The minsterof health was quoted widely in national dailies expressing the intention of Nigerian government to import medical doctors from Europe and America, ostensibly, to complement the existing manpower on ground. According to him, the initiative is capable of curbing medical tourism, brain drain and could inject confidence into our health care system.
The issue of medical tourism had remain recurrent decimal in health care discourse in Nigeria and every government relentlessly harps on it. But the question is that who sponsors medical trips? Most of medical tourism are sponsored by state and federal governments. Only few individuals use their hard-earned money to seek treatment abroad. How can importation of foreign doctors stop medical tourism? I vividly remember a politician during my National Youth Service who was sponsored for inguinal hernia operation in Egypt by state government that already had expatriates doctors working for them.
Medical profession could metaphorically be liken to a tree that has branches and sub-branches. The major branches of medicine are surgery, internal medicine, obstetrics and gynecology as well as pediatrics. Each of these branches has more than twenty sub-branches. Additionally, there are other smaller yet indispensable branches namely; ophthalmology, Otorhinolaryngology, Anesthesia, hematology, oncology, neurosurgery, public health etc. How many of these specialists and subspecialists is the government planning to employ to cover the 36 states of Nigeria? Or are they all going to be based in Abuja?
The Minister was specific that they are going to import doctors from Europe and United States of America. According to Medscape Physician Compensation Report 2019, which is the most comprehensive and widely used physician salary report in the United States, an average annual salary of a specialist in US was 341,000 USD which translate to 28,416.7USD or N10, 258, 416.7 per month. The over ten million naira one month salary of an American doctor that they are willing to employ is enough to sponsor a Nigerian consultant for subspecialty training in some of the best centres in the world. This in the long run will be more cost-effective to the country.
The Minister opined that the employment of the expatriates could scale down the wave of brain drain bedeviling Nigerian health sector. On this point, I want to honourable disagree with the minister. Every year, National Postgraduate Medical College of Nigeria, West African College of Surgeon and Physician churn out hundreds of specialists but only few of them are absorbed into the federal civil service under the guise of no money or no slots for employment. Many of the physicians that left this country did so against the backdrop of poor remuneration and paucity of slots for new employment. Agreed there are fractions of individuals that are hell -bent on leaving the country but largely failure of successive governments to provide conducive working environment has been the major drive for exodus of professionals out of this country.
The Minister was silent on infrastructural upgrade of our tertiary health institutions before the employment of the foreign doctors. Many federal medical centres and teaching hospitals in Nigeria are currently battling with provision of basic electricity to run the hospitals. Substantial proportion of their Internally Generated Revenue are spent on fueling and servicing generators. Some Nigerian doctors that had opportunity of additional training abroad could not operate at their full capacity due to lack of basic facilities they need. Is it not more logical to invest the fund meant for the salary of the expatriates in purchase of equipment for our hospitals? I think we need to have a rethink of this idea.
I have no doubt that our postgraduate training has some deficiencies and I am under no illusion that Nigerian specialists are as proficient as their counterpart in the Europe and America. This is tantamount to saying Nigerian military are equivalent to the US military or Nigerian Universities are equivalent to American Universities. However, I don’t believe importation of foreign doctors could bridge the gap. On the contrary, what I believe is that if Nigerian specialists can be exposed to the same training and facilities America exposes their doctors, our physicians will perform to their full potentials. Besides we have Nigerians who are excellent surgeons and physicians practicing in US.
Federal Government in 2011 established Tertiary Education Trust Fund (TETFUND) to manage and disburse education tax. The scheme has been providing infrastructural development to many tertiary institutions in the country and ensures capacity development of university lecturers. TETFUND Through their scholarship sponsored PhD of significant number of university lecturers in refutable universities outside the shore of Nigeria. The quality of medical services in Nigeria could profoundly be improved in the long run if government could expand the scope of TETFUND scholarship to cover medical fellowship or introduce similar programme for health care professionals. When this is done and then supported with provision of state of the art facilities, Nigeria could become a destination for medical tourism.
International Centre for Eye Health in London School of Hygiene and Tropical Medicine in collaboration with Queen Elizabeth Diamond Jubilee Trust launched a 5-year intervention programme under the auspices of Common Wealth Eye Health Consortium (CEHC) to strengthen eye care system in commonwealth countries. The scheme sponsored subspecialty training of Sixty four Nigerian ophthalmologists in various world-class centres abroad. The sponsors could have sponsored foreign doctors to come and do one or two free eye surgeries but they know the ripple effect of training locals would be more far-reaching.
In conclusion, if Nigeria can close its boarders in order to encourage local rice production, then it should as well close it boarders to hired foreign doctors and develop the capacity of local specialists to be at par with their peers globally.
Mohammed writes fromK Kano via