I recently participated in an “International Conference on Africa–Middle East Relations” that went beyond violent extremism (the customary focus) to examining the historic and current links between Arabs and Africans in politics, diplomacy and economy. A recent example was raised repeatedly by the participants at the hybrid event held in Nairobi: the breaking news that over 500 Nigeria specialist doctors took part in a recruitment exercise organised in Abuja by Saudi Arabia’s Ministry of Health. This is just one of the multiple ad hoc recruitment centres set up by the Saudis, suggesting that thousands have expressed an interest in taking their skills elsewhere.
The testimony of one applicant interviewed by Arise TV was especially chilling. She recounted that she finished her medical school 10 years ago, but on her arrival at the centre, the first person she stumbled into was her university lecturer. He was not interviewing candidates, but was in the same position as her: an applicant wanting to try his luck. This is unlikely to be an isolated occurrence: it is not just newly qualified doctors that are departing Nigeria en masse; it is also the highly experienced, entrusted with the education of other doctors. Multiple generations of health professionals have had enough of their frustration in the system and are migrating, taking with them their enormous skills and experience.
But this Saudi medical exodus is just the tip of the iceberg of an issue that has worried many for a long time: thousands of our doctors working overseas while we face acute shortage in domestic health provision. There are, according to the BBC, about 4,000 Nigerian doctors practising in the United States and another 5,000 currently registered in the United Kingdom. Thousands more work in Canada, Australia and the Gulf countries. The Association of Resident Medical Doctors claimed in 2018 that 12 of their colleagues leave Nigeria every single week while a poll in the same year found that 88 per cent of Nigerian doctors are considering working abroad. That is to say, nine in every 10 of our doctors would, given the opportunity, jet out. Nigeria spends billions of dollars of our very scarce resources in training health workers, only for richer countries to snatch them with the lure of better pay and service conditions.
It would be very easy to blame the wealthy countries doing the snatching, or even the doctors fleeing the country that trained them. That would be wrong in my considered opinion. Countries across the world are struggling to fill vital gaps in their health sector, especially in the wake of the COVID-19 pandemic, so it is natural that they headhunt in places where they have a comparative advantage and Nigeria is easily a top target. This is simply acting in their national interest, just as we hope that our own leaders do. And on the other hand, however, many resources we put into medical training, to expect Nigerian doctors to stay after the frustrations of years of strike and stagnation, unmanageable workloads and terrible service conditions, hyperinflation and growing insecurity is to expect them to act entirely against their own interest. In this atmosphere, it is hard to resist somewhere with better facilities and working environment, higher salaries, career progression, an improved quality of life and better opportunities for their children.
Without a doubt, the emigration of skilled workers can become a huge problem if it drains much-needed resources from critical sectors – and this is certainly happening in our health sector. At the moment, we have only 35,000 doctors for our 206 million people. That is just a doctor for virtually every 4,900 Nigerians. With the third wave of COVID-19 and cholera outbreaks across Nigeria, the pressure on our fragile health service may have catastrophic consequences for our present and our children’s futures. Of course, a dearth of credible, up-to-date data leaves us in the dark over precisely what consequences we will face, but any consolation we may derive from our ignorance is false and destructive.
But the emigration of skilled workers is not intrinsically bad. The problems we face in this key sector is a negative consequence of a generally positive Nigerian characteristic. Our citizens are found working all over the world and if we are smart and strategic, this can be a huge benefit to our country. For one thing, remittances to friends and family and investments by nationals working abroad can be a big contributor to diversifying our economy, alleviating poverty and building our infrastructure. In Kenya, the millions of dollars remitted by Kenyans working elsewhere is presently the country’s greatest source of foreign income, propping up the country’s economy, which is otherwise reliant on tourism, is reeling from the impact of the COVID-19 pandemic.
Having received over $40 billion in remittances in 2019 and 2020 (even despite COVID-19), Nigeria is Africa’s number one receiver of remittances, but given the size of our population and reputation for industry, we can earn far more if we are strategic. With innovation, we can turn exporting skilled labour into a goldmine, especially now that crude oil is increasingly becoming unviable. What this requires is a comprehensive plan and proper implementation. Our population is expected to surpass 300 million by 2050, taking us from the 7th to the 3rd most populous country in the world. Our country’s median age, currently 18.1 years, will fall even further, so there will be millions of young, economically productive Nigerians. On the other hand, the Western world’s ageing population and skilled labour shortage will worsen, while the Gulf is full of rich countries with an acute human resource shortfall.
We should make the production and export of our best brains an economic priority, with appropriate allocation of resources. We should harness our human talent to become the major supplier of both high and lower-level professionals and workers such as health workers, engineers, plumbers, carpenters and tailors. To achieve this, our higher institutions of learning would need to be reformed to produce a surplus of professionals, so that their emigration does not leave Nigeria undersupplied. We must modernise our vocational training institutions and skill centres and set up new ones to provide internationally recognised skills.
We also need to put in place robust domestic legal and policy frameworks and build bilateral agreements with countries needing our human talent on conditions of work and pay. This will not only ensure that Nigerians working abroad are protected from exploitation and domestic abuse by employers, but also that they will get the highest pay and the best working environment possible. With such care for our expatriates, we will be able to export more, import more remittances, and even tax overseas workers.
The talent and industry of Nigerian professionals and workers has been discovered across the globe and they will continue to be headhunted. The ‘brain drain’ is here to stay. The decision we need to make as a country, therefore, is whether we want to be deliberate about it and plan, or if we want to continue bewailing it and doing nothing. If we strategise, individual Nigerians and the country will be better for it. The alternative is that both Nigeria and its citizens will lose as brain drain continues to happen to us.
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