and new medical graduates are leaving.
“The consultants are supposed to train the younger doctors to specialise and now they are leaving. The younger doctors who just graduated are also leaving; now where will they get the manpower to fill in the gap?
“Before making that statement, he needed to know those who are leaving and if those leaving are significant enough to make an impact in the health sector, which is actually true.
“I don’t agree with Ngige, even though he is entitled to his own opinion and, unfortunately, he is a doctor. I think he should have been more circumspect before making such comment, but for me, it is a misguided statement,” he said.