Politicians, others must respect doctors, stop foreign medical trips – Enabuele

Dr. Osahon Enabulele is the former President, Nigerian Medical Association (NMA), Vice President Commonwealth Medical Association (CWMA) and Adviser, World Medical Association. He spoke on why more Nigerian doctors are going abroad to practice and proffered solutions.

What is responsible for the brain drain?

Nigeria will continue to experience brain drain of medical personnel, as long as federal, state and local governments have poor priority for the health of their citizens and for medical professionals, most of who compete favourably with their counterparts in the developed world.

One would have thought that recent governments in Nigeria would learn from the experiences of the past, particularly the massive brain drain of the 80s.

But it seems little or nothing has been learnt, hence the increasing mass exodus of medical professionals to other countries that have more hospitable work environments, better working conditions and better respect and recognition of their worth.

There are protean and multi-dimensional push and pull factors responsible for the exodus. Of prime importance in my view is the disconcerting disregard and disdain for Nigerian medical professionals by many of the country’s top political and public office holders.

The preference by President Muhammadu Buhari and other top political and public office holders easily demonstrates this.

So, since medical professionals are not well treated in their father and mother land, they seem to have decided to move to countries where these same political and public office holders will value their professional worth and accord them deserved respect.

Tied to this are the issues of appropriate remunerative benefits, working conditions and work environment, which still remains pitiably poor and non-competitive, compared to the much more alluring and competitive remunerative benefits and working conditions offered in the destination countries.

Along with this is the increasing unemployment and underemployment of medical professionals, due to the increasing contraction of job spaces and defective recruitment policies in many public and private health institutions.

There are also the issues of poor political commitment to the development of Nigeria’s health sector and the health of the citizens; rising state of insecurity, kidnapping and other violent crimes, as well as rising inflation and poverty, largely traceable to sustained poor governance and the perennially poor socio-economic and political engineering of the country by people who seem to have a very narrow understanding of the place of medical professionals and indeed the health sector in the socio-economic development of the country.

There is also the factor of Nigeria’s poorly developed private health sector and what younger medical personnel perceive as the increasing unattractiveness of postgraduate training programmes, particularly what they describe as prohibitive examination fees and failure rate at the exams, compared to postgraduate training experiences in most developed countries.

How can the situation be reversed, so that appropriate number of personnel would be available to deliver robust healthcare?

The first point here is for our political and public officers, including Mr. President, to respect the professional worth of medical personnel in Nigeria.

They need to patronise their expertise and accord them deserved respect. There is also the need for better and strategic human resource development planning, with competitive wages and improved working conditions offered to medical personnel.

In this regard, state governments yet to implement the corrected CONMESS circular for medical personnel are advised to do so immediately, if they are to retain their medical personnel. There is also the need to expand job vacancies and opportunities for all cadres of medical personnel.

The need for improved political commitment and budgeting for health cannot be overemphasised. So also are the need for improved socio-economic and political governance and the committed implementation of the National Health Act, including the strict implementation of one of its fundamental provisions restricting government sponsorship of foreign medical treatment for political and public office holders.

There is also the need for improved security and economic management with control of inflation and reduction of poverty. Certainly, the need for a holistic review of Nigeria’s undergraduate and postgraduate medical training institutions and structures cannot be overemphasised.

Where are the doctors going?

Information available to me points to the fact that Nigerian physicians migrate to countries in both developing and developed parts of the world, with current statistics showing a predilection for the United Kingdom, Canada, Australia, United Arab Emirates and South Africa.

What are the qualities in other climes that make them leave?

Better political commitment to health; better appreciation of the worth of medical personnel, along with better and competitive remuneration, better working conditions and inspiring work environment, better security and access to social amenities, attractive and globally respected postgraduate training programmes, etc.