How practicable is stopping skills flight in Nigeria’s medicals, education, banking, others abroad?
By BASHIR ADEFAKA
The much mouthed, long sighted and heavily invested Nigeria’s 2023 general elections have come and gone. The question of whether they were conclusive, inconclusive or marred by widespread ‘raw violence and thuggery’, to use the words of Arise News in reporting the coverage of the March 18 governorship and state house of assembly segment of the transition process in largely Lagos, Rivers, Ogun, Kano, Kaduna, Abia and other parts of the country, remains a thing that only posterity will live to examine in the future.
Issues that failure in getting elections right in a democracy generates, however, would continue to stare the country in the face as yet another controversial matter bothering on governance is quick to emerge, less than 30 days after the general elections. This is the issue of a Bill sponsored by Honourable Ganiyu Johnson, an All Progressives Congress (APC) member of the House of Representatives, which seeks to impose a law on medical doctors with a view to stopping them from seeking greener pastures abroad where their profession is much more appreciably valued and appropriately remunerated.
Just before I look into the matter of the Bill with responses that I have watched on the television by a journalism giant Dr. Reuben Abati and other doing well colleagues, it is important to point out how scary the healthcare sector of the Nigerian public life has become. It is a sorry situation that, from my personal experiences and what I have seen come out of the health sector in the country where I am equally a citizen, the Nigerian hospital is not one that I can readily recommend for any sick person as doing that can be more considered a wicked act as it can mean recommending for a death sentence.
In 2019, my father and mentor, Alhaji Kola Animasaun, spent 24 hours in a Lagos public hospital without being attended. If a big gun in Nigerian journalism that he was could undergo that experience, how much of a right would ordinary Nigerian have to claim an entitlement? It took my text message to the then Commissioner for Health, Dr. Jide Idris (he didn’t have to know me if we had a better country), to have five consultants now having to fall on one another as if they had earlier cared.
I, however, had no evidence his death within the same week was due to that experience. But in this same public health sector in Nigeria, two of my loved ones were respectively lost to, one, carelessly handled normal Caesarean Section (CS) and, two, badly managed lump in the breast, after long dragged attention due to either inexistence of consultants or stretched appointment dates by the particular one that they had.
Through those horrible circumstances, my friend and brother in Islam, Idris Asorona, lost his beautiful, well cultured wife and my own wife lost her immediate younger sister, the beautiful Kabirat. We still have a sad memory of having to lose those two innocent would-have-been greater Nigerian women. This is a country that when I cry over pains, someone would be quick to caution me against being tagged as enemy of state. If this is how the state gets an enemy, who cares?
To tag me enemy for crying over a pain that you inflict on me can only be tantamount to oppression, suppression and afflicted depression. At 50, not such fear would matter in my thinking at this time. Although litigations were prevented from arising from those two cases as they were both left to Allah, how many more of such cases that have happened to helpless Nigerians are known and how many of them shall we be able to have in the future which will also be left to fate?
Myself? Since 2016, due to wrong prescriptions in an orthodox medical centre under the watch of the country of my father, I have continued to nurse ailment that has cost me not just N5 million and still spending but also trauma of knowing that I have one diagnosis of a disease or the other. And I do all of these without help from anyone not even government of my country to which I am committed as a patriotic journalist. Nigerian medical sector!
Personally as a journalist working then with Vanguard Newspaper in Lagos around 2014, I used my pen to raise over N1.7 million for a Nigerian woman who had been down by breast cancer in form of my social responsibility giving back to a society that knows nothing about how I live my life except that I survive in the society breathing free air. That money in addition to what the parent and other families and friends had raised was spent basically on Chemotherapy. We lost her. Does it mean that breast cancer is truly a death sentence? What about Hypathitis in the categories of B and C? How about being able to save those lives that have been lost as a result of this terminal disease from which death is avoidable? Nigerian medicals!
As at 2015, a publication in The Guardian raised the alarm about how 100 million Nigerians were unable to screen for Hypathitis and how even the 25 million of them who lived with the liver-related viral disease were unable to get treatment due to the fact of high cost that is highly unaffordable and government doing not enough to provide support. That report thus provided research report of endorsed alternative medicines that are herbs connected and which have since proved to deliver. Aside that Guardian’s report, how much effort has Nigerian government asserted to building on more publicity and actualisation of application? None. But, how about the pharmaceutical conspiracy that seeks to deprive approval of alternative medicines? Does it really matter anyway?
Now, the medical practitioners say the complaints by members of the public who patronize their services stem from the standpoint of lack in all its ramifications. They talk about lack of adequate medical support equipment and training within and outside of training to make personnel grow to point that is of global standard and practices.
They have gone on strikes many times to this effect and many of us have thought the practitioners to be the transgressors and oppressors. We also have our reasons. Some doctors would rather prefer the same poor man, who visits government hospital for cheap but quality healthcare delivery, to take the medicare in his private hospital. That is not inclusive of when the doctor lists all manner of needless laboratory tests that pave to nothing in the end.
By the time the poor man considers the amount of money he has spent on carrying out test alone – the money he does not have and exclusive of money for treatment – and in the end he is diverted to private hospital either of the medical doctor or one of his interest, just like he has earlier been diverted to do laboratory tests, which should have been done within the medical facility of government hospital, in that of private owned either by friend or his own private hospital, the next time such poor man is sick, he would rather choose self medication and commit himself to that than trusting any hospital for it. This is our own Nigeria!
By and large, the question is, what could have made medical doctors be that unethical to the detriment of fellow citizens whose health is entrusted to their professional capability? We gathered that government does not make the atmosphere for their medical practice conducive to enable them give their best to the people. Is this enough for a professional doctor to choose to watch people sick until point of death, as against the more desirable will for their survival? What is the job of a medical doctor and other workers in the health sector? To put in their best in saving life. Are our medical doctors of Nigeria putting in their best to save lives? We have gathered: yes and no. Either side, it is blamed on the government.
Japa syndrome as last resort
When the blackmail became too much for the medical practitioners to bear, they choose the japa syndrome and are moving in droves outside of their own country in search of greener pastures abroad, where things work. Are they blamable? Honourable Ganiyu Johnson of the Nigeria’s House of Representatives said ‘yes’. And he followed that up with a Bill to impose a Legislative Act to stop them from looking abroad for their own better conditions of service and improved welfare.
Rep Johnson said: “There is heavy decline on medical brain drain. From 24,000 to now as I speak we have less than 10,000 doctors in Nigeria. So, that is alarming. So, I now talk to myself that, ‘Okay let us look at our laws, what is happening’. I noticed that the vacuum is that, immediately after housemanship, we notice that most doctors because of greener pasture, there is a capital flight from Nigeria to UK, America and all that.
“Now, government has invested so much money in training these medical doctors. So, if they can now take advantage of our situation and now open their doors, 2020 UK opened healthcare visa to people. They were all going to UK and US too and Canada.
“So, what should we do? Should we fold our arms? I now said okay to give back to the society, that is to our people, after training you, yes, we are not saying you cannot go abroad to make your money but if the state government has subsidized your tuition to the tune of 40 to 150 thousand, the least we can get from you is that, after your housemanship, before you are given full license, at least you can give back to the society within a period of five years. So, after five years, you are free to go. At least you have given back to the society.”
Government’s concern for citizens health in UK
From our investigations, it has been found out that they are not only givers of healthcare services, who the doctors, nurses, radiographers, all of the microbiologists and others represent, that have migrated their skills abroad but also, even Nigerian seekers of quality healthcare and who can afford it have ceaselessly taken to medical tourism abroad. This is despite the global standard diagnostic centre established by the Aminu Waziri Tambuwal-led government of Sokoto State with a view to making the North West state a medical tourism destination of choice for many Nigerians. Citizens facing serious health challenges still go abroad to seek proper diagnosis and follow it up with treatment because they have completely lost trust in ability of any health facility in their own country – Nigeria – to fill the gap.
For example, COVID-19 is a dreaded disease that could pass a death sentence if not committedly handled by government. During the heat of the lockdown it imposed on the world, whereas governments in other nations of the world especially in the West and the East took the welfare and medicare of their citizens to their hearts, the only we had in Nigeria was when the Federal Government made its quick release of money in billions to Lagos State Government but saw not the workings of the money.
Not even the palliatives, massive fumigations the Federal funds were intended to provide and carry out, as well as the physical food items provided to the South West state of Lagos for onward benefits and ease of hardship of the people were seen. They boiled down on quality of leadership that either people voted or who manipulated electoral process to get themselves into government. That was happening at a time in Canada, a Nigerian resident and working in the America’s heighbouring country sent message home to us to tell how 1,250 Canadian Dollar was being passed under his flat’s door every two-week for its pick.
In the United Kingdom, country where politicians in government think ahead for the good health and life system of their people, a Nigerian in the King’s country, having saved himself from the ineptitude of the medicals of our own country, has just been sent a letter informing him about the an already fourth state of COVID-19 that government of the country has made and has gotten ready for anyone that lives there and only requires and guides him on “How to get your next COVID-19 vaccination”.
Read the UK where medics work: “Our records show that you’re eligible to receive a further COVID-19 vaccination this autumn. Your protection from previous does may now be reduced and will continue to decline. A further dose should reduce your risk of becoming severely ill from COVID-19 this winter. If you’ve already booked an appointment, please ignore this letter.”
The more beautiful thing about that is that the letter further directs him on how to book online for the fact that booking that medical care online will definitely also work just like it is physical and the website address was provided.
It is also in the UK that I have had a cousin of mine say he fell sick in the house and could not go to work but that it only took him to use his phone call through to an ambulance, which came in no distant time and not only took him to the hospital but added the social service of having to take an information to his workplace announcing to the management that he was sick and would not be able to come to work.
That is the country where you get job and would have no stress being able to cater for your accommodation, energy needs and you even have the easy affordability of owning a car at no neck-cutter of a cost and that is where, as medical doctor or worker of any class, you can sit down and say “fulfillment”. That is the country that our Nigeria’s lawmaker has just sought a law to ban Nigeria’s medical professionals not to go to serve.
Journalists’ responses
But a panel of journalists on The Morning Show on Arise News here in Nigeria have also responded to the lawmaker, they included Dr. Reuben Abati and co, who did not think the APC’s Ganiyu Johnson’s Bill, sponsored for a law to stop medical doctors of Nigeria to take their profession abroad where things work, can succeed.
Asked what his thought was on it, Abati specifically said, “I don’t think that the Bill will stand. The House of Representatives has passed it, second reading, but it was also a very controversial process in the House of Representatives. Some of the members of the House of Reps made a point that this would be a violation of fundamental human rights.
“Okay, if a country is going to say if you have been trained you cannot take your skill to another country for five years, what is that based on? Are we being told that everybody that goes into medical training in Nigeria has signed a bond? Many people go to study medicine in Nigeria, they are not legally bound to work for Nigeria.
“In fact, we live in a country where the national scholarship scheme has failed, where even state bursaries offered by statement government no longer exist. In our time, even the state bursaries that you were given irregularly and episodically and unwittingly never worked.
“If a family sent its child to school to study medicine, what is the legal right that the Nigerian government has to tie you down to a bond that you must work in Nigeria for five years? So it doesn’t make sense. I think that those members of the House of Representatives, yesterday, who raised the issue of fundamental human rights were in order.
“The Speaker of the House of Representatives, Femi Gbajabiamila, who incidentally is a lawyer, pointed out that Section 45 Sub-section 1 of the 1999 Constitution says ‘rights are not absolute’. Okay, yes, that section says so. He said ‘oh with regard to public health’. But that section is not on all force with the rights of the individual to make a his own choice in a world that is driven by principle of globalization and individual choice.
“What kind of government will say you can’t go where you want to go? Anyway, don’t let me waste time on that. The whole principle behind this is that the man who proposed it, Johnson, an APC candidate from I think Ekiti State, was saying that we need to stem the tide of migration, brain drain, particularly of medical doctors.
“Last year August, even the Nigerian Medical Association had expressed concern that more and more doctors were living the country. We had seen picture of Nigerian doctors queuing up at hotels to exit to other countries. The concern here is not just the medical doctors and the House of Reps is expressing concern about medical doctors. How about nurses? How about radiographers? How about other medical professionals who are also leaving Nigeria in droves?
“What we would expect in form of an intelligent bill would be a proposal by the legislature to say that Nigeria has to do x and y to deepen the health sector in Nigeria, to provide better hospitals, to provide better incentives for medical personnel to remain in Nigeria. Nurses are leaving in droves; many nurses want to go to US, they want to go to Saudi Arabia, they want to go to UK. Labour will follow where he can get better value.
“So this japa syndrome that it is called is because of the failure of the Nigerian state, it is because of the failure of the Nigerian leadership and so, a parliament of Nigeria should not specious argument about why people should remain. After all the Nigerian Constitution even allows for dual nationality, so there is nothing that stops anybody from saying ‘I don’t want to offer my services to Nigeria again. I want the nationality of another country and I am off’.
“A current minister of health, ‘oh we have enough doctors, anybody that wants to go should go’ and they invited Dr. Ngige to come and contribute to this conversation, what change in Dr. Ngige, Minister of Labour and Employment, reported that any medical doctor can just leave, Nigeria will survive. These are the dimensions in this conversation that I consider curious and debatable,” Abati submitted.
In Ayo’s comment it was said, “Actually it’s curious and ironic that the Minister of Labour and Employment is a doctor, Dr. Chris Ngige and under his tenure we have seen such a massive, in the words of this report, exodus of not just doctors but medical practitioners from Nigeria to the rest of the world.”
It was also added that it is not just the medical profession but also, as Ayo said, “if you look at other industries, the banking industry and tech industry, Nigerians are leaving in droves (why?) in search of greener pastures.
“The National Association of Resident Doctors said that 85 percent of doctors are leaving to seek greener pastures. This figure is corroborated by the Medical and Dental Consultants of Nigeria, which said nine out of ten Nigerians are leaving to seek better opportunities abroad.
Rush for bill to infringe on rights needless
“Rather than the House of Representatives pushing a Bill of – first of all – investigating and understanding the reason why this is happening, they are rushing to pass a bill to infringe on the right of these doctors. How about passing a bill to improve the conditions of doctors in Nigeria? How about investigating as we asked earlier on as bringing the Minister of Labour and Employment in for questioning as what is going on in that sector rather than trying to fix the problem by making it even worse, by doing something, which could potentially be illegal?
“It is a big issue. This is not the first time we are talking about it that we are losing our best heads in Nigeria to different parts of the world. Canada is said to be the new capital of Nigeria because we have so many Nigerians who are moving in droves to Canada. The United States of America has always attracted the best in our medical profession.
“The United Kingdom has opened its doors to, not just doctors but, nurses and teachers also. We have a critical issue on our hands and we are not facing it with the right solution. Instead, we are looking for ways to stop people, who legitimately, want to live well, earn and look after their families without fixing the problems that we have back home. It would not work. And this is a call to the government officials, particularly the Minister of Labour and Employment, to fix these problems.”
