Ngige, Nigerian Doctors Must Stay

Tunde Odediran writes that Minister of Labour and Productivity, Dr. Chris Ngige, must retract his recent statement on doctors entirely or allow someone who understands national development to run the ministry

The NMA says it's "unsafe for members to continue to provide healthcare services under the present confused arrangement" / Photo credit: thenationonlineng.net
The NMA says it's "unsafe for members to continue to provide healthcare services under the present confused arrangement" / Photo credit: thenationonlineng.net

The federal minister of labour is also a physician. His name is Dr. Chris Ngige.

In spite of being a physician and having a lengthy experience as a politician, Dr. Ngige wants medical doctors to start leaving Nigeria to practice abroad. This is not just because he imagines we have too many of them and opportunities for advancement are shrinking, but for the billions of dollars they could pour back into the economy at home.

In his original comments on national television and the revised version of his statements in the newspapers, the former governor and employer-general for the nation, declared we no longer have enough room to contain the doctors we train. The way out, he reasoned, is an exodus into the Diaspora market, where remittances become Nigeria’s gain.

The Labor Minister opined that it was always alright for nations to send highly skilled labour overseas when you have produced enough, while reminding us that many Nigerian students had been taught by Indians, Ghanaians and Pakistani teachers in the past. It was Nigeria’s turn to export excess capacity, he argued.

The minister is either ill-informed or suffers from myopia. For, with the abundance of technology professionals in Silicon Valley, the United States is always thirsty for computer experts.

In spite of the abundance of engineers in Germany, she keeps producing more of them and expanding its engineering prowess.

Not even China, with the world’s largest population and a well-educated workforce, is opening the door to emigration. India made this mistake many years ago, but has since found a way to grow talent and use their services within her borders.

Every nation needs an abundance of skills and talents to develop. Sending them to slavery abroad is a temporary solution that creates a permanent problem

It is almost as if Ngige just woke up from a 40-year slumber. But even if he did, he would have heard the Buhari-Idiagbon administration begging on Radio Nigeria that “Andrew” (a name representative of the Nigerian brain drain after the military took power in 1983) should not check out because, Nigeria needed him to survive.

Every nation needs an abundance of skills and talents to develop. Sending them to slavery abroad is a temporary solution that creates a permanent problem.

We cannot lose sight of the basic elements and ingredients of national development, simply because remittances from Nigerians in the Diaspora have become cheap money to the economy.

High-growth nations expanded their economies by exporting products, not human resources; and importing knowledge and technology.

It is mind-boggling that a minister of labour in any nation would see the export of knowledge and scarce skills as beneficial to national development.

One can understand the minister’s pedestrian thought process though. Diaspora remittances account for nearly 20 per cent of Nigeria’s GDP today, This is because they send back $25bn to families and friends per year.

In fact, Diaspora remittances have become a bit more important than petroleum to Nigeria’s economy.

Ngige is making a valid but twisted argument that should not be peddled by anyone in government.

This is because governments exist to solve complex problems and not look for easy solutions. As an official, whose role it is to create jobs and raise worker productivity, one has to wonder if he has not been assigned the wrong portfolio by the Buhari administration.

There is no nation that is doing well which sends highly skilled labour abroad

The minister is not just advocating brain drain, which no public official should support, he makes it look like the government has accepted its own failure to develop Nigeria, provide security to her citizens and guarantee a safe environment to fully harness the potentials of her people. Ngige has given up hope on Nigeria’s capability to weather the storm.

It is incredibly disturbing that such an experienced official would throw up his hands in total surrender and ask young doctors to look outside for opportunities Nigeria ought to provide to them as a right.

Clearly, Ngige is admitting that the Buhari administration has lost the ability to steer the ship, because his solution is tantamount to a parent selling the child into slavery to solve a financial problem.

Nations find it shameful to allow their citizens to seek opportunities abroad, and will do everything possible to avoid it; so, they do not encourage emigration of the professional class or propagate it as an answer to problems.

Therefore, the idea that Nigeria is better off when doctors and other highly skilled professionals leave is sick and demented.

The plan of a sane society would be to capitalise on such excess capacity by turning Nigeria into a medical Mecca, so that other nations may come to Nigeria on medical tourism as they do in India, Spain, Portugal and South Africa.

There is no nation that is doing well which sends highly skilled labour abroad. Cuba, which has the highest ratio of doctors in the world, is far poorer than Nigeria and keeps most of her doctors at home.

India, where I have had the opportunity to work closely with IT professionals, does not send her citizens abroad, not anymore.

Today, rich nations outsource jobs to India. As a low-cost economy, India is thriving, and so are her citizens, who are employed in their own country and keep the productivity optimally high, creating an economic multiplier effect that is good for the health of the local economy.

It is generally known that the gold standard for a good health system, which Ngige used, is a ratio of one doctor to 600 in a population

Instead of embracing developmental ideas that work, it seems the minister has not only given up on Nigeria, but is creating a self-serving solution with fudged numbers by claiming that Nigeria has created an abundance of doctors.

The labour minister’s facts are flat wrong. It is generally known that the gold standard for a good health system, which Ngige used, is a ratio of one doctor to 600 in a population.

My review shows that while Nigeria has progressively improved since independence, the ratio is still anywhere between 2,500 and 6,000 patients to a doctor. Better, but far off.

In fact, the Minister of Health, Professor Isaac Adewole, disagrees with Ngige too.

In a speech at the 38th Annual General Meeting and Scientific Conference of the National Association of Resident Doctors of Nigeria, he gave the ratio of one doctor to the over 4,000 population, which although is better when compared to many other African countries, is still lower than the standard of one doctor to 600 persons.

“The data obtained from the Medical and Dental Council of Nigeria as of May 30, revealed that 88,692 doctors are registered in their books.

Of these doctors, only 45,000 are currently practicing and that gives us a ratio one doctor to 4,088 persons,” Professor Adeosun said.

The minister went on to explain that, “The problem that we have in Nigeria is that there is a huge imbalance and disconnect between urban and rural areas, the North and the South; and about 50 percent of the doctors in Nigeria can be found in Lagos and Abuja axis whereas many of the facilities in the North and rural areas have no doctors.

(The) Federal Government is concerned about the disparity and has set a special committee to look into the issue of the brain drain and what can be done to keep doctors,” the Health Minister stated.

Professor Adewole then concluded that “in the bid to attract doctors in the Diaspora, the government has initiated a scheme called “One-Eleven”, that encourages doctors in the Diaspora to work for one month and enjoy eleventh month holiday in the country.”

Knowing that there is a problem of distribution as well as a need for doctors from abroad, why then would the minister of labour nurse any euphoria about the emigration of Nigerian doctors?

Ngige also underestimates the effort that Nigerian doctors put into qualifying to practice abroad because of their poor training at home

Ngige put a spacious hole in his own argument by admitting that the rural population in Nigeria has large shortages of medical professionals, a problem even he tried to solve by offering money to doctors who would serve in rural Anambra.

Ngige also underestimates the effort that Nigerian doctors put into qualifying to practice abroad because of their poor training at home.

They do not hit the ground running. Many of them spend years in foreign countries trying to certify and qualify to get a job.

They have been trained with obsolete books and equipment in Nigeria, but are smart enough to adapt after a few years. I have seen Nigerian doctors move into other professions such as technology and finance out of frustration, in America.

And when they do qualify, it is a mere assumption by the labour minister that a Nigerian doctor in the Diaspora will send more money home.

Some send nothing. Most will never return home. And Nigeria’s investment in their education may never be rewarded.

Medical professionals in Nigeria have warned that the problem is not just that our doctors are leaving, but that the ones leaving are the most priced – the specialists, who have the most experience and provide critical services to the nation’s health sector. Dr. Ngige should have known this.

Many nations profit from medical tourism instead of selling doctors to foreign slavery, but that is not the Nigeria of Ngige’s dream. What Nigeria needs to do is to build world-class hospitals, employ those doctors that Ngige has given up on and provide first-class medical treatment to Nigerians first, before selling it to foreigners for hard currencies.

Again, many have observed that our doctors are a notch below their peers. A responsibility of government is that doctors should be well trained, wherever they decide to use their skills, so that they don’t kill people unintentionally.

Medical tourism requires highly trained doctors and facilities, items that do not seem listed on the federal government’s dream list.

Our doctors lack the most modern tools and need an enabling environment to evolve and develop their skills. It is wrong for the government to equate the rapid production of doctors to the creation of qualified medical personnel.

Last month, we lost to breast cancer, the wife of a close friend after raising money for her treatment on WhatsApp. She did survive, but only for six months.

I will save you the details. Nigerians are being hit with serious medical conditions such as cancer, diabetes and heart diseases in much higher numbers than before and the hospitals are incapable of treating these diseases properly because our hospitals are ill-equipped and ill-manned.

Dr. Ngige must think deeply about the problem and its solution, and then schedule a third interview to explain his ignorance of the facts and apologise to Nigerians, who are worth more than he thought they deserve

Nigeria faces a shortage of specialists both in the rural and urban areas and all kinds of doctors in the rural communities, as the health minister has revealed. This gap must be filled before we can even entertain any thought of losing a single doctor, if we must at all.

A lot of affluent Nigerians go abroad for the treatment of minor health problems for a reason – the immaturity of local health sector.

A sick President Muhammadu Buhari spent a good portion of his first term in the United Kingdom because he has no faith in the Nigeria medical system and he is there again now, ostensibly to be safely treated.

Nigeria is so far behind in creating a standard medical system that serves its people properly. We have also not reached a point at which we can dispense with our doctors.

It is not a misspeak that Ngige’s statements are borne out of ignorance about his job, but more importantly about what it takes to build a nation.

He is unqualified for public office and does not understand why he is sitting on the chair of a minister. He must retract his statement entirely or allow someone who understands national development to run that ministry.

Dr. Ngige must think deeply about the problem and its solution, and then schedule a third interview to explain his ignorance of the facts and apologise to Nigerians, who are worth more than he thought they deserve.

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Written by Tunde Chris Odediran

Tunde Chris Odediran studied and practiced journalism in Nigeria. He is now a Technical Communications and Information Technology professional in the United States.