Sometime last year, the incumbent Minister of Health, Professor Isaac Adewole openly suggested that doctors who could not find work in Nigeria should consider turning to other careers. He had been responding to journalists who questioned him about the unusually long waiting period required in order to get residency training in Nigeria. He had said “it might sound selfish, but we can’t all be specialists, we can’t. Some will be farmers, some will be politicians…. The man who sews my gown is a doctor. He makes the best gown. And some will be specialists, some will be GPs (General Practitioners), some will be farmers”. This statement was angered a lot of doctors and medical students as we felt he was trying to make light of a situation we consider really serious.
Was he not, by his statements, encouraging brain drain?
Brain drain is simply a term used to indicate the movement of skilled individuals from a less developed area to a more developed area. It is a process in which a country loses its most talented and educated personnel to other countries. Brain drain is simply one of the results of Human Capital Flight (the other being Brain Gain).
According to Wikipedia, human capital flight is “the emigration or immigration of individuals who have received advanced training at home.” The net profit of “human capital flight” gained by the host country is what is being referred to as Brain Gain while the net cost spent by the home country on these individuals is referred to as Brain Drain. In most cases, this is done out of the belief that one would receive better education or be exposed to favourable professional opportunities in the country he/she intends to migrates to.
Over the years, this issue has been continuously overlooked by the Federal Government and has affected the Nigerian Economy in a number of ways. Highly skilled and qualified Nigerians continue to migrate to developed countries and end up contributing greatly to the economy of these countries thereby denying their home country of potential future entrepreneurs, ingenious ideas and a host of other benefits.
“The NMA says that there are only 40,000 doctors in an estimated population of 196 million. The latest data from the World Health Organization (WHO) reveals that Nigeria’s doctor to patient ratio is 4 to 10,000 patients and patients often wait hours to be seen. In the US the ratio is 26 doctors per 10,000 people and 28 in the UK.
Nigeria repeatedly falls short on its 2001 commitment to spend at least 15% of its budget on health. Last year just 3.9% was allocated.”
A reason for the increasing level of Brain drain witnessed in the Nigerian Health Sector is as a result of the poor working conditions that come with being a practicing doctor in Nigeria as only 4% of Nigeria’s budget is allocated to health. Data obtained from the United Kingdom and United States show that each week, at least 12 Nigerian doctors are employed in the UK and more than 4000 are already practising in the US.
Also, a poll conducted in 2017 showed that 9 out of 10 doctors were willing to leave the country to further their medical training abroad. The most worrisome thing about this high level of emigration is the degree of apathy shown by the Nigerian Government towards fixing this problem and its inability to put in measures that would encourage medical students to not only want to do their residency programme in the country but also consider full medical practice.
Another reason for the accelerating emigration to these countries (mostly the United Kingdom, United States and Canada) is due to better facilities, higher quality of life and a greater possibility of being recognized for one’s hard work and excellence. According to the Africa Report (an online magazine), Nigeria state employed doctors earn as little as 150,000 naira ($416) while consultants earn up to 800,000 naira ($2191) a month. As high as this may seem, it is way below what these doctors could earn in developed countries.
Former Minister of Labour, Dr. Chris Ngige who is a trained medical doctor himself also once said that Nigeria has a surplus of doctors and that there was nothing wrong in them travelling out since they earn money and send them back home. He also added that the country could gain foreign exchange earnings from them as opposed to oil which the country largely depends on as a source of revenue.
Now, this isn’t too far from the truth as Nigeria also benefits a great deal from the issue of brain drain especially in circumstances when these doctors send back money earned abroad to their families. However, one cannot ignore the fact that the same Nigeria was also mentioned among nine countries who were said to have lost more than $2bn since 2010 training doctors who eventually chose to migrate. The other countries include Ethiopia, Kenya, Malawi, South Africa, Tanzania, Uganda, Zambia and Zimbabwe. Apparently, It takes each African country $21,000 and $59,000 to train a doctor.
Annually, Nigeria is also estimated to be losing $2.0 billion through brain drain in the health sector alone. This is according to the Mo Ibrahim Foundation. It is also important to note that in the developed countries these doctors choose to move do not pay for the cost of training these doctors and therefore they end up saving a huge amount in terms of training costs thereby benefiting more.
There are numerous ways to curb this brain drain problem and reduce the efflux of Nigerian medical students to these Western countries either for residency or full-time practice. One of these ways is to allow medical students to train in these developed countries with world class clinical settings and encourage them to return to practice in Nigeria. Unless proper incentives are put in place to encourage them to practice in Nigeria, we would continue to lose these trained individuals to countries like the US and UK who give strong incentives like a permanent-visa status and a valid license to practise medicine.
Finally, Residency is a final stage of the training process for medical students and Nigeria as a country, should try to provide more residency programs to reduce the number of medical students willing to go abroad for this program. However, all these will not be possible unless the federal government is willing to acknowledge this pressing issue and allocate more funds in the annual budget to the health sector which is clearly suffering compared to other sectors of the economy and what is obtainable in other countries who have been able to keep their best minds. The Nigerian government should also be open to interacting with physicians and medical students to look for a more decisive step in the right direction.
Kolette Okoro is a blogger at www.kolettespeephole.com
References
1. Mo Ibrahim Foundation http://mo.ibrahim.foundation/news/2018/brain-drain-bane-africas-potential/
2. theafricareport
3. https://www.weforum.org/agenda/2016/10/how-to-reverse-the-medical-brain-drain/
4. Does Nigeria have too many doctors to worry about a brain drain by Yemisi Adegoke https://www.bbc.com/news/amp/world-africa-45473036
Loved the article
👌