OBVIOUSLY cashing in on the simmering discontent among medical practitioners in Nigeria’s health sector, Saudi Arabia, in partnership with some recruitment consultants, recently offered them a way of escape to work in the oil-rich Middle East country. In a widely circulated ‘Important Notice’ in the media, the Saudi Arabian authorities, declared, “There will be an interview session with the Ministry of Health delegates, Kingdom of Saudi Arabia, for consultants and specialists in all specialities, slated for 24th August 2021 at Sheraton Hotel, Abuja.” Earlier, it had held the Lagos leg of the exercise without much fuss.

This is a sad commentary on the country’s already challenged health sector. It has continued to retrogress over the years due to several factors, which include gross underfunding, poor remuneration of health workers and government neglect. Incidentally, one major reason the masterminds of the 1983 coup d’état that ousted the Shehu Shagari government gave to justify their action was that the country’s hospitals had become “mere consulting clinics.”

In the speech announcing the overthrow of the government, Sani Abacha (then a brigadier-general) lamented, “Health services are in (a) shambles as our hospitals are reduced to mere consulting clinics without drugs, water and equipment.” Depressingly, 38 years after, the last 22 years under civilian rule, not much improvement has been witnessed in the sector. Currently, resident doctors are on a long-drawn strike to demand better conditions of service and improved funding of the sector. With the mass exodus of doctors fleeing an increasingly hostile work and economic environment, if care is not taken, there will be nobody to consult at the decayed “clinics” again. That is a dire situation that demands action.

Things have deteriorated in the sector so much that even the President, Major General Muhammadu Buhari (retd.), alongside the political elite, does not trust the country’s hospitals enough for his medical needs. Instead, he resorts to medical tourism in the United Kingdom at huge public huge expense. The British Broadcasting Corporation says Nigeria spends about $1billion annually on medical tourism, particularly to India.

Consequently, doctors are now jumping at every opportunity to move out in droves as exemplified by the Saudi Arabian recruitment. This should be addressed.

In fact, this is the second time in less than three years that the Saudi authorities would directly come shopping for Nigerian doctors to revitalise and reinvigorate their own healthcare system. In the well-advertised recruitment held in Abuja and Lagos, hundreds of doctors made up consultants, specialists, and other related experts in all medical fields except psychiatry, with varying years of experience, trooped out to the two venues. An account put their number at about 500. The specialties of those interviewed included anaesthesia, ICU, paediatrics surgery, family medicine (consultants only), obstetrics and gynaecology, ENT, emergency medicine, all sub-specialties (surgery), all sub-specialties (internal medicine), orthopaedic surgery, ophthalmology, radiology as well as haematology and histopathology.

This could potentially sound the death knell on the country’s health sector currently challenged by a dearth of medical doctors. Statistics from Nigeria HealthWatch indicate that there are 80,000 doctors registered with the Medical and Dental Council of Nigeria as of June 2021, out of which only about 35,000 are practising in the country. The rest are practising overseas – with about 4,000 in the United States and 5,000 others in the UK – while a few moved to other professions.

This means only 35,000 doctors are overseeing the health needs of over 200 million Nigerians. This is grossly inadequate. The World Health Organisation recommends a one-doctor-to-600-patients ratio for member countries, to achieve the Sustainable Development Goals targets in health provisioning. The Organisation for Economic Cooperation and Development says that while India attained this milestone in 2018, 44 per cent of the WHO member countries have less than one medical doctor to 1,000 citizens. Nigeria, for instance, has a paltry 0.3 to 1,000 citizens, compared to 1.8 for China, 2.6 for the UK, 2.8 for the US, 4.3 for Sweden and 5.83 for Italy. Put differently, the country has one doctor attending to 5,000 patients. Bizarrely, the Minister of Labour and Employment, Chris Ngige, himself a medical doctor, once falsely claimed Nigeria had a surplus of medical doctors and could afford their exodus to other countries. This is preposterous.

The Buhari regime responded to the embarrassment by sending operatives of the State Security Services to disperse the applicants at the Abuja venue on the second day, thereby bringing the exercise to an abrupt end. That, unfortunately, is not a sustainable measure to end the brain drain phenomenon in the sector. Rather, it is a brazen violation of rights. Individuals have a right to seek greener pastures and pursue career fulfilment anywhere they desire.

Instead of resorting to highhandedness, the Federal Government should sincerely address the multifarious challenges bedevilling the health sector. For instance, Nigeria and other member states of the African Union in the Abuja Declaration of 2001 committed to allocating at least 15 per cent of their national budgets to health. Sadly, the country has never gone beyond six per cent in the last 18 years. Except for the 2021 health budget of N547billion, amounting to seven per cent, the health budget has been less than five per cent. The 2019 budget was a beggarly 3.4 per cent. A recent report by a real estate consultancy, Knight Frank, estimates that Nigeria would “require 386,000 additional beds and $82 billion of investment in health-care real estate assets to reach the global average of 2.7 beds per thousand people.”

Figures from the World Bank are similarly depressing. Nigeria’s public spending on healthcare amounts to just 3.89 per cent of its $495 billion GDP, compared to 8.25 per cent in South Africa and 5.17 per cent in Kenya. In 20 years, recurrent expenses gulp 78 per cent of the total health expenditure, while capital takes only 22 per cent. Comparing the growth rate, recurrent expenditure increased by 2,822 per cent between 2001 and 2021, while capital expenditure increased by just over 400 per cent.

If the government genuinely wants an end to the debilitating brain drain syndrome in the sector, it should take the bull by the horns by making the environment conducive for the practitioners.

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