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Our health sector conundrum

Two videos that circulated in the media last week and were forwarded many times, verily exposed the quagmire our health sector has sunk into. The first was an, seemingly, innocuous exercise of recruitment of medical personnel by the Kingdom of Saudi Arabia (KSA). The recruitment exercise was staged at the Sheraton Hotel Abuja. It would probably not be the first time this recruitment drive was openly carried in Abuja or in other centres around the country by the Saudi Authorities or other countries preying on our burgeoning medical personnel industry. What made this exercise noteworthy was its timing: It was undertaken in the heat of an ongoing national strike by the National Association of Resident Doctors (NARD). Since by the sheer number of the members of the NARD in the medical services, about 40 per cent of the medical doctors, they constitute the backbone of most of the government hospitals.

What made the video to stand out was the graphic visuals of our trained medical personnel, sorely needed in our hospitals, now negotiating for letters of contract appointments that would keep their services away from the country for at least a number of years. The video also contained comments, most of it unsavoury, by the affected personnel expressing their relief in getting away from what they regard as a stuffy and suffocating system and looking forward to work in an Eldorado of sorts where their services would be valued and they would have working tools and the right atmosphere to perform and prosper.

The second video that is closely related to the forgoing is the interview on Channels TV conducted by the anchor, Maupe Ogun with the Minister of Labour and Employment, Dr Chris Ngige. Responding to a specific question on the recruitment of medical personnel, the minister replied in his usual deadpan manner that he saw nothing wrong with that. He claimed that this country has surplus doctors and there would be nothing untoward if some go out to gain experience and earn some foreign exchange for the nation. He claimed that at some point in the 1970s and 80s this country had also employed large number of foreign nationals – Indians, Pakistanis, Egyptians, etc., –  as medical doctors and other professionals because those countries had surplus.

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To say the least, I was flabbergasted by the insensitivity of his assertions – for many reasons. For one, Chris Ngige is a medical doctor. Secondly, he is a second term minster of the Federal Republic and had also served in the preceding years as governor of Anambra State and thereafter as a Senator representing Anambra Central. In the earlier years, post-graduation, he was a staff of the Federal Ministry of Health where he rose to the position of Deputy Director before he retired in 1998. For a person of this rich public service background, I guess he must be aware of the sordid statistics in the health sector particularly as it affects government hospitals at all levels. He could be right that we have many doctors without jobs, but as he very well knows, this is because many government hospitals have not generated the right capacity to absorb them. He knows that there are many government hospitals deep in the rural areas without doctors. It would be the height of sophistry to continue to argue that we have surplus doctors.

To compound matters, Dr Ngige, as Minister of Labour, is at the centre of the negotiations with the leadership of the NARD who have had a number of strikes before the present one all bordering on the same issues of better pay and improved working conditions. Now with a minister negotiating on behalf of the government, displaying such condescending attitude to NARD, on the opposite side of the table, it is no wonder that they would find no common grounds to agree. In the next few days, the matter would even become more complicated as the Nigerian Medical Association (NMA) has given notice to the government to level up with NARD failing which they would also throw in their hats in the ring.

The last time I checked, there were over seventy thousand doctors registered with the Medical and Dental Council of Nigeria (MDCN) as well as with the NMA, though close to half of that number were said to be practising abroad. The World Health Organisation’ standard is one doctor to six hundred people but in Nigeria, sadly, it is one doctor to five thousand people. If one digs further, these statistics might not even reflect the Nigerian reality, as most of our doctors are congregated within a few urban centres leaving the majority rural areas with a paltry few.

Now with our doctors leaving in droves for greener pastures abroad, that ratio of 1:5000 is bound to be reviewed upwards, to the eternal shame of our government. The country is now in the midst of the COVID-19 pandemic and an outbreak of cholera and doctors are expected to be the frontline health workers in the battles against these killer diseases. Half of the doctors expected to be in the frontline are on strike for close to a month now. Yet the minister leading the negotiations is telling us that the doctors can as well leave the country if they so wish. Unbelievable! Isn’t it?

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