INTERVIEW: Bill stopping doctors going abroad is modern day slavery-Kwara NMA chairman

Last week a lawmaker representing Oshodi Isolo II Federal Constituency in the House of Representatives, Ganiyu Johnson, sponsored a bill seeking to stop medical doctors from going abroad to practice. The bill is already generating ripples in the medical field. In this interview, Chairman, Nigeria Medical Association (NMA) Kwara State, Dr Abdulkadri Ahmed told our Correspondent, Mosunmola Ayobami that the introduction of the bill is a misnomer and an exercise in futility.

What is your reaction to the bill by a member of the House of Representatives seeking to stop medical doctors from travelling abroad until after five years of working in Nigeria?

You see the bill is a very sad thing to hear. People that are supposed to be representing us; to speak about our welfare and proffer solutions to the myriad of problems around us in Nigeria could come up with such ridiculous bill, is really disturbing. The lawmaker who sponsored the bill looked at the problem in the surface, forgetting the symptoms of the bigger problem. The main problem he was trying to tackle is brain drain. Brain drain doesn’t affect only doctors; it cuts across everybody in Nigeria. Lawyers are leaving, engineers are leaving, pharmacists are leaving and bankers are leaving, so why singling out medical doctors?

Why are doctors leaving the country?

Remuneration of doctors in Nigeria compare to where they are going; Europe and America, the margin is so big, and the work load here is huge plus the working condition is poor. But over there, you have less work load, good working environment and better pay. Why won’t you go there? Unfortunately, the take home pay of these Nigerian lawmakers is higher with less job than the pay of parliamentarians in Europe and America. Instead of looking at the problem raised, he was looking at ways of stopping doctors from going outside the country to work. Look at our infrastructures, how many of them (lawmakers) receive treatment in Nigeria? They quickly want to go outside Nigeria to go and receive treatment. If the Nigerian healthcare system is so fantastic, why are they not staying to receive treatment here. Meanwhile, Nigerian doctors have the knowledge and the skills to perform your duty but the infrastructure for you to do it is not there. In some hospitals, there is no light when you want to do operations on patients. No Lab. You may have to send patients to 5-6 kilometers to perform investigation and then bring the result for you to act on. What level of support is government giving the private doctors; they are rendering services, they are paying taxes. There is nobody who is not willing to serve fatherland but because of the situation of things they have to move. Look at the insecurity in the country.

Doctors are being kidnapped, many health workers are being exposed to kidnapping. Armed robbery is there. In 2013, I was a victim of armed robbery attack in this Ilorin. I was going for call duty when armed robbers attacked me in this Ilorin. They kidnapped me with my car, took me to Ogbomoso, collected my car. I had to trek to Eyenkorin before I could get a taxi to Ilorin. Up till today, I have not seen that vehicle. So, why would people not leave? These are the things they are supposed to legislate on in the Nation Assembly to address so that doctors can stay. But they didn’t look at this, but want us to stay by force.

What are the implications of the bill?

The bill will worsen the situation we have on ground. The bill is going to infringe on our fundamental human rights. This is modern day slavery. Then they are now discriminating. Is it only doctors that are leaving? He is so myopic that he’s picking five years to leave. Who is going to train the young doctors when the senior ones are gone? Under what condition are they going to practice; no license and those with experience have left.

What do you think lawmakers and the executive need to do to prioritize quality healthcare services?

Remuneration of health workers generally, not doctors only, needs to be looked into. In Europe and America, there’re mortgage for house, loan for car. In Nigeria, there is nothing like that. There should be welfare packages to encourage health workers to stay. Go anywhere in the world, Nigerians are the leading doctors. But here they can’t perform because of poor infrastructure. Is it not a shame that some of these people go abroad for healthcare and meet same Nigerians for consultation? Why can’t you build your own? They should legislate that these politicians don’t travel abroad for healthcare services. With that, they will be able to forcefully fix the infrastructures, make sure our hospitals are functioning to the fullest to be able to give qualitative healthcare services to our people. People are dying from malaria till now. Maternal mortality death is there. We are improving but at a slow pace. The same thing goes for insecurity. They need to do something about insecurity so that you know you can go and attend to your patient at any time without the fear of being kidnapped or robbed. If all these are looked at, some of the problems will be solved.

What programmes do you have for NMA members in the state?

The major programme is to ensure improvement in welfare of my members because the sole aim of being a member of an association is the welfare. And since we came in, we’ve been doing a lot to ensure that welfare package is improved. We’ve engaged the government and the management of UITH to see to the welfare packages of our members. When we came in, one of the challenges we were faced with was assault on our members; doctors being attacked here and there. It has happened in the UITH and we have taken it up. The case is still in court. There is another one in the Generally Hospital, Ilorin. The matter is with the police. So, we are doing our best to ensure everything is going on well. We are also participating at the national level so we will not lag behind in national activities

How do you plan to take healthcare services to the indigents as an association?

What NMA has been doing over time is to ensure annual medical and surgical outreach to selected rural communities where people get free healthcare services. But that’s just once in a year. What happens after we have left? So, we are on radio regularly. We encourage people every week on what they can do personally to prevent diseases. Those that are sick, what they can do to curb it from spreading and we encourage enrollment on health insurance scheme. Kwara is about 3million people. Each time we go out, we don’t do more than 500 people and when government is carrying out activities, we key in to ensure they have successfully outing

What do you look forward to see in the second term administration of Governor AbdulRahman AbdulRazaq in the health sector?

I want to appreciate the governor, His Excellency, AbdulRahman AbdulRazaq for what he did in his first term. And I believe it’s what he did that earned him second term. He did very well in the health sector in the area of infrastructural development. When it comes to counterpart funding he paid. The area we have been lagging behind for a long time he was able to close that gap. The major challenge that we have is the manpower. We have a huge manpower gap. A lot of our health workers have left because of brain drain. Ab initio, we are not enough. There are two issues; there’s brain drain from state to federal and from federal to abroad. Yes, there was a time he gave approval for recruitment but people didn’t come because remuneration was poor when compared to the teaching hospitals. In fact, the few people that came left, those they met on ground also left. We have written to him, had meetings calling for improved payment for all health workers. With that, you will be able to retain the ones there. With that, there will be headway. He also needs to look at infrastructure deficit. He has tried but it is not enough.

What areas do you want him to improve upon?

Within Ilorin, there are opportunities. It’s fair compared to the rural communities. There are some communities that their primary healthcare centres have nothing to write home about. There are some communities that don’t even have at all. According to Basic Healthcare Provision Fund (BHPF), funded by federal and state governments, they expect that we have one primary healthcare per ward and we have 193 wards in Kwara. But as at today, we have PHCs in 186 wards. Out of the 186, only 142 are good enough to provide healthcare for our people. So, there’s need to work on other ones so every Kwaran will benefit. He needs to also support the health insurance more. As at today, the civil servants are not on board in health insurance.

What is the stand of Kwara NMA in the case of former Kaiama hospital CMD who was slammed with murder allegation?

I have stopped talking about the case as it’s still under investigation and it’s in court. But what I will say is that as a doctor, he is still our member until he is convicted. The condition that made you a member is that you’re licensed to practice. You practice in Kwara and you pay dues. As at the time before he was arrested, he was paying his dues. If the state government stop his salary, he’s not going to pay again as the due is being deducted from his salary. But we don’t condone any criminal activity whether it’s confirmed or not. Even attributing a doctor to any crime is an embarrassment to the association and profession at large. So, we totally condemn what Dr Abass Adeyemi has been accused of. We will allow the law to take its course, then we know what to do

Your advice to your members

My advice is to continue to be law abiding, to continue to give care irrespective of the situation we find ourselves. Giving care is a humanitarian service. I want to encourage them to keep on doing their best, continue to pray for Nigeria. Though I can’t stop anyone not to leave, but I want to encourage them not to leave but support us, and hope that one day it will soon be better. Kwarans should continue to give support to health workers. Health workers are doing a lot in rendering services to them despite the challenges. In a standard setting. a doctor is expected to see 28 patients in a day. But some of our doctors are seeing close to 50-60 patients in a day. This same doctor will be the one to enter theater, attend to emergency in labour room, have patients in the ward. As at today, we have over 3million people in Kwara. As at the time I took over, we have over 700 doctors in Kwara. As at today, we are having around 500. Now if they say a doctor to 500 patients, let us assume we have 700 divided by 3 million plus people, so we are looking at one doctor to 5000 patients and that is what is happening all over Nigeria. So, we are encouraging the masses to understand the plight of the doctors and other health workers on what we are facing to provide healthcare services to them.