Doctors’ underemployment – The Nation
We have to employ our doctors, especially in the villages
The headline was more than a little misleading. Newspapers wrote that 40 percent of Nigerian doctors are jobless. And they attributed it to the president of the Nigerian Medical Association (NMA), Francis Faduyile, though represented by the chairman of the Federal Capital Territory (FCT) branch of the association.
Here is the quote. “Many of them are employed by private hospitals that are not even paying them enough because of the economy. We don’t have enough doctors and the ones we have are not being utilised,” said the NMA president.
According to news reports, he noted after their national youth service, they do not clinch a job until a year or two. This follows former health minister Chris Ngige’s assertion that Nigeria had more than enough doctors and that he was not bothered by what has been characterised as waves of brain drain of the medical profession.
Ngige did not say they were all employed. But what the NMA president seems to have pointed out is that they are underpaid and that the major problem is not so much that 40 percent of them are underemployed as that they are underpaid.
But the NMA president said though the doctors are not enjoying full employment, they are not enough. That is where he contrasts with the former minister. Describing Ngige’s assertion as unfortunate, he referred to an important statistic. “The World Health Organisation stated that, for optimal healthcare to be achieved, we need doctor/patient ratio of one to 600. In Nigeria, we have 40,000 doctors taking care of 200 million people.”
One of the major statistics that has not been documented is how many doctors go to the rural areas. The majority of Nigerian patients do not live in the major or medium-size cities like Lagos, Ibadan, Port Harcourt, Kano, Kaduna, Enugu or Warri. They abound in the villages and hamlets.
It is not common for a doctor, after spending close to a decade studying, to abandon the opportunities the urban scent gives and decide to work in a hamlet clinic, where there are probably no modern drugs, equipment, or even the seduction of prosperity because they would have no power, no pipe-borne water, no good roads and other infrastructural allures of the city.
Only a few humanitarian, selfless souls would opt for a rural redoubt many hours outside Damaturu. In the western countries, it is often the case. But they have an answer. Doctors are lured with special remunerations, far more attractive than they earn in the cities. Most of the doctors who fall for this are usually foreigners from Asia and Africa, including Nigerians referred to in the Ngige assertion.
So, the issue is not a medical one alone. It is a challenge of development. We cannot churn out doctors without opportunities. Yet, the irony is jarring that we have many Nigerians dying daily of preventable diseases and ailments. Such problems could easily be treated if a doctor was around just to diagnose and prescribe a little and accessible solution.
Part of the problem is that our people have given up on modern medicine, and they now seek traditional alternatives, a practiced chockfull of superstition and quackery. Medical doctors in a village may find themselves competing with a man swaddled in frowzy garments and making concoctions whose efficacy derives from the psychology of desperate optimism by patients who neither know nor trust any other world.
Budgets after budgets, federal and states, stress rural clinics. Progress is tardy, if any. So doctors will continue to be underemployed in the cities when they can extend the power of their Hippocratic oaths to the emergencies in rural areas.