By Rafiq Raji, PhD
In a recent encounter with a Nigerian doctor, as one recovered from the inevitable failures of the human body that tend to occur from time to time, it emerged the owner of the soothing voice that aided one’s convalescence was unhappy. Not with her patient, a challenging case no less, but with her career in her country of birth. And she is one of the fortunate ones. As a doctor in a private hospital in a highbrow area of Lagos, she was relatively well-paid. And judging from what one garnered from those long hours of forced idleness, there is a lot that gets by the hospital’s way in terms of cases. Imagine the irony: whereas the individual hopes to suffer little afflictions, if at all, the doctor’s joy comes from a case worth his or her time. The more complicated, the better. Still, a doctor’s experience, even in the best teaching hospital in the country, pales in comparison to that of lesser professionals in Europe and elsewhere. Money is also a huge motivating factor. Still, whether in the United Kingdom or the United States, the experience does not always turn out as dreamed. Racism is usually a problem. And career mistakes are punished severely. Nonetheless, those with some training in these climes beforehand are able to easily bank on a coping mechanism honed during their grinding student days.
Whereas other professionals, in financial services, law, and so on, could easily keep abreast of developments in their sectors, whether they are in their country or abroad, the peculiarities of the medical profession and rapid technological advances in the sector mean practitioners not adept in the most advanced and recent practices would find themselves no more than quacks over time. Ironically, being initially trained in Nigeria allows for mastery in the old-school ways of medicine that tend to come in handy in chiller climes where practitioners have become “spoilt” with various technological aids. And in fact, the continent is wealthier by the experience garnered by its medical professionals abroad, who whence accomplished often give back in the form of free surgeries and so on.
But how many Nigerian doctors actually seek greener pastures abroad? More than 60 percent of registered Nigerian doctors practice abroad. Most of the remainder who grudgingly ply their trade locally plan to cross the seas at the slightest opportunity. And despite the backlash against migrants in Europe and elsewhere, doctors and other advanced professionals are actively courted. Not entirely. The UK put a cap on the migration of skilled non-EU workers recently. Short of medical staff, the government has reversed itself. Now, migrant doctors with firm offers from UK hospitals do not have to worry about getting a visa: they will get placed. No doubt music to the ears of many expectant Nigerian doctors.
The exodus comes at great costs for the country, though. There is 1 doctor for about 4,000 Nigerians at the moment. With more doctors heading abroad, that statistic would only get worse by the day. And were the situation ideal, quality healthcare is out of the reach of those that need it the most. The privileged, who can afford healthcare anywhere in the world, are ironically the ones with the means to avail themselves of the local best. To be fair, the authorities are not insensitive to the problem. A compulsory health insurance scheme for Nigerians in paid employment means almost anyone with a job would be able to afford basic and secondary medical care. Of course, it is another matter if the ailment is more advanced and require extensive, sustained care; and perhaps more abroad. A newly instituted patients’ bill of rights also means that any Nigerian, of any means, would not be subject to the gross abuse that many poor patients, who also tend to be ignorant of their rights, get subjected to with impunity. What would prevail in practice is another matter, though. During one’s recent forced interaction with the medical universe, each stage of treatment was presaged by a business executive brandishing a point-of-sale terminal: swipe your card, get treated. Quality medical care in Nigeria remains exclusive.
Also published in my BusinessDay Nigeria newspaper column (Tuesdays). See link viz. https://www.businessdayonline.com/columnist/rafiq-raji/article/stopthekillings-nigerian-doctors-still-see-gold-abroad/