That the entire world is at its wits end over the rampaging COVID-19 pandemic is self-evident and requires little elaboration or rehash. Fortunately, it is something that is affecting the world impartially in terms of its cause and effect; there is no selectiveness and preference. The developed countries are as subdued by it as everyone else, including Nigeria; in fact, some may say that we have been pretty unscathed in terms of its human tolls.
As bad and frightful as the situation may be, there may be some silver linings underneath for us in particular, and this is the time to look ahead, because this challenge too will pass, like every other thing in life. That our health care system is in the deplorable condition is an understatement; even amid the COVID-19 scourge, medical doctors in Abuja and elsewhere were on strike over issues of working conditions. Luckily, they rescinded their decision for the public good to join in the task of fighting the virus.
A major reason for the exodus of doctors from Nigeria to other countries is the poor working condition: poor funding, lack of right tools, poor welfare, low morale etc. The mass emigration of health care professionals, especially doctors, pharmacists and nurses, is on the verge of crippling the nation’s health sector, now reaching an alarming proportion, with more than 1,500 doctors abandoning the country in the last two years with fewer practising physicians and consultants to over 180 million Nigerians.
Nigerian Polling Organisation, NOIPolls, in partnership with Nigeria Health Watch, revealed that about eight out of every 10, representing 88 per cent of medical doctors in Nigeria are currently seeking work opportunities abroad. Of about 75,000 medical doctors registered with the Medical and Dental Council of Nigeria only approximately, 35,000 are currently practising in the country. The United Kingdom and the United States are the top destinations. World Health Organisation (WHO) requires one doctor for every 600 persons.
This means Nigeria needs more than 237,000 medical doctors to meet the WHO standard of doctor-patient ratio. The nation’s doctor-patient ratio is among the worst in the world currently hovering above 50,000 patients
Nigeria’s universities produce less than 3,000 doctors each year, while the vast majority of these graduates seek greener pastures abroad. Average budgetary allocation to the health sector in the past decade is about 4 per cent, which is a paltry 3.9 per cent of the total budget, far less than the 15 per cent that was agreed at the Abuja declaration of 2011.
For example, the lowest pay a fresh medical doctor from medical college earns range between N160, 000 to N170, 000 per month. It is, however, a bit lower in private hospitals, where new doctors earn between N100, 000 to N120,000.
The implications of this are dire; and this is just for the human capital aspect, although the low budget directly affects the capital investments and provision of working tools. Many believe that the saving grace from this pandemic is the existing structure provided during the 2014 Ebola epidemic, which served as a take-off point for the present need; otherwise, we were bound to have been caught, as usual, napping. Even with the sufficient warning we had from across the world, we still bungled the preparation against it.
Fortunately, the current health emergency is a wake-up call to address some of these issues in our health sector by providing more permanent solutions and systems, because though this, COVID 19, will pass, there will be other health challenges of a global or regional nature in the future, such that we need to be prepared. Whatever caused the COVID-19 pandemic is bound to happen again; as it were, man has become his own worst enemy and primed for self-destruction.
With donations pouring in from the private sector and other groups – in cash and kind – the challenge may no longer be the funding but the leadership capacity and political will to change the situation for the better in the sector. The joke in town is that for the first time, our leaders are being compelled to patronise local health institutions for their health challenges because there is nowhere in the world to run to; otherwise, they all would have escaped.
It is good and public-spirited that people and organisations are giving, but it is far better that these donations are properly and judiciously deployed to improve the sector. In times like these when everybody is distracted and desperate, the monies could disappear into extraneous provisions, as is traditional with our bureaucracy. All donations should be accurately collated, documented and published for proper and transparent accountability.
First, the cash donations should not be used for stimulus package; rather the government should find the money to do it if can or forget it. The donations should all go into improving the health sector and saving the lives of Nigerians. Daily reports of unnecessary deaths in our hospitals are heartbreaking; most doctors leaving the country complain of this. A major issue with government under-funding affects capital projects as most funds go into recurrent expenditure.
So this is the time to fill the funding gap with the donations to upgrade our health facilities to global standards, at least some.
As a newspaper, we believe that the opportunity presented by the pandemic is apposite and should not be another lost hope. The government should set up a committee that will include the private sector to implement an emergency health intervention programme of improving the sector to save the nation the huge cost in foreign exchange of over $2.3 billion incurred on medical tourism annually.
The NCDC should be properly equipped to carrying research and development of the vaccine in communicable diseases and not wait dormant until another epidemic is upon us. The N5 billion given to the NCDC by the government should not be the last; part of this donations should go to it also. Also, the previous policy of centres of medical excellence should be revived and promoted further because it will enable the country to develop capacity in different areas of health and medical services. We believe this is the best way to utilise the donations when all this is over.