Al­ter­nate View with MD Aminu

Weekly Trust - - Front Page - with MD Aminu, PhD.

The Nige­rian min­is­ter of health, Pro­fes­sor Isaac Ade­wole, is cur­rently be­ing se­verely crit­i­cized for his com­ments in re­sponse to a re­porter who asked him why it is be­com­ing in­creas­ingly dif­fi­cult for newly minted med­i­cal doc­tors to find a place for res­i­dency train­ing in a bid to be­come spe­cial­ists in the var­i­ous dis­ci­plines of medicine. The min­is­ter said that it is not nec­es­sary for all doc­tors to be­come spe­cial­ists in medicine, as some of them can try their hands on other pro­fes­sions or vo­ca­tions such as farm­ing, pol­i­tics, or even gownsewing.

To even give us a closer ex­am­ple, the min­is­ter said that his tai­lor makes the best gowns in spite of be­ing a doc­tor. Be­ing a med­i­cal doc­tor who has prac­ticed the pro­fes­sion for sev­eral decades both in the clinic and the academia, and hav­ing risen through the aca­demic ranks to be­come a pro­fes­sor of ob­stet­rics and gy­ne­col­ogy, plus a priv­i­lege to serve as the Vice Chan­cel­lor of a fore­most in­sti­tu­tion of higher learn­ing in Nige­ria, that com­ment from Pro­fes­sor Ade­wole, can­not be said to be in­spir­ing, no mat­ter how you choose to eval­u­ate its worth.

It is com­mon knowl­edge that health­care sys­tem in the coun­try is in dire straits. The health­care sec­tor is as bad as the Nige­rian roads; in some parts of the coun­try. The con­tribut­ing fac­tors are quite enor­mous, and in­cludes, but is not lim­ited to, cor­rup­tion across the health­care hori­zon, poor ed­u­ca­tion of both man­age­ment spe­cial­ists and the doc­tors, ill-trained nurses, un­avail­abil­ity of med­i­ca­tion, lack of fi­nanc­ing on gov­ern­ment med­i­cal fa­cil­i­ties, lack of mod­ern tools, hy­giene de­fi­ciency, etc. The con­se­quences of these do not only cre­ate a want in em­pa­thy from the med­i­cal prac­ti­tion­ers them­selves, it also leads to an even greater dis­ad­van­tage for Nige­ria by giv­ing rise to what is pop­u­larly termed brain drain.

It is no longer news that Nige­rian doc­tors find it fas­ci­nat­ing to mi­grate to other coun­tries as a way of fur­ther­ing their ca­reers and im­prov­ing on their so­cio-eco­nomic sit­u­a­tions. These mi­gra­tions have­been rec­og­nized by the World Health Or­ga­ni­za­tion as a key cre­ator of im­bal­ances in the global health work­force. Al­though it is of­ten re­ported by most re­searchers that there is very lit­tle data that ex­ist on the em­pir­i­cal ev­i­dence that quan­ti­fies mi­gra­tion rates of med­i­cal doc­tors from Nige­ria to the de­vel­oped coun­tries es­pe­cially to the cul­tural and geo­graph­i­cal West, how­ever, ac­cord­ing to a 2005 study in the med­i­cal jour­nal, The Lancet (Ihek­weazu, C., Anya, I. and Anosike, E., 2005. Nige­rian med­i­cal grad­u­ates: Where are they now? The Lancet, 365(9474), pp.1847-1848.), about 40 per­cent of med­i­cal grad­u­ates in Nige­ria may be liv­ing abroad-with the USA, UK and Ire­land as the most pre­ferred des­ti­na­tions for these grad­u­ates. The study ex­am­ined the where­abouts of three con­sec­u­tive grad­u­at­ing classes in the med­i­cal col­lege of the Univer­sity of Nige­ria.

The of­fi­cial class lists for the years 1995, 1996 and 1997 were ob­tained and many in­di­vid­ual mem­bers of the classes were reached through in­for­mal net­works such as email group lists, tele­phone in­ter­views and emailed ques­tions. Ac­cord­ing to the au­thors of the study, a “snow­ball” ap­proach was also used by which some par­tic­i­pants in the study rec­om­mended other sources of in­for­ma­tion on the lo­ca­tions of their class­mates. The re­sults from that study sug­gest that out of the 468 grad­u­ates sam­pled, 416 were lo­cated, which ac­counted for 89 per­cent of the to­tal. The lo­ca­tions of 46 grad­u­ates were un­known while 6 were said to be de­ceased. While the re­sults from the study may be said to have its own lim­i­ta­tions for which far-reach­ing con­clu­sions should be made with some de­gree of cau­tion, none­the­less, in gen­eral terms, the re­sults speak of the ex­treme scale of the brain drain phe­nom­e­non within Nige­ria’s med­i­cal pro­fes­sions.

But all hope is not lost on Nige­ria as the hu­man cap­i­tal mi­gra­tion is pos­si­ble to be re­versed. The case of China and In­dia can be used as good ex­am­ples of coun­tries where very many pro­fes­sion­als are re­turn­ing home af­ter many years of ex­pe­ri­ence abroad in order to set up some busi­nesses, teach in uni­ver­si­ties, or work for multi­na­tional com­pa­nies based in their home coun­tries.

It is es­sen­tial to note, how­ever, that for the brain drain to be re­versed, cen­tral gov­ern­ment poli­cies are very cru­cial. These poli­cies must as­sure steadi­ness in the do­mes­tic en­vi­ron­ment, free­dom of move­ment, po­lit­i­cal sta­bil­ity and the con­ti­nu­ity of gov­ern­ment poli­cies es­pe­cially on the econ­omy, and the gen­eral in­ter­ests of the gov­ern­ment in its utiliza­tion of hu­man cap­i­tal. Re­turnees, who are pro­fes­sion­als in their dis­ci­plines, may be ap­peased with dif­fer­ent in­cen­tives such as the cre­ation of a space that guar­an­tees higher so­cial sta­tus and bet­ter ca­reer op­por­tu­ni­ties.

In the STEM dis­ci­plines, for ex­am­ple, the gov­ern­ment can en­cour­age com­pe­ti­tion amongst uni­ver­si­ties and re­lated in­sti­tu­tions by cre­at­ing state-of-the-art re­search lab­o­ra­to­ries and en­ter­prises as the im­me­di­ate en­claves for re­turn­ing in­tel­li­gentsias. For in­stance, China was able to achieve this by in­sti­tut­ing a new life science school at Ts­inghua Univer­sity, Bei­jing. As many Chi­nese sci­en­tists as pos­si­ble were re­cruited in that univer­sity; who were pre­vi­ously lo­cated in more de­vel­oped coun­tries as the USA-giv­ing China an op­por­tu­nity to con­struct a science pro­gram from the scratch and to in­vest heav­ily on re­search and de­vel­op­ment for the ad­vance­ment of their coun­try.

Con­sid­er­ing that Pro­fes­sor Ade­wole is ex­pe­ri­enced enough to un­der­stand the dire straits of med­i­cal doc­tors in Nige­ria, yet he chose to say that they be al­lowed to es­pe­cially be­come tai­lors is ap­palling, to say the least. As noted by Dr. Ab­dul­lahi Dahiru of the Kano State Hos­pi­tals Man­age­ment Board, why should the Nige­rian gov­ern­ment ex­pend so much re­sources to train doc­tors who would later be­come tai­lors? Would it not be eas­ier for the gov­ern­ment to train them as tai­lors in the first in­stance? These are very fun­da­men­tal ques­tions that should be left for the health min­is­ter, Pro­fes­sor Isaac Ade­wole, to an­swer.

The case of China and In­dia can be used as good ex­am­ples of coun­tries where very many pro­fes­sion­als are re­turn­ing home af­ter many years of ex­pe­ri­ence abroad in order to set up some busi­nesses, teach in uni­ver­si­ties, or work for multi­na­tional com­pa­nies

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