Buhari’s lamentation on brain drain in the health sector

LAST week, President Muhammadu Buhari touched on a sore point for many Nigerians when he lamented the brain drain in the country’s health sector, admitting that the exodus of doctors and nurses from West African countries was detrimental to the needs of the citizenry. Speaking at the virtual groundbreaking ceremony of the African Medical Centre of Excellence (ACME), a hospital project being implemented by African Export–Import Bank (Afreximbank) in partnership with the Federal Government, Kings College Hospital, London; University of Winsconsin Teaching Hospital, USA and Christies Hospital, Manchester and which is expected to significantly transform the healthcare sector in the West African sub-region, Buhari observed that the problem of inadequate health facilities had been further exacerbated by the significant brain drain experienced by the continent. As he noted, the flight of doctors and nurses to other continents had resulted in a significant gap between the required treatments for non-communicable diseases (NCDs) and the available treatment and care. In his view, stronger partnership with the private sector would help in improving health facilities and access in the country.

The president said that in addition to providing comprehensive care across the three critical care areas, the AMCE,  a 500-bed specialist facility expected to provide services in the areas of oncology, cardiology, and haematology and address the significant shortage of clinical care options in the West African sub-region, would offer educational services to develop talent and establish itself as a world-class research centre. He said: “The success of the AMCE will pave the way for future investments and partnerships in the sector while raising the local standard of healthcare and providing a blueprint for quality of services required to address Nigeria’s and Africa’s healthcare and economic challenges. The AMCE represents a return to fundamentals, and the understanding that there is no African development agenda without able-bodied Africans to execute our vision of transformation.”

Buhari is indeed correct in his submission that the rising NCD burden coupled with inadequate medical infrastructure on the continent threatens the future of the West African people, as many hospitals in the region are underfunded, under-equipped, understaffed and relatively inaccessible to most patients, especially from the rural areas, and that these challenges combine to create a regional health market with poor access to critical services and low perception of quality of care available. It is indeed an alien from Mars who would dispute Buhari’s averment that brain drain has created a gap in the provision of quality medical treatment in Africa, and that international partnerships such as those represented by the AMCE project would to a large extent address some of the health needs of the West African sub-region. But the critical question is what Buhari and his colleagues in the sub-region are doing to address the extant challenges. In Nigeria, it is a fact that since the return to civil rule in 1999, public hospitals have struggled to transcend the limitations which caused the late Head of State, General Sani Abacha, to tag them as “mere consulting clinics.” To be sure, there have been efforts to refurbish and re-equip the universities over the years, including the Olusegun Obasanjo administration’s project of giving university teaching hospitals a facelift, but such efforts have been few and far between, and below par. Thus, having correctly identified what the problems are, President Buhari is duty-bound to outline the steps he hopes to take to address them. Sadly, that has not been done till date.

In recent editorials, we have had occasion to deplore the massive exodus of doctors and nurses from Nigeria over poor working conditions. Amidst the ravages of the coronavirus pandemic, the Republic of Saudi Arabia recruited Nigerian doctors willing to transfer their services to the country, thus leaving Nigerians in a difficult position. Worse still, although the country is critically short-staffed in the health sector, Dr. Chris Ngige, the Minister of Labour and Employment, once declared unabashedly that the country had nothing to worry about, as it had enough doctors!  Speaking during a television programme while responding to a question on brain drain and the deliberate recruitment of Nigerian doctors by foreign embassies in April 2019, the minister, himself a medical doctor, claimed that Nigeria had 350,000 medical doctors, far more than the 260,000 which, according to him, the World Health Organisation (WHO) prescribed for the country. His words: “I am not worried about doctors leaving the country. We have surplus. If you have surplus, you export…We have surplus in the medical profession in our country. I can tell you this.”

But the then president of the Nigerian Medical Association (NMA), Dr. Francis Faduyile, refuted Ngige’s claim. Faduyile said  that Nigeria had 75,000 registered doctors, out of which only about 40,000 were practising in the country. On his part, the Minister of Health, Dr. Osagie Ehanire, has often failed to adopt a conciliatory tone while dealing with the demands of striking doctors. It is thus safe to submit that the official reaction by the federal cabinet to the welfare of healthcare professionals in the country is poor. If the government does not see working hard to retain healthcare professionals in the country as a priority, then there is no point dissipating energy on brain drain rhetoric. To be sure, no one can blame healthcare professionals in the country for wanting a better life, and neither can other countries be blamed for employing them if they are qualified and they (those countries) need them.

The foregoing should lead no one to conclude that the problems in the health sector are those of the central government alone. The fact is that sub-national governments have not exactly covered themselves in glory in that regard. There is therefore a need for demonstrable change at all levels. Those who cannot guarantee that have no business occupying political office.