Job Osazuwa
A downpour of potent and acidic criticisms has continued to rain upon the Minister of Labour and Employment, Dr. Chris Ngige, over his submission that the mass exodus of doctors from Nigeria was nothing to worry about.
On April 24, Ngige had said that he was not bothered about the decision of medical doctors who chose to leave Nigeria for greener pastures outside the country.
While featuring as a guest on a television programme, Ngige said the practice was not alien to Nigeria, because he was taught by Indians in secondary school.
His words: “I am 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.”
Since the minister made the declaration, Nigerians have thoroughly lambasted him, using the traditional and social media to express their disappointment.
A concerned Nigerian, Henry Njeakor, expressed his anger on his Facebook page. He wrote: “Walk into a teaching hospital close to you. Ask for the general out-patient department (GOPD). You would see patients who probably have been sitting from 4am, 5am and 6am in the morning, waiting to see a doctor. Sometimes, because of the immense crowd, the department might choose to only see a particular number for a day. Let’s put the number at 150 (I am being modest, really).
“Then walk in and ask for how many doctors are on duty that will see these people. Sometimes, not more than six to eight doctors. (I am being very generous). That means each doctor would see about 18 to 25 patients in a day. If these doctors dedicate only 15mins for each patient, it means he will sit for more than six hours that day just consulting.
“Now, here’s my question: do you think his or her mental faculty is going to be alert enough to give the last three patients adequate attention? I doubt it. That also means a patient has spent more than eight hours waiting to see a doctor who eventually is fatigued when it is his turn.
“This patient is probably eventually sent to see a specialist by the family physician. And when he gets to the specialist clinic, he’s given an appointment to come in three months, as that is the nearest available time to see the specialist. This is because there are few specialists and there’s also so much that a specialist can see in a day. If you have been to a teaching hospital, you know this scenario is very familiar.
“When next you hear statements like that of Dr. Ngige, the Minister of Labour, saying Nigeria has surplus doctors and can even export them, you realise that the people that have been entrusted with the power to heal the country are sick themselves. God help us.”
A media consultant, Mr. Asade Opeyemi, said: “It is very sad that, with one doctor attending to more than 5,000 Nigerians, Dr. Ngige said he was not bothered by the increasing number of Nigerian registered doctors who have relocated abroad. If this could come out from a minister of labour, it means Nigeria is in a deep mess.
“The minister owes us a quick apology over that reckless statement. We have an emergency situation in the health sector already and Ngige said it is normal. This is the same country where there has been a persistent high infant and maternal mortality rate. Our life expectancy is placed at less than 50.”
The World Health Organisation (WHO) recommends that there should be one doctor to 600 citizens of every country. But this is in sharp contrast to what is obtainable in Nigeria, where one doctor reportedly attends to 5,000 people.
Many people are wondering if Ngige, who was trained a doctor, was armed with the WHO’s recommendation before he made the statement.
A medical practitioner at the Lagos University Teaching hospital (LUTH), who pleaded not to be named, said what the minister said was far from the truth.
Speaking with this reporter on telephone, he said: “The minister needs to get himself acquainted with the reality on ground. Most private clinics have only one doctor attending to all manner of illnesses that are brought to the practitioner. And the minister must be aware that we have thousands of private hospitals in Lagos State alone.
“Most of us who work at government-owned hospitals are overused to the extent that we fall sick regularly. The situation is like this because there is an obvious huge shortage of doctors. In such a scenario, the patient will always be at the receiving end. Many patients might have died while waiting for their turn to see a specialist in many public hospitals.
“For Dr. Nigige to have made such an unguarded statement shows that there is something wrong with those at the helm of affairs in this nation. I still find it difficult to believe that he actually said it because even the layman on the street knows that there is a dearth of medical personnel in the country. With this statement, Nigerians can now understand why the government does not take the welfare of medical workers seriously.”
Another doctor, Olusola Anyandokun, a general practitioner with a private hospital in Lagos, said four of his classmates that graduated with him the same year have travelled abroad to continue their practice.
“The only reason I didn’t leave Nigeria all this while is because I’m the only child of my parents. I have attempted on many occasions to relocate just as my friends did but there has always been strong resistance from my parents, particularly my mum.
“Every Nigerian doctor has enough reasons to travel abroad and this has nothing to do with surplus number or not. Apart from the monetary reward in the developed world, the equipment is sophisticated and the condition of service is superb. Even South Africa is far ahead of Nigeria in quality health care delivery. Instead of the minister to be sober and suggest how to address some of the challenges fuelling the brain drain in the health sector, he went to the media to make a mockery of his office.
“Initially, I thought it was one of those fake stories, until one of my colleagues called me to draw my attention to it. I quickly went online and watched it myself. It was a national embarrassment, considering the office he occupies. Is he aware of the WHO recommendation on doctor-patient ratio? What he said was completely false and I expect him to have apologised to Nigerians by now,” Anyandokun said.
In the same interview, when Ngige was asked if the brain drain was not hurting the health sector, he said, “Brain drain will only be inimical when, for instance, neurosurgeons travel and we don’t have neurosurgeons here.”
Taking a swipe at the minister, the president of Nigerian Medical Association (NMA), Dr. Francis Faduyile, described the statement as worrisome. He said it was important that medical experts in Nigeria are retained by Nigeria.
Said he: “That is an unfortunate statement, which shows that he has done nothing in medical practice. The WHO stated that, for optimal health care to be achieved, we need doctor-to-patient ratio of one to 600. In Nigeria, we have 40,000 doctors taking care of 200 million people.
“It is unfortunate; we do not have enough doctors. Maybe he is looking at the monetary part but there is the opportunity cost. He says it will generate revenue when the doctors bring back money. But that is coming at the expense of our people that are dying daily because of lack of facilities in the health sector to take care of simple ailments and complex ones like cancer.
“Nigeria has a maternal mortality rate that is about the highest in the world. To correct it, we need more health professionals around. Africa’s head of states met in Abuja and declared that at least 15 per cent of annual budgets should go to the health sector. Nigeria has never gone beyond 6 per cent since 2001. The current budget gives about 3.8 per cent to health. You can see that Nigeria has no interest in taking care of its citizens.”
Faduyile added that there were states with fewer than 50 doctors in their health sector and expressed worries that some have not paid doctors for 10 months.
He explained that it would take Nigeria 15 years to have adequate number of doctors if no doctor leaves the country within the period.
A concerned Nigerian, a Benin-based educationist, Chief Chima Saturday Chukwudalu, said there were many communities across Nigeria, especially in rural areas, with no doctor.
He said: “Many laboratory scientists, pharmacists and many other medical workers now pose and operate as doctors. Could it also be that the minister was referring to quacks as the surplus doctors?”
Executive director of Socio-Economic Rights and Accountability Project (SERAP), Adetokunbo Mumuni, also disagreed with Ngige.
“Everyone has a legal right to travel and work in any country that he or she wishes,” he noted. “But if he says we have sufficient medical doctors in Nigeria, he should tell us the areas of specialisation he means. Is it in the area of surgery or what is he telling us?”
While commenting on the effects of Ngige’s statement on Nigerians’ right to health, the president of the Joint National Association of Persons with Disabilities, Ekaete Umoh, also faulted the minister’s position.
She said: “The minister should have tried to understand why the doctors are leaving. People have the right to move but, if they are leaving in large numbers, we should be concerned.
“If they are leaving because we don’t have the infrastructure and if they are frustrated that is a big problem for Nigeria. If you underfund the health sector, it is a big problem. A lot of the doctors would have loved to wait but they cannot practise under a difficult situation. Ngige should be worried.”
Also disagreeing with Ngige was the Speaker of the House of Representatives, Yakubu Dogara. At a public hearing organised by the House Committee on Health on two bills at the National Assembly in Abuja on Wednesday, Dogara stated that the attendant brain drain in the heath sector was becoming worrisome. He called for quick intervention.