By Grace Akan-Francis
On November 29, 2023, no fewer than five wards, comprising about 150 beds, were closed at the Lagos University Teaching Hospital, Idi-Araba, due to a shortage of health workers.
Many health workers at LUTH, especially nurses and doctors, have departed from the once reputable teaching hospital in search of better opportunities.
“The alarming rate of migration of health workers is fast becoming a national embarrassment,” said Dr. Magaji, the Chairman of the House of Representatives Committee on Health in Lagos State.
In recent times, Nigeria has experienced a significant exodus of its medical professionals, leading to debates over whether this should be considered a brain drain or if there are potential advantages to consider.
While this move provides these professionals with better incentives and improved structures, Nigerians who cannot afford costly private medical care are left to suffer the consequences.
The Nigerian Medical Association has warned that the country might lose more than 50 percent of its skilled healthcare workforce by 2025 due to the mass migration of doctors and nurses.
Dr. John Odedele, a medical doctor in Ibadan, Oyo State, says factors such as “the harsh economic conditions, escalating security challenges, poor remuneration, and inadequate top-notch diagnostic facilities, with doctors expected to work with primitive tools, have contributed immensely to the migration.”
The departure of experienced healthcare professionals has raised concerns about its impact on the nation’s healthcare system and its ability to provide adequate medical services to the populace.
In Search of Greener Pastures
For Dr. Ajayi, the pressure to relocate began one afternoon as he walked from the operating theater to his office. After completing a 72-hour shift, he was exhausted. As he settled at his desk, his phone beeped with a bill of N250,000 from the mechanic who had repaired his car over the weekend.
“I looked at my account balance and realized all the stress I’m going through isn’t worth it, especially considering what my counterparts abroad are earning. I can’t even afford to pay my bills, yet I’m expected to work non-stop. I really can’t do it anymore.”
Like Dr. Ajayi, many healthcare professionals’ decisions to migrate stem from long working hours and poor remuneration, among other factors.
“As long as these issues persist, medical practitioners will continue to leave in droves, and there’s really nothing anyone can do about it,” says Dr. Ajayi.
A Matter of Life and Death
With only about two weeks left in her one-year internship at the Lagos State Teaching Hospital, Odan, Dr. Vwaere Diaso left her room on the 9th floor of the doctors’ residence to pick up food from a dispatch rider. Unbeknownst to her, this simple errand would end tragically. The elevator crashed as soon as she entered.
Eyewitness reports stated she lay in the ruins of the crashed elevator while emergency rescue took an hour to arrive. She eventually died in the emergency room.
According to reports, the elevator had been faulty for over three years, and despite numerous complaints and reports, no concrete action was taken to repair it.
A doctor residing in that building, identified only as Oluchi, wrote on X (formerly known as Twitter), “I can’t count how many times we didn’t have water or electricity in that useless HSC. We were even robbed several times. We complained about the elevator, but all they did was patch it up and tell us to be grateful we even had quarters to stay in.”
For some health workers, leaving Nigeria has become a matter of life and death.
“Many times we have had to improvise due to the lack of resources, for instance, using a carton as an incubator or performing surgery by candlelight due to the country’s erratic power supply,” says a matron at a primary health center in Bayelsa State.
In addition to the deplorable working conditions, the low salaries compared to what their international counterparts earn is another major issue for Nigerian health workers.
In 2019, the Federal Government increased the minimum wages for workers, affecting all categories of workers under its payroll, including medical doctors.
However, the salaries for doctors still pale in comparison to what is offered in many countries to which Nigerian doctors migrate.
Data from the National Salary, Income, and Wages Commission (NSIWC) show that in 2019, an entry-level medical doctor received N1,812,600 ($5,911.94) per annum. This is less than 10 percent of what doctors in some other countries earn.
The impact of this talent migration on Nigeria’s healthcare system and the quality of life for its citizens is significant.
In rural areas, the shortage of skilled personnel puts a strain on healthcare delivery, especially where the need is great. Patients may experience longer wait times, limited access to specialized care, and a decrease in service quality. “The departure of seasoned professionals not only reduces the capacity of the country’s health system to care for those in need but also undermines efforts to tackle public health issues like infectious diseases, maternal and child mortality, and non-communicable diseases, potentially leading to the imminent collapse of the healthcare system,” Dr. Odedele explains.
Despite these challenges, some argue that the migration of health workers could also bring benefits to Nigeria, as some medical practitioners replicate their professional exposure and experience by building facilities that can compete with those abroad, while others give back by establishing NGOs affiliated with international bodies.
“Nigerian medical professionals living abroad can act as conduits for sharing knowledge and fostering collaboration between Nigeria and other countries,” says Dr. Odedele.
By leveraging international connections and collaborations, Nigeria can access important resources, knowledge, and technology to improve the healthcare system.
“This exchange of ideas and best practices has the potential to inspire innovation, enhance healthcare systems, and promote global health cooperation,” he added.
Ultimately, the departure of Nigerian health workers presents a complex situation with various challenges and potential benefits. While brain drain can negatively affect the country’s healthcare system and overall development, it may also offer opportunities for economic growth, international collaborations, knowledge sharing, and skill development.
However, the critical question remains: what happens when five hospital wards with 150 beds in a public hospital are shut down?
What happens to Nigerians who cannot access timely medical interventions due to this exodus?
Does the return of medical practitioners to the country after two or three decades abroad to build state-of-the-art medical facilities compensate for the immediate losses caused by the collapsing health system?
