As a failing electric grid further burdens the creaking health system, doctors continue to seek opportunities abroad
The waiting rooms at the Ifako Ijaiye hospital in Lagos are overcrowded with patients waiting to see doctors. Often people have to stand outside.
“It is now like this every day. We have to come early and pick numbers before we can meet the doctors. Even though the doctors try to see everybody, it has got worse,” says Oluchi Ezegbo, a market trader from Okearo, in nearby Ogun state.
Ezegbo came here as it is the closest government-owned doctor’s surgery to her home. Even though the distance is only 4.3km (2.7 miles), the roads are in very poor condition and the journey takes more than an hour.
When she was here for an appointment in October, the power went out. “I was not connected to a machine that needs electricity to function, but what if it was in the middle of surgery?” Ezegbo asks.
Power cuts, low pay and challenging work conditions for medical professionals are compounded by Nigeria’s larger problems of economic instability, insecurity and nepotism in recruitment processes, resulting in many doctors leaving the country.
“I left to work in a system that worked and also to have a better quality of life,” says Dr Olufunmilayo Harvey, a Nigerian doctor now working in the UK.
“There were situations where doctors were performing surgeries and carrying out deliveries using torchlight. There is a serious systemic problem with the medical system in the country that worsens the mortality rate.”
According to the Nigerian Medical Association, of the 75,000 doctors registered in the country, about 40,000 practice outside Nigeria. In the UK alone, it is estimated that 12 doctors from Nigeria are registered every week, with more than 5,250 Nigerian doctors already working there.
Nigeria faces a host of healthcare problems, from budget limitations, lack of support infrastructure, mismanagement and poor governance. The proposed 2020 budget of the Federal Ministry of Health is 427bn Nigerian naira (£0.9bn), which amounts to about 4% of the budget. This is despite a 2001 pledge of 15% of the national budget towards healthcare by member nations of the African Union.
The lack of allocation of funds to the health sector has led to understaffed and underfunded medical centres. In some states in Nigeria, doctors are owed salaries, leading to strikes that often last for months. Patients are forced to sleep on bare floors and battle mosquitoes in teaching hospitals across the country.
The frequent trips of the president, Muhammadu Buhari, to Britain to seek medical help for an undisclosed illness are noted with irony by Nigeria’s poorest.
A general state of mismanagement accounts for a lack of electricity in Africa’s most populated country. Despite continuous huge investments in power, Nigeria has suffered over 206 grid collapses in nine years with as many as 12 in 2019. This problem has resulted in doctors performing surgeries using candles, lamps and mobile phones.
Even in the better-funded private sector doctors are leaving, due to shortages of equipment and drugs. One told The Guardian that doctors often earn just N450 Naira (90p) per hour even in private hospitals.
Victims of gunshot wounds could previously not be treated in Nigerian hospitals without presenting a police report, a policy that led to several deaths. The Compulsory Treatment and Care for Victims of Gunshot Act, introduced by Buhari in 2017, was intended to end this practice, but some doctors claim the legislation is not always enforced and that police might still extort them if they treat patients with gunshot wounds.
Last month, a 28-year-old podcast host who had been stabbed in the neck by armed robbers in the Gbagada area of Lagos died after being rushed to a hospital. According to her fiance, she was allegedly rejected at the gate because a police report was not presented. The hospital denied the claim, saying she had been referred to a another hospital.
A few Nigerian startups are looking to improve the medical skills shortage. After practising for more than seven years in Nigeria, Dr Debo Odulana started a company to connect patients and professionals.
“I was interested in becoming a neonatal surgeon, but I could not find any consultant to train me in the country, so my company Doctoora is an aggregation of medical experts that are generally absent in the country,” Odulana says.
Despite evidence of growing numbers of doctors looking outside the country for residency programmes, the Nigerian minister of labour and employment, Dr Chris Ngige, has said there are enough medical personnel in Nigeria. The Nigerian minister of health, Prof Isaac Folorunso Adewole, also claims that the ratio of one doctor to 5,000 people in Nigeria is better than other African countries.
The World Health Organization regards countries with less than 10 doctors per 10,000 people to have an “insufficient” number of medical personnel.
Ifeanyi Nsofor, director of policy and advocacy at Nigeria Health Watch and Atlantic fellow for health equity at George Washington University in the US, believes that there is a solution. “Mandatory state health insurance schemes are gaining speed in the country and I believe that if people have health insurance, there will be money available to hospitals for their development and to hire more staff.”
Currently, less than 5% of Nigerians are covered by the Nigerian national health insurance scheme.
Ezegbo is not covered by health insurance, but says she is lucky to be able to get some services for free.
“I have not had to pay for any surgeries and it is mostly the drugs that are expensive. I don’t have the money to pay for any extra medical bills. School fees and rent already eat up my money.”
BREAKING: ONDO HEALTH COMMISSIONER DIES OF CORONAVIRUS
Ondo state commissioner for Health, Dr Wahab Adegbenro has died of COVID- 19 infections
Adegbenro was said to have died at the state infectious disease hospital.
His death came a day after Governor Rotimi Akeredolu announced that he has tested positive for COVID- 19.
A native of Ilara-Mokin, Ifedore, Adegbenro could not survive
BREAKING: Nigeria Records 553 New Cases of COVID-19
Nigeria has recorded the highest number of daily new cases of COVID-19.
The Nigeria Centre for Disease Control, NCDC tweetedthat the five hundred and fifty three (553) new cases of COVID-19 were reported as follows;Lagos-378
The total number of confirmed cases in Nigeria now stands at nine thousand eight hundred and fifty five (9855), 2856 has been discharged and the number of deaths increased to 273.
553 NEW CASES OF #COVID19;
9855 CASES OF #COVID19NIGERIA
— NCDC (@NCDCGOV) MAY 30, 2020
Below is a breakdown of the cases according to states;
Stop Asking Me About Chinese Doctors, Minister Of Health Tells Nigerians
The Minister of Health, Dr Osagie Ehanire, on Thursday, said he would really be grateful if Nigerians stopped asking him about the whereabouts of the Chinese medical team.
He said; “On the Chinese Doctors, I want to, first of all, explain that I think not all of them were doctors and I think that I heard that some of them are Technicians but they are staff of CCECC.
“The Ministry of Health is not their host. So, we cannot always explain what happened to them or where they are. There seems to be a lot of interest in these doctors but they are staff of the company and I think they are on the company visa.
“So, I will be very happy if you do not ask me about where they are because they are not really our guests in that sense. But we have been able to learn some things from them by interacting with them on their experiences in their country.We have shared experiences as to what they did in their country, how they managed their Covid-19”.
Vanguard recalls that the PTF had on April 6 defended the coming of the Chinese team, saying every country needs all the help it can get and that even the “almighty United States of America USA” is seeking external help.
According to the PTF, the Chinese will only offer their experiences and expertise as they are not accredited by the Medical and Dental Council of Nigeria to ply their trade in the country. He, however, said no country on earth has greater experience than China when it comes to managing the Covid-19.
The SGF had said; “One major support that has attracted public commentaries is the offer by CCECC, a Chinese company to import about 256 equipment and items in different quantities, notable amongst which are, 1,300,000 medical masks, over 150,000 pieces of assorted personal protective equipment as well as 50 medical ventilators.
“The company has also proposed, on its own, to sponsor public health experts to help strengthen our public health capacity and advise on processes and procedures.
“However, I wish to clarify that all Countries of the world are seeking assistance and are receiving help in the fight against COVID-19. Even the ‘almighty’ United States is looking for heal elsewhere.
“The support coming from China is a Corporate Social Responsibility initiative by CCECC, a company with total value of infrastructure contracts worth over $10 billion in Nigeria.
“The professionals that have been invited from China are public health specialists and medical engineers that will support Nigeria’s capacity in managing the Pandemic on advisory basis when necessary while drawing from the experience of the Chinese.
“In no way shall there be case management and interface with patients. They will train our manpower, advise on procedures and methods, install and test the equipment donated before handing them over.
“I, therefore, use this medium to appeal to our medical professionals to see the positive aspects of this gesture as an extension of development in the field of medicine.
The PTF recognizes and respects the competence and capability of Nigerian Doctors and other medical personnel.This is a state of war against the coronavirus and time should not be devoted to unhelpful controversies”.