More doctors to leave Nigeria as COVID-19 gets worse in USA

• 9m Nigerians left in last 5 years
• Number higher than previous years

More doctors are likely to leave Nigeria as coronavirus (COVID-19) gets worse in the United States of America. This would be in addition to an estimated 9million Nigerians who left the country between 2014 and 2018.

As the COVID-19 pandemic takes its toll across the globe, health officials in the US had warned that the country’s coronavirus death toll could rise above 100,000 people. As a result of this development, instead of shutting its door against migrants as it did previously, America is luring foreign medical professionals seeking to work in their country.

Following reports in March that US was inviting medical professionals from other parts of the world, including Nigeria, to help in the fight against COVID-19 pandemic, which has claimed thousands of lives in that country, the president of the Nigerian Medical Association (NMA), Dr Francis Faduyile, said people had the right to work anywhere they chose. He, however, called on the government to strengthen the country’s health system to encourage more medical practitioners to stay behind.

This is even as inquiries at the US Embassy showed that only doctors and nurses who are already processing exchange and visitor programmes in the US are encouraged to seek the visa approval now. But potentially, this could impact negatively on the Nigerian health sector, as in the last five years, many doctors, among millions of other Nigerians, have left the country for greener pastures.

Already, the US health system relies heavily on immigrants, who make up 17 per cent of all health care workers and more than one in four doctors, according to a report .

Dr Joe Uba, a medical doctor with the Abia State Government, said he was looking forward to relocating from the country like many of his colleagues.

He identified Saudi Arabia and the United Kingdom (UK) as the preferred destinations for his colleagues.

However, with the growing interest of the US on foreign medical professionals, priorities will begin to change for Nigerian doctors, who are yearning to leave for greener pastures.

“I think every doctor would like to leave if given the opportunity. It is the cost of moving that is the problem. You could spend not less than N2.5 million to process it. But they pay very well, especially in Saudi Arabia,” Dr Uba said.

Also, Joseph Simon (not real name), an Abuja-based lawyer, has just returned from the UK, where he registered for an LL.M programme. He hopes to stay back there after studies.

“My short visit to London was to understand the procedure to relocate. I can only return to Nigeria if things improve. The best way is through the master’s programme,” he said, citing UK’s new policy which allows postgraduates to stay up to two years after graduation in search of jobs.

Data from the National Bureau of Statistics (NBS) shows that 1,361,580 individuals left the country in 2014. In 2015, 2,640,508 also left.

In 2016, the figure of emigrants dropped to 1,181,211, but rose marginally to 1,344,318 in 2017 and increased to 2,322,585 in 2018.

While the number of departures recorded for the country between 2014 and 2018 may not be permanent, the figure is higher than the numbers between 2005 and 2010, which remained between 900,000 and 100,000 migrants.

Data analysis of Nigerians leaving for greener pastures showed that people leaving the country are not restricted to skilled individuals. Even the unskilled are leaving the country in droves from both regular and irregular means.

For instance, the National Agency for the Prohibition of Trafficking in Persons (NAPTIP) reported that about 2,894 persons were rescued from irregular migrations between 2014 and 2018. Of this figure, 330 cases were reported in 2014; 285 in 2015; 320 in 2016; 1104 in 2017; and 855 in 2018.

These were persons who were involved in sexual exploitation outside Nigeria, external prostitution, forced labour outside Nigeria, armed conflict, illegal immigration and smuggling.

According to the Nigerian Immigration Service (NIS), about 4,364,668 Nigerians were issued with new passports between 2014 and 2018. But besides being a national identification and travel data, this indicates travel source states or regular departure points of most Nigerians.

A breakdown of passports issued between 2014 and 2018 showed that the South-West has the highest number, at 650,958 new passports issued. Lagos has the highest number (1,264,528), followed by Oyo (233,004), Ogun (166,920), Osun (109,016), Ondo (91,161) and Ekiti (50,857).

The South-South came second, with Edo topping at 172,435 new passports. About 158,304 received their passports from Delta, while 157,177 received in Rivers, followed by Akwa Ibom (41,042), Bayelsa (38,100) and Cross River (26,806).

The North-West came third with 484,766. Kano received 169,941 within the period while Kaduna got 110,856; Katsina, 68,132; Jigawa, 40,793; Sokoto, 36,932; Kebbi, 29,735 and Zamfara, 28,377.

In the South-East, Enugu and Imo received the fourth highest number of new passports issued, at 440,228. While Imo had 126,049, Enugu was second with 99,416. Others are Anambra (97,579), Abia (95,236) and Ebonyi (22,008).

In the North-Central, 320,024 new passports were issued. Out of this number, Plateau had 109,016 while Niger had 77,354. Others are Kwara (71,565), Kogi (28,766), Benue (17,890) and Nasarawa (15,433).

Also, 511,059 new passports were issued in the Federal Capital Territory (FCT).

In the same period, the North-East had 137,332 new passports. Borno recorded the highest number with 29,977, followed by Gombe (26,965). Others are Adamawa (26,157), Bauchi (25,026) and Taraba (15,852).

Major destinations for Nigerians

Reports show that countries such as USA, UK, Saudi Arabia, South Africa, Cameroun, Italy, Cote d’Ivoire, Benin Republic, Australia, UAE and Canada are top destinations for skilled Nigerians, while some European and Asian countries are top destinations for Nigerians without much skills.

The Canadian government estimates that Nigeria ranks third in the countries that have received the highest number of Canadian Express Entry in 2018 under the ITA scheme, which is usually offered to software engineers and developers, behind China and India in second and first respectively. While 6,025 Nigerians received the offer, 6,248 Chinese and 41,675 India received it the same year respectively.

Canada welcomed 341,000 immigrants in 2019 under its skilled labour programme; about 10,000 of them are Nigerians. It is a steady increase as only 2,000 Nigerians were received in 2015; 4,000 in 2016; 6,000 in 2017; 8,000 in 2018 and 10,000 in 2019.

With the US visa ban on Nigeria in place, more Nigerians are expected to head north in the coming years. However, with the recent US demand for foreign medical professionals, Nigerian doctors and nurses may likely use the window of opportunity.  Canada is projected to welcome 700,000 immigrants as permanent residents before the end of this year, which makes it an attractive destination for Nigerians of all categories.

The National Diaspora Commission estimates that between 5million and 15million Nigerians now live abroad. And some of the best brains go to these countries.

Although there are concerns of loss of skilled workers in critical sectors of Nigeria’s economy, the NBS figures showed that as Nigerians left the country in droves within the last five years, remittances from the Diaspora has risen steadily to $25.08bn in 2019, up from $3bn in 2013.

Leaving for greener pastures

The serious economic hardship in the country has been pointed out as the major reason for the departures. Specifically, migrations are spiked by the high unemployment rate, which the NBS put at 23.13 per cent in quarter three of 2018, with a steady increase from 12.5 per cent in 2014.

Other factors include insecurity and poor infrastructure to support decent living, over taxation, high poverty rate, population explosion, climate change and environmental degradation, corruption, low access to credit, absence of meritocracy in public appointments, poor public health system, poor remuneration for workers, and among others.

Similarly, the World Data Lab, in its latest update, found that of the 201,623,008 total population of Nigeria, 95,903,776 people, representing 48 per cent of the population live in extreme poverty, which is defined to mean that they earn less than $2 a day.

Chilaka Anthony, a travel agent and frequent traveller, identified the economic situation in the country as the major reason more Nigerians are leaving the country. He disclosed that the situation is so critical that parents who fund their children’s studies overseas in international universities encourage them to find a way to stay back in those countries.

“The economic situation in the country has deteriorated, to the extent that we don’t know what to say. Many that pretend to be travelling for studies are actually intending to leave the country for good,” he said.

Also, Hillary Anosike, who has a business centre at the Chinese Visa Centre, said a lot of Nigerians travelled to China to buy cheaper goods and return to sell because of the high manufacturing rate in that country. He believes that the goods from China, which are cheap and competitive, are helping to sustain livelihoods for Nigerians who run small shops.

Writing on how climate change has affected migration, Ochiaka Ugwu, a journalist, stated that many people who engaged in agriculture in Nigeria had been forced to leave due to desertification, receding rivers, streams and lakes.

“Look at the herders-farmers clashes. Because streams and grasses are drying and pastures are disappearing, they are moving to locations where lands are greener, and in the process, they clash with farmers,” he stated.

But as more Nigerians leave the country, other nationals find it attractive. Nigeria is becoming a major economic host country for some intraregional migrants within the Economic Community of West African States (ECOWAS) with low skills. This has been projected to increase, given the recent Federal Government’s new visa-on-arrival policy, which was recently suspended as a result of the ravaging COVID-19 pandemic.

Nigeria’s loss, others’ gain

At the launch of the Nigeria Health Workforce Country Profile, 2018 and handover of the Nigeria Health Workforce Registry by the Ministry of Health, in collaboration with the World Health Organisation (WHO) and other partners, Human Resources for Health, Ministry of Health, Shakuri Kadiri, said Nigeria had only one doctor to 2,753 patients. He put the number of medical doctors registered with the Medical and Dental Council of Nigeria at 74,543; implying that there are 36.3 medical doctors per 100,000 population.

Of these registered medical practitioners in Nigeria, many have left the country due to the unconducive environment for practice. And the situation is expected to worsen with the recent US enticement.

A 2019 survey showed that about 2,000 Nigerian doctors leave annually. This has caused substandard medical care for Nigerian patients. The growing medical tourism by Nigerians, with a huge impact on foreign exchange, has been directly attributed to this.

The spokesman of the NIS, James Sunday, a Deputy Comptroller of Immigration, said travellers provided different reasons for their trips, but in some cases, as humans, what they gave as reasons may not actually be the reason for the travel.

He added that the responsibility of the NIS is just to capture individuals’ data and cross-check if there are criminal objections to their trips. He explained that once such criteria are met, they are allowed to go, as it would be against their fundamental rights to do otherwise.

“If you fall within the eligibility category for immigration, we allow you to travel,” he said.

The International Organisation for Migration (IOM) rates Nigeria as one of the largest origins of international migrants.

“Nigeria has continued to experience high internal and external migration due to its population, economic climate and porous borders,” IOM stated on its website.

On the way forward, a professor of Political Science in the University of Abuja, Yusuf Ali Zoaka, said the solution for the perennial issue of Nigerians leaving the country for greener pastures was to develop the country and put in place, “necessary facilities” that would keep Nigerians in their country. He said government should develop the country by creating the necessary facilities.

Also, the director, Centre for China Studies, Charles Onunaiju, said necessary incentives and creating the enabling environment for creativity, research and professionalism in Nigeria would encourage more professionals and other citizens to stay back and even attract the best brains outside the country.

“It is important for the government to entrench a system where merit, rather than where a person comes from, determines their position,” Onunaiju said.

Meanwhile, Nigeria’s Minister of Health, Dr Osagie Ehanire, said government had started working to obtain accurate data on the existing health workforce in the country to facilitate human resource for health planning, and thereby deliver efficient, effective and high quality health services to citizens.

He stated this at the launch of the Nigeria Health Workforce Country Profile 2018 and handover of the Nigeria Health Workforce Registry by his ministry.

This report was supported by Code for Africa, via its Academy Hacks/Hackers Community Initiative