Japa in the health sector: A crisis in the making

The exodus of workers in the health sector started first with nurses who, in locust fashion, massed out of the country to foreign lands, particularly the UK where they have gone to save lives, leaving their own people to die in pain in largely empty hospitals.

Good health, housing, and education are top of man’s social needs. They are essential to a person’s overall growth. A person who is in good health does not run the risk of dying, except by accident.

To ensure safety from the unpredictable weather, a healthy individual needs adequate shelter or a home. Education allows people to overcome ignorance and transcend animal impulses, and so it is essential for humankind. It is one of the most fundamental things separating man from beasts.

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Most civilizations, particularly those in the world’s sophisticated economies, prioritise and allocate sufficient funds to these areas. However, Nigeria, the largest economy on the continent and Africa’s big brother, cannot be considered to be like that.

Here is a country where these important human needs are treated as if they are a luxury. With about 25 percent homeownership level, over 80 percent of its 200 million population as renters and about 20 million housing units deficit, representing 40 percent of the continent’s total, Nigeria’s housing story is just pathetic.

The education sector is in a mess. Besides over 20 million out-of-school children, the school calendar is a sham made so by a lot of factors, including frequent industrial action by university teachers over poor pay, failed agreements, and poor funding of the university system.

Lately, the sector has been hit hard by brain drain which is now known, colloquially, as ‘Japa’.

We had expected that having a president whose health condition is not always sound is enough reason to build a world-class hospital comparable with the ones that attend to them in foreign countries where most of our ‘japa-ed’ health workers find themselves

‘Japa’ has become a phenomenon, consciousness, or movement that is sweeping through all sectors of the economy with its headquarters in the health sector. It is alarming; it is a testament to a country where nothing works. In the health sector, japa is symptomatic of a system on a highway to extinction.

We are worried, to say the least, more so with the indifference that defines the government’s attitude to the very ugly state of affairs in this all-important sector.

The exodus of workers in the health sector started first with nurses who, in locust fashion, massed out of the country to foreign lands, particularly the UK where they have gone to save lives, leaving their own people to die in pain in largely empty hospitals.

Today, japa in the health sector involves everybody and anybody and the rate is terrific. Recently, Abiodun Otegbayo, the chief medical director (CMD) at University College Hospital (UCH), painted a sordid picture of the situation with alarming figures.

“Every week, I sign resignation letters of 15 health workers in this institution, who are mostly clinicians, that is, nurses, doctors and pharmacists, among others,” the CMD said, adding that from 2020 to October 15, 2022, no fewer than 600 clinical staff had left the hospital.

About five wards with 150 beds have been closed down at the Lagos University Teaching Hospital (LUTH), Idi-Araba due to a shortage of health workers, according to a December 1, 2023 report on BusinessDay.

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The UCH and LUTH stories are not isolated cases. They are just a microcosm of a macro-problem. Available statistics give a shocking picture of the bad situation. In 2021, over 783 pharmacists left Nigeria while about 5,000 doctors also left the country in the last eight years.

Record shows that in 2015, 233 Nigerian doctors moved to the UK; in 2016 the number increased to 279; in 2017 the figure was 475, in 2018, the figure rose to 852, in 2019 it jumped to 1,347; in 2020, the figure was 833 and in 2021 it was put at 932.

It also shows that a total of 727 medical doctors trained in Nigeria relocated to the UK in six months, between December 2021 and no fewer than 400 consultant anaesthetists left Nigeria for greener pastures between 2001 and this year, according to the Nigerian Society of Anaesthetists.

A 2022 UK immigration report shows that 13,609 Nigerian healthcare workers (including doctors) were granted working visas in the past year, making the country second only to the 42,966 from India.

That is UK alone, not all over the world. And this is happening in a country where it is estimated that from 1963 to date, it has produced only 93,000 doctors.

The question that readily comes to mind in the face of all these is ‘why are these workers leaving?’ What is chasing them away, worsening the already poor doctor-patient ratio of 1:5,000 in the country as against the World Health Organisation (WHO) recommendation of 1:600? What is the government doing to stem this tide?

Like many other sectors, poor funding is an issue. It is sad to note that in 2021, the government allocated less than 5 percent of its annual budget to the health sector. Added to this is the allegation by the health workers that the government has not done a comprehensive review of their salaries since 2009 despite inflation.

It is hard for us to believe that the country’s health story remains the same one government after another. Nigeria has had the misfortune of having a couple of ailing presidents including the sitting president who have had cause to seek medical attention abroad time without number.

We had expected that having a president whose health condition is not always sound is enough reason to build a world-class hospital comparable with the ones that attend to them in foreign countries where most of our ‘japa-ed’ health workers find themselves.

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We appeal to the government, especially the one that will be formed after the February 2-23 elections to get its priorities right. The country needs world-class hospitals in each of the 36 states of the federation to attend to special cases, especially cancer.

This, in our view, has the added advantage of reducing the rate of medical tourism and the attendant loss of foreign exchange earning, and also saving the citizenry from avoidable deaths. Government needs to wake up and end this disquieting indifference to the exodus of health workers.