In a recent encounter with a Nigerian doctor, when in hospital recovering from an illness, 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 more 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 garners from those long hours of forced idleness when admitted in hospital, this particular hospital gets a number of cases.
Imagine the irony: whereas the individual hopes to suffer less 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 (UK) or the United States (US), the experience does not always turn out as dreamed of. Racism is usually a problem. And career mistakes are punished severely. Nonetheless, those with some training in these parts (West Africa) 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 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 often give back in the form of free surgeries and so on.
How many Nigerian doctors actually seek greener pastures abroad? More than 60% 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 aspiring Nigerian doctors.
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The exodus comes at great costs for the country, though. There is one doctor for about 4,000 Nigerians at the moment. With more doctors heading abroad, that statistic would only get worse by the day. 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 best locally.
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 requires 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 my recent forced interaction with the medical world, 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.
– Rafiq Raji