Reversing the Brain Drain Phenomenon

The subject of brain drain or professional intellectual loss from underdeveloped to developed countries remains a hot topic.This phenomenon is not unique to medicine and, in fact, encompasses many professional fields including other areas of science, humanities and professional sports.

To elaborate on the brain drain attributable to the medical profession, let me start by saying that many people choose to go into the medical field for various reasons. Most physicians have the gift of knowledge, forming the core of intellectual elites that elect to delay their gratifications from many years of educational torture that might eventually result in a comfortable life style.While many choose the profession to help others, some believe they do so because of the respect or prestige bestowed by the society at large. Others do so for money and yet others pursue the art of medicine because of their special gifts.

Whatever the reasons for choosing this noble profession, the fundamental act of practicing medicine must be supported by the right environment, offering adequate nurturing , security and diagnostic equipments to treat the sick and the injured. Any imbalance in this unique medical equilibrium will create an uncomfortable force that shifts the effort of the professional giver to look elsewhere and transport their expertise to a more favorable environment. Large scale migration of trained medical professionals whether from Nigeria, India or any other place seems to have the common denominators of poverty, lack of adequate medical infrastructures, poor security and inadequate allocation of health care funding. Thus the same brain that is been drained from one area can easily be filled elsewhere with the right environment. The transformation of acquired skill from a country with poor health structures is therefore not because of incompetent professionals or pure monetary seeking behavior, but rather because the new environment offers the right climate of innovation, improved experience, competency and well equipped facilities to entertain favorable and humane health care practices.

Unpleasant Tales from a Nigerian Hospital (1)

Nigerian doctors and nurses work under conditions that few of us in the Diaspora can fathom. Despite lack of equipment, broken facilities, and poor remuneration, the vast majority of these health workers do a fabulous job. We have noted on this blog the atmosphere of insecurity under which Nigerian doctors perform their work, having become targets of a thriving kidnapping industry, particularly in the South Eastern part of the country. The incessant strike actions, such as those recently called by Lagos State and Edo State doctors, reflect deep overall dissatisfaction by these doctors. So, it is not surprising that such poor working conditions might take a toll on their professionalism.

While we feel common cause with our colleagues at home, and support their fight for better working conditions, we are troubled by the myriad complaints that ANPA members receive from family members and friends alleging unprofessional and unethical treatment at some of Nigeria's flagship hospitals. The following from a Nigerian parent is, unfortunately, an all too common tale (the identity of the patient, doctors, and hospitals have been removed):

"My daughter's condition exposed me to the level of corruption in the public healthcare system in Nigeria. The doctors are a Lord unto themselves, operate private hospitals and divert patients to their hospitals with impunity. The only language that drives them is money. At the first private hospital we went to, we met a doctor who turned out to be a [Teaching Hospital] staff. He initially said the condition could be treated with antibiotics. Each time we went, we were arm-twisted to buy antibiotics at four times the normal price. Even when the X-ray showed that surgery was necessary, he continued to prescribe the same drugs for us which must be purchased in the clinic. On another visit, we met a second doctor who was so lackadaisical in his manners and utterances that we decided not to go back to the hospital.

Nigeria's Health Minister, Professor Onyebuchi Chukwu, Speaks to The ANPA Blog

Several weeks ago, Professor Onyebuchi Chukwu, Minister of Health of Nigeria, was at the United Nations headquarters in New York where he addressed a summit on the Millennium Development Goals (MDGs). With only five years left until the 2015 deadline, there is a renewed sense of urgency among under-performing countries such as Nigeria to accelerate progress towards achieving the MDGs.

Soon after Chukwu took office six months ago, he lamented that Nigeria faced unique problems that made attainment of the MDGs very difficult. Within a few months, however, he was more optimistic, touting the National Health Strategic Development Plan before the Commonwealth Health Ministers meeting in Geneva, a plan which Chukwu said specifically addresses core health-specific MDG targets for infant mortality, maternal mortality, HIV and AIDS, tuberculosis and malaria.

Taking the podium at the UN, Chukwu while acknowledging the difficulties ahead was also exuding confidence, reeling off statistics to show recent progress:

"Nigeria is reasonably on course to achieve the target of MDGs on reducing child mortality with a fall from 100 per 1,000 to 75 per 1,000 live births between 2003 and 2008. Similarly, in the same period, the under-5 mortality rate fell from 201 per 1,000 to 157 per 1,000 live births .... and a drop in the maternal mortality ratio of 545 maternal deaths per 100,000 live births........a fall in the prevalence of HIV/AIDS from 5.8% in 2001 to 4.24% in 2008; doubled treatment of patients from 16.7% in 2007 to 34.49% in 2008." 

During his UN visit, the Honorable Minister who revealed that he reads The ANPA Blog, agreed to take questions from Deji Adefuye and Ben Nwomeh, in the first of a periodic feature in which we will interview stakeholders in Nigeria's health system. In subsequent posts, The Blog will report the Minister's views on a wide-range of issues, particularly those of concern to ANPA members.

Is ANPA a Social Club ?

I have been debating this question for the past few weeks. I typically try to take stock when the year begins to come to a close and one of the thoughts that came across my mind was what exactly does ANPA mean to me or in what ways does it impact Nigeria as a whole in the Health care sector.

I reviewed the different posts by members on the group emails, blogs etc. and the comments reflected issues of concern to Nigeria i.e. safety, kidnapping, state of the economy, healthcare delivery, criticisms of the government , discussions about dues, membership issues etc. We celebrated the successes of our members and their families and commiserated with the families of those that passed away (may God Bless their souls). But really, how do these conversations differ from the conversations we have in other fora or gatherings? When we meet at parties and other occasions where 2 or 3 are gathered in the name of Nigeria, the same conversations take place.

So what is the value of ANPA?

The Abuja Medical School

It was really sad for me to hear that there are now 3 classes of medical students (class A, B, C) waiting to take their first professional MBBS exam at the University of Abuja.

While this university is still admitting and frustrating the young and bright in Nigeria who chooses to become doctors, both the Nigerian University Commission (NUC) and Medical and Dental Council of Nigeria (MDCN) have removed their accreditation.

My question is: Should schools be allowed to admit and collect school fees without accreditation? Should accreditation be given to a school without facility to run a medical school as was the stated reason for removing accreditation by NUC?

Nigeria: Partnership for Health Conference Opens in London, November 6, 2010

The second "Partnership for Health Conference" organized by the Public Health Foundation of Nigeria (PHFN), convenes at the Royal College of Obstetricians and Gynaecologists in London on November 6, 2010.

The PHFN is a network of individuals and organizations that advocate evidence-based public policy for health in Nigeria. It's mission also includes building professional, organizational and system capacity for public health and creating and sustaining peer support for Nigerian public health professionals. A spokesperson for the PHFN, Dr. Chikwe Ihekweazu, said that this year's conference "will focus on how sustainable collaboration between Nigerian health professionals working in the West, and Nigerian health institutions can lead to health gains for the Nigerian people."

Speakers at the conference to be drawn from NGOs, government and the private sector, will include Dr. Dilly Anumba, President of the Medical Association of Nigerians across Great Britain (MANSAG).

Registration for this event is still open.