"...But
then, according to the Medical and Dental Council of Nigeria, we have
approximately 35,000 practicing doctors in the country. Which means, it's 1
doctor to 5,200 people in Nigeria, which further means an average Nigerian
Doctor works almost 10 times more than expected, 10 times more than his/her
colleagues in saner climes... "...the body holding data on doctors in the
UK, says that 5,250 Nigerian doctors were working in the UK as at April 25,
2018. Checking the same data today, May 13, 2018, that number has grown to
5,273 - that is an alarming increase of 23 emigrant doctors in 17
days...."
Last year, my 7-month old son was sick. A good friend had introduced
us to a kind pediatric Doctor who owned a private practice somewhere in town.
He doubled as a Senior Registrar at the University College Hospital (UCH),
Ibadan.
The day came to meet up with this Doctor, and he was by obligation
at work in UCH - we had to go meet him there and not at his private practice as
hoped.
Well, we saw hell.
The Doctor ordered a Malaria Parasite (MP) test and a Full Blood
Count (FBC) for our son. Let me just say myself and his mother weren't thinking
aright right there that day - because, somehow, we made the unthinkable mistake
of approaching the UCH Laboratory for these tests. Five freaking hours later,
we were still waiting for the results. Yes, 5 hours, you read right.
I can't remember the number of times I went back to that Lab that
day asking and asking "what's up, how far?", only to be served an
unproductive and lukewarm response. I also can't remember the last time I was
that vexed to stupor - waiting in pain, waiting in vain.
We finally received sense, drove out of UCH to a private lab just
across its second gate, and paid 100% more (₦3000) than what we paid to the UCH
lab for the same procedure(s); in barely 25-30 minutes, we were done and headed
back with results of the tests.
The Doctor provided consult, and as we headed out, I bumped on some
activity at the Emergency Unit of the hospital that added more flux to my
vexation.
Three accidents victims, all bathed in blood and apparent writhe,
were brought (not rushed) to receive emergent treatment at that supposed
Emergency unit. The first Nurse came out strutting and laughing tiresomely off
a banter she was having with a male colleague, who on his part, was sifting
through some rack of files inside.
I shouted twice, "E se kia now! E se kia! " [Hurry!]
Whether I was heard or not, I still can't say till today; because,
it was as if I just bellowed into thin air, they did not flinch.
Picture the pace of a snail in reverse, that was the nonchalant pace
these guys, three nurses and a Doctor, were using to render deemergent
treatment at a supposed Emergency Unit. No urgency, no passion, no drive, and
no Hippocratic appetite in sight.
At that point my vexation had morphed into indignation, and I chose
to just walk away from that scene before I burst into a fit. It was a hell of a
day.
All my indignation was clearly directed at the poor services I
experienced and witnessed, and also directed at the people behind it (laboratory
guys, the nurses, the doctors and the admin of the hospital).
But, later that fateful day, after rechanneling my anger into deeper thought
about the whole UCH experience and also a thought about the big picture, I
reckoned that the anger I felt and expressed was misdirected.
I reckoned without doubt, that the average Nigerian Medical
professional is also a victim; that, they too are victims of a crushed system,
victims of the listless lull largely existent in Nigeria's healthcare system.
They are not the ones I should direct my indignation towards.
Dear reader, the average Nigerian medical professional encounters
our national decay on a daily basis and at a very close personal and
professional range. And, sadly, a lot of compromise in effort and output
definitely stems from this.
Either partly or fully, that frustration that you see, that inhumane
tendency, that poor service, that lack of drive, passion and urgency, that
apathy you complain about, all have valid roots in the agelong crack in the
system.
They are overworked, fatigued, underpaid, sometimes unpaid,
discouraged, and most unfairly, de-skilled.
As an example, I know for fact, that apart from the overworking, the
worst thing you will do to any Medical Doctor who is primed by oath to save
lives, is to drown him/her in a swathe of theory, and thereby de-skill and "de-teach"
them, albeit in a supposed "Teaching hospital".
This above, is a modest way to describe the unbelievable and
unbearable theoretic torture most Resident doctors face in UCH and in most, if
not all of our teaching hospitals across the country.
Last week, I visited a couple of my Doctor friends who work inside
UCH, and all those indignant feelings from my experience months ago came back
to me while we talked. Two of them are junior residents, and the other one, a
final year student who could have graduated by the end of this present month if
they weren't on strike.
They wailed endlessly about the substandard and anachronistic work
environment they are forced to put up with as Doctors.
"Sayo, I sought residency here because I felt UCH was the best.
But, bòbó, imagine that they don't even have IVF equipment in their OB-GYN. All
we do in a supposed residency program is theory, theory, and more theory",
one of them said.
"They have only one malfunctional MRI machine Sayo. A machine
that's supposed to give you a clearer image for better diagnosis, gives you the
opposite", another moaned.
"Sayo, in another 5 years, maybe only CHEWS* will remain to
dispense Healthcare in Nigeria", she echoed.
"See, me, I'm already saving money for my PLAB, I can't wait to
finish and leave here. It's like we are being trained to kill lives, not save
lives", chanted the one in his final year.
Well, you should know, that almost every Nigerian Doctor or medical
professional you meet has at least one personal tale of woe along their
professional journeys, that brews from the substandard and neanderthal nature
of medical practice in Nigeria; surgeries by candle light, a litany of
preventable mortalities, NEPA 'showing up' at bad times, getting stuck to
antique techniques, etc.
As at the time of writing this piece, the UCH, Nigeria's premier
teaching hospital, is dry and competes with the graveyard in decibels of
silence. Almost every arm of activity therein is on industrial strike. The
Provost of the college and the medical students too are at an impasse regarding
a sudden hike in fees.
So, for some weeks now, it's been 'no treating, no teaching' at the
"iconic" teaching hospital.
A dirge of emptiness, empty beds, empty drug shelves, empty hands,
empty labs, empty, empty, empty, rings into your consciousness as you walk
round the hospital, and sadly, this is not sensationalizing it. I wish I were.
The way it is today, if Queen Elizabeth visits UCH now, instead of
being unable to recognize the edifice she commissioned years ago due to graded
levels of improvement over the years, she'll have perfect nostalgia [SELAH].
The way it is today, a sick Nigerian stands a better chance to be
correctly and promptly diagnosed and treated by watching some episodes of
Grey's Anatomy drama series, than inside a government hospital in Nigeria.
The way it is today, the best Nigerian Doctor is the one whose
guess-work game is exponential. Guess work.
In all, most Nigerian Medical professionals are just tired to the
marrow. They are just tired. And yes, they are fleeing in droves to better and
befitting pastures.
According to AfricaCheck.org, Nigeria loses an average of 12 Medical
Doctors to the UK alone every WEEK!
The UK General Medical Council, the body holding data on doctors in
the UK, says that 5,250 Nigerian doctors were working in the UK as at April 25,
2018. Checking the same data today, May 13, 2018, that number has grown to
5,273 - that is an alarming increase of 23 emigrant doctors in 17 days.
This efflux of hands to the UK alone. That means more figures when
other countries are considered.
Actually, a survey conducted in August 2017 by a Nigerian Polling
organization, NOIPolls, in partnership with Nigeria Health Watch, revealed that
about 9 out of every 10 (88 percent) medical doctors in Nigeria, from final
year students to Consultants, are actively and currently seeking work opportunities
abroad. This figure includes my three Doctor friends I mentioned above.
In fact, at the time when this poll was conducted, many Nigerian
doctors were (and many more are) registered to write foreign medical exams such
as PLAB for the UK (30 percent), USMLE for the United States (30 percent), MCCE
for Canada (15 percent), AMC for Australia (15 percent) and DHA for Dubai (10
percent) amongst others.
In addition, the World Health Organization (WHO) recommendation puts
the ideal doctor-patient ratio at 1 to 600. National Population Commission
(NPC) projects our current population to be about 182 million at a 3.5% growth
rate from the 2006 census. This means we need about 303,333 medical doctors
now, and at least 10,605 new doctors annually to join the workforce in order to
fit that WHO recommendation, like some other countries who don't have a quarter
of Nigeria's potential. I mean, if a country like Libya can meet up....
But then, according to the Medical and Dental Council of Nigeria, we
have approximately 35,000 practicing doctors in the country. Which means, it's
1 doctor to 5,200 people in Nigeria, which further means an average Nigerian
Doctor works almost 10 times more than expected, 10 times more than his/her
colleagues in saner climes.
It's all sickening maths,...these figures.
While we were talking, my Doctor friends told me one of the stories
that keeps fueling their acquired lack of faith in Nigeria and their resolve to
leave soon.
Over a year ago, they said the Minister of Health, Professor Issac
Adewole, who is a product of UCH himself and who is also the immediate-past
Vice Chancellor of the University of Ibadan, was around on a working visit. My
friends said they were "moved" by the way the Minister spoke,
especially after promising that his office will "promptly" facilitate
the procurement of modern facilities into the hospital and even an IVF
equipment to their department. But, while they (new residents at the time) were
clapping for the Minister, to their surprise, their senior colleagues seemed
totally uninterested in the Minister's talk and promises. They later asked why,
and were told that their uninterest stems from the fact that they've heard many
of such promises from government officials without any fulfillment.
Almost a year and half later, the senior colleagues remain right, my
friends clapped for nothing, because nothing has happened indeed. And that
point, I even asked, "must promises be made before a government realizes a
need to perform an obligation in the first place?"
This is the saddening situation of things in Nigeria's health sector
at the moment, also how it has always been.
And now, if you raise convictions against the present government
that they haven't "CHANGEd" anything in true effect as promised, and
that they should allow Sai Baba to retire in order to pave way for something
new and braver, Buharideens will call me names and say hogwash like,
"errr, people like you don't understand how government works, errr, 16
years of...."
16 years kee you dia!
In this era, the Minister of Health oversaw the
"rehabilitation" of the President's son in Germany after suffering a
head injury from a biking spree; the President himself just came back from his
umpteenth foreign medical checkups against the gradient of his words; he's back
to be ushered into a party congress that will cement his reelection bid, a
party congress reported to gulp a six(6) Billion Naira contribution from APC
Governors.
It is obvious that the political elite in our country just seems
deliberately blinded to the consequences of our failed health sector, as no
sane person should be able to understand why a UCH for example, just like any
other Nigerian tertiary or general health institution, can be not only
substandard in setup and output, but also rendered totally useless for weeks!!
Among many endless things that 6 billion Naira will do to change the
fortunes of medicare and medicarers in Nigeria, it will setup complete IVF
equipment in 20 of our 22 teaching hospitals as an example, or buy 10 MRI
machines spread across them. But, then, according to vuvuzelas of CHANGE, the
underpaid and frustrated Nigerian Medical professional can't "understand
how government works".
Yes, they can't, and today, I rise in their defence, choosing to
totally understand their desire to fly away in order to learn better and earn
better, as against staying here to moan whenever and yearn forever.
PS: Oh! I forgot to tell you that we eventually got my son's test
results from the UCH Laboratory that day, some 7 hours later; the FBC was
inconclusive. No kidding.
*CHEWS - Community Health Extension Workers
No comments:
Post a Comment