Katsina State is among the worst hit by the problem of insecurity, particularly banditry, which has adverse effect on virtually all facets of life.
However, insecurity has considerably subsided, but another serious challenge, which is the exodus of health workers known as brain drain, has aggravated the already poor health indices, bringing the entire health sector in the state to the verge of collapse.
This problem of brain drain in Katsina is of two types. While some have gone abroad, those who remain behind have engaged in internal brain drain, moving from the state healthcare service to the available federal institutions and international organisations within the state for higher pays and better working conditions.
Doctor’s population
Daily Trust gathered that, five years ago, the Katsina State government had over 300 doctors in the state service and 25 doctors in the local government areas. Today, according to statistics, those numbers had drastically reduced to 110 (for the state) and 16 in the services of the local government areas (LGAs).
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The state has less than 10 house officers at the moment compared to almost 70 that were there four years ago.
Of the 110 medical doctors on ground, 60 are within the state capital, which comprises two LGAs of Katsina and Batagarawa, and they are spread across General Hospital Katsina, Turai Yar’adua Maternal and Child Hospital Katsina, General Amadi Rimi Specialist Hospital Batagarawa, Psychiatric Hospital and Eye Hospital Katsina.
The remaining 50 are distributed in 18 general hospitals across the remaining 32 local governments, while the 16 with the state Primary Healthcare Service are distributed across eight local government areas in the state.
Daily Trust also gathered that nine local governments amongst the 34 LGAs in Katsina have no medical doctor at whatever level with Funtua zone worse affected as its six out of 11 LGAs have no doctor on ground.
Some units closed, or about to be closed
The number of doctors and other health workers which is grossly inadequate to attend to the healthcare needs of the people of the state, have forced the closure of some units in hospitals.
For instance, at the General Hospital, Katsina, our reporter gathered that one of the sections worst hit is that of the Obstetrics & Gynaecology unit where pregnant women go for services. A personnel in the section told our reporter that only three doctors are in the section.
“As we speak, the Gynae clinic, where women generally, not necessary pregnant, come for one problem or another, has closed down, only emergencies are seen, due to lack of personnel”.
Our reporter gathered that the hospital has no incubator for premature babies, in which case, the patients had to be referred to a tertiary institution that charges far higher for medical care.
Similarly, at the general hospital, the dialysis section is not functional despite the number of kidney issues. Patients have to be referred also to other places. The result is that patients either pay where they could afford or remain at home unattended to.
“It may interest you to know that in the whole healthcare service of Katsina State, there is only one nephrologist (Kidney doctor) because the state could not employ more. What will happen if he is sick or if he travels?” a medical personnel told our reporter.
The situation is similar or worse in other places. For instance, Daily Trust observed that a doctor sees tens of patients at the Dutsinma Hospital, and he is expected to go round different units and do all the shifts, with no one to take over from him. This is not to talk of LGAs that either have no doctors at all or are even hard to live due to insecurity.
“Let me give you an example, in the code of practice, a nurse or a midwife looks after four patients and a time, that is the standard, but here, you see a nurse looking after 40 patients at a time, how could you ten times the amount of work that you are supposed do and do it adequately? There is no way,” the source lamented.
“It is not easy for one to remain while his peer is receiving three times more and they go to the same market, they offer the same service and they all have families to take care of,” he said.
Situation requires urgent government intervention – NMA
The Chairman of Nigeria Medical Association (NMA), Dr Adamu Saminu, said the situation was dire and there was need for the government to urgently arrest it.
He said doctors are majorly leaving due to poor remuneration, lack of infrastructure and equipment and for career opportunities, adding that those of them that have chosen to remain are only being patriotic as they are sacrificing a lot considering the economic situation of the country.
He said, “The pay gap between these federal facilities, non- governmental organizations and the Katsina State government made it impossible for doctors to stay.
“It is a time bomb. And if leaders keep playing with this time bomb, there is a very real chance that retaining the little number on ground will be next to impossible. “There is a real guarantee that in the next three months, there will be grossly inadequate numbers with no pool or well to fetch from”.
To solve the ugly challenge, Dr Saminu said the state must commence residency training in at least four medical specialties to ensure career progression, specialised and critical care.
“The remuneration must be competitive to attract and keep medical doctors, attract trainers and trainees in residency training too. The hazard allowance must be reviewed for all medical and healthcare workers.
“It is not enough to upgrade infrastructure, equipment must also be provided. The medical school in UMYU must be given all the necessary support to flourish. The government must be ready to invest heavily and wisely in its health sector,” he said.
Government carefully observing the unfortunate trend – KTSG
Reacting to the situation, the Director General (Media) to Governor Radda, Maiwada Danmallam, said the government is carefully observing the unfortunate trend and will explore all means to stop brain drain or fill in the expected gap it will create in the system.
He said, “Government is already pursuing a programme to incubate and harvest doctors across the 34 LGAs. The policy on future doctors scholarship is designed to recruit and train doctors cutting across all the 34 LGAs to feed rural communities across the state.
“We should bear in mind this will take some time to begin yielding results but we have to start from somewhere. It’s very important to accept that Katsina State is ours to build and we cannot do that by abandoning the state to its own devices to go after better paychecks.
“Apparently this is a phenomenon created by unending search for better job packages and job packages must be considered from the viability of the government’s finances and its other equally critical responsibilities. This explains Governor Radda’s call for all hands to be on the deck to move Katsina State forward”.
Danmallam added that sacrifices must be made to help the state stand on its feet, saying “Doctors and medical workers shouldn’t always look at their jobs from the perspective of pay cheques. They have a bigger responsibility to help build the state to achieve the economic solvency that could give them better pays.
“On its part, the government is committed to providing them with an excellent atmosphere to operate commensurate to their sacrifices and within the affordability of the state’s finances,” he added.
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