The COVID 19 pandemic has made everyone realize the importance of good health. We have seen how a global health crisis has come to affect almost everything in our society from education to agriculture. The statement “health is wealth” never sounded truer than now. In Nigeria and indeed the African continent, we have come to understand the importance of health the hard way. COVID 19 has greatly exacerbated the state of our already failing health sector.
For a long time, the ruling and middle class ignored the deterioration of the health sector. For them, there was always the option of traveling overseas for treatment. Year after year there were promises to give more allocation to healthcare in the national budget, but it never came. Even in 2020, only 4.5 per cent (427.3 billion Naira) of the budgeted 9.45 Trillion Naira was allocated to the health sector. Whereas in 2001, The Heads of State of the African Union met in Nigeria and resolved to allocate at least 15 percent of their national budgets towards health sector reform in a resolution known as the Abuja Declaration. After almost 2 decades this has not been achieved in Nigeria or any AU member country.
The refusal or inability to prioritize this most important of human requirements – good health - has led to damaging consequences in Nigeria. Health professionals on the front lines feel it the most, daily. For decades, news of sudden strikes and protests by doctors and other healthcare workers have dominated the media. Each time, the complaint is the same: deterioration or the lack of infrastructure and equipment, delays in the payment of salaries and other entitlements, poor working environments, low wages etc. For example, in July 2019, long before the Covid-19 pandemic, the National Association of Resident Doctors (NARD) threatened to go on strike. One of many complaints was the delay in salary payments up to the sum of 23.6 billion Naira. This amount is even more alarming when one considers the low wages of our doctors. It is not uncommon to see a medical practitioner get paid between 120,000 and 150,000 Naira per month, an equivalent of between 250-300 US dollars.
Lack of medical equipment, protective gear and infrastructure could mean a death sentence for medical professionals and their loved ones. There is little incentive for doctors to remain on the front lines and risk their lives. Furthermore, the hazard allowance that is normally given to medical practitioners to cushion the effects of a crisis is an inconsequential sum of 5,000 Naira per month. In the meantime, doctors are being infected by the virus. According to the Nigerian Centre for Disease Control (NCDC), over 800 healthcare workers have been infected.
In June 2020, NARD threatened to go on an indefinite strike due to lack or protective gear and equipment, poor remuneration, and poor working conditions amongst others. Nurses are not exempt here. According to the Nigeria Medical Association (NMA), ‘Nigerian nurses work in inhumane conditions capable of exposing them to dangerous health risks and death in the course of the job.’ This condition is exuberated especially as nurses hold multiple forefront positions in the against the coronavirus, exposing them to dangerous health risks and even death while saving other lives.
Indeed, the current situation only means that Nigeria will lose doctors and other healthcare professionals to the virus. Doctors will also continue to flock to other countries that give them more favourable options. Nigeria has already lost many of its brightest to brain drain in pre-pandemic times. At the moment, foreign countries continue to encourage expatriate doctors to come and work in their countries. In December 2019, the then President of the Nigeria Medical Association (NMA), Dr. Francis Faduyile, lamented that 75,000 doctors were registered with the NMA however over 33,000 of them had left the country leaving about 42,000 doctors available to treat a population of over 200 million.
The situation is very dire. At a ratio of 1 doctor to 4,700 people, Nigeria falls far below the World Health Organization recommendation of a ratio of 1 doctor to 600 people. According to Dr. Faduyile, the UK was employing on average of 12 Nigerian doctors every week as at December 2019. Nigeria is also losing doctors to smaller countries on the continent such as Senegal, Ghana, Namibia and South Africa. As Africa’s most populous nation, we will only have ourselves to blame if we do not advocate for the welfare of our medical practitioners and lobby for an increase in allocation of funds to the healthcare budget. It is the right thing to do. It is also in the best interest of every Nigerian to take action because we need our doctors alive and we need them to remain here to treat us.