Soyinka, who is doing part of her graduation internship at the Abeokuta Regional Hospital, has only one thing on her mind: to leave. “I made this decision during yet another university strike,” sighs the 25-year-old medical student. To leave Nigeria and work in Britain, she will have to pass an equivalency exam. "It wasn't my original plan at all," she says. I was afraid of being a victim of racism or of being considered a second-class citizen in Europe. But after a while, I understood that it was the best solution to secure myself a future. »
Driven into exile by an ailing economy - inflation exceeded 22% in March in Nigeria - widespread insecurity, failing infrastructure and low salaries, between 100 and 200 doctors leave the country each month . The World Health Organization (WHO) issued an alert in March on the number of medical workers available in Nigeria. In an attempt to retain them, an MP tabled a bill in early April that would force them to practice for five years in Nigeria before graduating.
While the WHO recommends a ratio of one doctor per 600 patients, the most populous country in Africa (over 216 million inhabitants) has only one doctor per 10,000 patients, officially. But the crisis could be much more serious according to the president of the Nigerian Association of Resident Doctors (NARD), who instead puts forward the figure of one doctor for every 30,000 patients. "It's a huge deficit. Sometimes you have to wait days to see someone when you are sick. This situation obviously delays treatment and increases tensions in the hospital, "says Dr. Emeka Orji.
In both public and private establishments
However, the latter considers the bill "against the brain drain", "draconian and impossible to implement" and calls for its immediate withdrawal. He would prefer that the "problem be addressed at the source", with the improvement of working conditions and salaries for health workers in Nigeria. In the country, doctors do not receive insurance or other benefits related to professional risks, increased by the lack of protective equipment in public hospitals. But desertions are just as high in private establishments where salaries are often not much better.
“We lost a lot of members at the height of the Covid-19 pandemic and even more among doctors in contact with patients infected with Lassa fever. But there was no compensation for the families,” recalls Okhuaihesuyi Uyilawa, who was NARD president in 2020.
After sixteen years of practice in Nigeria, the 49-year-old man - now based in the United States - claims that he had not even been able to raise 3 million naira (some 6,000 euros) in savings. “We recently had to appeal for donations so that a fellow doctor who suffered from kidney failure could finance his operation! “, he exclaims, appalled.
Leader hypocrisy
Every month, at least two doctors leave their posts at the Edo State Regional Specialty Hospital, according to Joshua, who practices as a general practitioner there. “At least 80% of my colleagues dream of going abroad,” he says. The 29-year-old, who graduated two years ago, currently earns 184,000 naira per month (363 euros), despite working more than 70 hours a week. "We come to work exhausted and take care of so many patients for starvation wages... We can't even take care of ourselves," he said.
At the end of the day, the doctors look for all the possible exit doors. Chucks, 38, first thought of teaching medicine in the Caribbean, then considered moving to Saudi Arabia. Before finally opting for the equivalence exam for the United Kingdom. Since August 2021, he has worked in the hospital of a medium-sized town in the north of England, where he has settled with his wife and two children. His salary is "ten times higher" than what he earned in Nigeria.
"I think my colleagues who practice medicine in the country are wasting their time and wasting their degrees," he says, with no regrets. The expatriate also blames the hypocrisy of Nigerian leaders, well aware of the catastrophic situation in which the health sector in Nigeria finds itself, “since they themselves refuse to seek treatment in their own country”.
