In response to President Bola Tinubu’s pledge to deploy Nigerian health workers to the Organisation of Eastern Caribbean States (OECS), Nigerian doctors have warned that the nation does not have enough health workers to send to Saint Lucia.
On Wednesday, Mr Tinubu signed an agreement to deploy skilled manpower, including medical professionals, teachers, and agriculturists, to the Caribbean nation.
The deal comes at a time when Nigerian doctors are grappling with systemic neglect, poor salaries, and withheld allowances, among other longstanding challenges.
The brain drain in Nigeria’s health sector is a serious problem that has led to the loss of many skilled and competent healthcare professionals, placing immense strain on the country’s healthcare system.
As skilled workers continue to migrate abroad in search of greener pastures, critical sectors like health and education grapple with understaffing, poor funding, and the challenge of providing efficient and quality services to Nigeria’s rapidly growing population.
In 2024, the Minister of Health and Social Welfare, Muhammad Pate, lamented that Nigeria now has only 55,000 licensed doctors to serve its growing population of over 200 million; adding that there were only about 300,000 health professionals, including doctors, nurses, midwives, pharmacists, laboratory scientists, and others in the country.
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He disclosed that about 16,000 doctors left the country in the past five years with about 17,000 transferred. This brain drain, he said, has deprived Nigeria of its top medical professionals, leading to a severe shortage of healthcare workers. As a result, one doctor now attends to over 5,000 patients, far below the World Health Organisation’s (WHO) recommended 1:600 doctor–patient ratio.
“We did an assessment and discovered that we have 85,000 to 90,000 registered Nigerian doctors. Not all of them are in the country,” Mr Pate said.
Data from the Development Research and Project Centre (dRPC) shows that 233 Nigerian doctors moved to the UK in 2015. This number increased to 279 in 2016; in 2017 the figure was 475, in 2018, the figure rose to 852, in 2019 it jumped to 1,347, before dropping to 833 in 2020, and then rose again to 932 in 2021.
Amidst the ongoing brain drain, the Nigerian government has signed a deal to deploy its already scarce healthcare practitioners to Saint Lucia in the Caribbean.
The Nigerian Medical Association (NMA) has criticised the government for this decision, revealing that while doctors serving locally in Nigeria currently earn only N11.9 million per annum, those under the Saint Lucia arrangement are to receive N40.8 million annually, to be paid by the same Nigerian government.
Meanwhile, the government of Saint Lucia pays its doctors N131.7 million annually, which underscores the inequity in the proposed deployment scheme.
‘There are no doctors to export’ – ENT surgeon warns
Reacting to Mr Tinubu’s pledge, an Ear, Nose, and Throat (ENT)/head and neck surgeon, Folaseye Adebayo, said that the Nigerian health system is in a state of “denial medical crisis.”
Expressing her frustration in an X post, Ms Adebayo said, “The truth is that there are no doctors to export anywhere, Mr President. Even I am overwhelmed with work here in Lagos”.
According to her, the entire medical system in Nigeria has collapsed, noting that in her field of ENT surgery, there are fewer than 500 specialists in the country, with less than 30 in Lagos State. “Among these 30, some are already halfway out of Nigeria.”
Ms Adebayo likened the situation to the country’s insecurity crisis, describing it as “medical insecurity.” She lamented that while WHO recommends a doctor-patient ratio of 1:600, Nigeria is closer to 1:5,000, “yet the government acts as though there is a surplus of doctors.”
She said: “The young doctors don’t even listen to our pleas to stay a little longer in Nigeria. Their bags are already on their way to the airport. The few doctors who remain for residency are only staying to earn enough money to write foreign exams and leave the country.
“Is all these international self-seeking hypocritical approach going to help Nigerians in any way? Nigerians, please come let us reason together and help us ask Mr Tinubu whether St Lucia is his primary assignment. At home, his administration has failed to adequately fund or reform the crumbling healthcare system.
“Thousands of Nigerian doctors are leaving the country due to poor pay, insecurity, and lack of equipment, yet no decisive steps have been taken to retain them. Mr Tinubu is exporting the same “scarce” doctors that Nigerians desperately need, as local hospitals remain understaffed and overburdened. Rather than tackling the brain drain crisis, the government is institutionalising it as a foreign policy and economic strategy. While exporting doctors, government officials including Mr Tinubu himself, rely on medical tourism.
“So President Tinubu, I don’t know who is advising you. Please listen to the NMA and revive the medical system. Yes, it will cost you an arm and a leg and your heart, but if Nigeria’s health system is revived, it can serve Africa because Nigerian doctors all over the world are among the best”.
Responding to Ms Adebayo’s post, a tech enthusiast and corporate consultant, identified simply as Oluwaseun, lamented that the healthcare services in his area have degenerated, saying most patients do not receive proper diagnoses due to doctors rushing to attend to many other patients.
He said, “In fact, the ratio is 1:50,000 in my location, as you see about 100 people on the queue to see just one consultant. Most people can’t even get a proper diagnosis in delicate medical situations because of the need to attend to the waiting list of patients. It’s truly an emergency situation.”
Also reacting, an aspiring neurosurgeon identified as Nduboy NWA 042 disclosed his plans to emigrate from Nigeria after acquiring his MBBS certificate.
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“In JUTH, doctors are leaving consistently to look for a better future abroad. I will get my MBBS certificate next year and I will also find my way out of this country. I tell my colleagues that if Nigeria is working and also paying their doctors well, nobody would want to leave,” Mr Nduboy said.
Deployment amid domestic crisis
The NMA has warned that the recent move by the federal government could worsen the country’s brain drain crisis and negatively impact healthcare delivery in Nigeria.
In a statement signed by the association’s secretary-general on Thursday, Ben Egbo, criticised the timing of the agreement, describing it as an attempt to bolster Nigeria’s international image while failing to meet the basic obligations owed to doctors at home who are toiling hard to serve the nation.
According to Mr Egbo, Nigerian doctors have continued working under harsh conditions, leading many to leave the country due to poor remuneration; chronic delays in payment of the Medical Residency Training Fund (MRTF); non-implementation of previously negotiated welfare packages and agreements; hazardous working conditions without commensurate risk allowances; and lack of universal implementation of the CONMESS salary structure.
“These challenges have overburdened the doctors left behind, resulting in burnout, stress, chronic diseases, and even death, which invariably increases morbidity and mortality among Nigerians.
“While we support regional cooperation and international engagement, it is morally unjustifiable to export healthcare workers to foreign countries and pay them five times higher than they earned while serving in Nigeria, thus encouraging brain drain with its attendant health consequences,” Mr Egbo said.
Tinubu seeks stronger African–Caribbean ties
During a special joint session of the Senate and the House of Assembly of Saint Lucia on Monday, Mr Tinubu pledged to build strong diplomatic relations with the country, where he was paying a state visit.
He pledged to deploy the Nigerian Technical Aid Corps (NTAC) to facilitate exchange of health, education, agriculture, and other technical services to the OECS.
Mr Tinubu said that the effort would serve as a point of reference for broader African–Caribbean collaboration.
Nigeria signs TMA agreement, begins deployment across Africa
On Wednesday, 2 June, the Director-General of the Nigerian Technical Aid Corps, Yusuf Yakub, and the Acting Permanent Secretary, Ministry of External Affairs, International Trade, Civil Aviation and Diaspora Affairs, signed the Technical Manpower Assistance (TMA) agreement.
The agreement outlines the terms and conditions for the deployment of skilled Nigerian professionals to Saint Lucia.
The agreement marked the commencement of the deployment, as Mr Yakub explained that over 300 Nigerian professionals have been deployed across Africa, the Caribbean, and the Pacific since it was revived in May 2023.
Additionally, he noted that while deployment has commenced in some countries, further engagements are ongoing to establish a regional framework for technical assistance.
“Since my appointment in August, we have deployed volunteers to Liberia, Sierra Leone, Jamaica, and other African nations. This programme was nearly dormant, but Mr President revived it with his strong foreign policy vision.
“Right now, we are deploying volunteers to Jamaica. Some are already there, and others will fly out tomorrow from Abuja. Four nurses will depart for Jamaica tomorrow. Additionally, six medical doctors are scheduled to leave for Grenada on July 9.”
The OECS
The Organisation of Eastern Caribbean States comprises seven developing states that are the original founding members, including Antigua and Barbuda, the Commonwealth of Dominica, Grenada, Montserrat, Saint Kitts and Nevis, Saint Lucia, and Saint Vincent and the Grenadines.
With a combined population of approximately 625,000, the OECS spans a 12-member grouping of islands, Leeward Islands and the Windward Islands spread across the Eastern Caribbean. The headquarters is located at Morne Fortune, Castries, Saint Lucia.