Nigeria lost 500 consultants to brain drain – Makanjuola, MDCAN President

The President of the Medical and Dental Consultants Association of Nigeria, Dr. Victor Makanjuola, shares with TUNDE AJAJA his thoughts on consultant brain drain, solutions and problems of mental health in the country

A lot Nigerians know about the mass exodus of doctors from Nigeria, but not much was heard of consultants leaving the country until you were talking about it recently, how serious is the situation?

That's pretty bad. We surveyed our 82 chapters in March, and of the 37 who responded, 253 consultants from different specialties have left the country for greener pastures in the past two years. The remaining chapters did not send their response for certain reasons. We estimate that if 90-100% of all chapters respond, over 500 consultants could have left the country in two years. This is our rough estimate and it is a major disaster for the country. However, there may be consultants working in the private sector who are not members of our association. Our members are those who work in government health facilities, both state and federal. Judging by the time it takes to train a consultant — six years in medical school, one year in housekeeping and one year in the National Youth Service Corps program — that's eight years. Then, the minimum number of years for residency training is six years. For some specialties, it takes longer and can be up to 10 years. This represents an average of about 14 years of training lost to other countries. It is therefore a great loss for Nigeria, and it is all the more so since consultants run most of the health services. This may lead to the closure or reduction of certain services in the places from which the consultants have departed. This is a frightening and unpleasant image.

The gradual depletion of staff presents a picture of an impending crisis in the health sector if nothing is done, has your association informed the government of this expensive trend?< /p>

Our first investigation was carried out in January and when we sounded the alarm, we contacted the office of the head of the Federation's civil service, and the permanent secretary was asked to meet us. The Ministry of Health was then instructed to create an inter-ministerial committee, but this line of discussion cooled for months. Finally, the committee was inaugurated last week on Wednesday (September 14). It seems that the government really realized the importance of the information we gave them at that time. The committee was asked to produce a report within four weeks.

Nigeria has an estimated population of 200 million, what does the current shortage of consultants look like?

We currently have approximately 5,000 consultants. We have honorary and hospital consultants; honorary consultants are around 3,000 and hospital consultants around 2,000. But even at 5,000 to 200 million people, this is still far from ideal. As for the ratio of doctors to population, the desirable figure is around one in 600, according to the World Health Organization. But Nigeria has about one doctor for every 5,000 people. For specialists, a population of 200 million for 5,000 consultants is equivalent to approximately one consultant for approximately 40,000 people. This is largely insufficient.

Could you share with us the sufficient number of consultants per specialization?

I don't have that number here. However, being a psychiatrist, I can tell you that we have approximately 200 psychiatrists practicing in the country. If you juxtapose that with 200 million people, it gives a ratio of one consultant for every million people. We sometimes joke among ourselves that we're so special that we're one in a million. We produce many psychiatrists, but most of them are now outside the country. Some other specialties have more consultants; there are more than 200 pediatricians and more internal doctors, but there are perhaps fewer than us, such as anesthesiologists. There are also very few neurosurgeons.

A report came out a few weeks ago that millions of Nigerians have mental health problems, could the shortage of consultant psychiatrists have worsened this prevalence and what are the other catalysts?< /p>

Inadequate mental health professionals can make the figure worse, but there are other factors. Lack of mental health education is a major catalyst; people don't know what constitutes mental health issues and they assume that only the person who stripped or screamed and destroyed things is the one with mental health issues. There are several mental health issues that don't include being destructive, hearing voices, or...