The last good doctor at the general hospital in my hometown just resigned. She is moving to the United Kingdom. Her salary will triple. Her working conditions will improve. Her children will have better schools. Her patients will have to find someone else. I should be angry. I should feel betrayed. I feel neither. I understand. And that understanding is the most damning indictment of Nigeria’s health system I can offer.
Here is what most people get wrong about the brain drain crisis. The problem is not that doctors are abandoning Nigeria. The truth is that Nigeria abandoned its doctors first. And here is why that matters right now: because no country can build a healthcare system on the backs of professionals who cannot afford to stay.
What the official report won’t tell you
The Nigeria Medical Association reports that over 5,000 doctors left the country in the last year alone. The UK’s National Health Service is actively recruiting Nigerian-trained doctors. Canada has streamlined visa processes for Nigerian nurses. Saudi Arabia offers tax-free packages that Nigerian hospitals cannot match. The government calls it a tragedy. The doctors call it survival.
You cannot shame a doctor into staying when staying means her children go hungry.
The numbers are devastating. Nigeria has approximately 3.5 doctors per 10,000 people. The World Health Organization recommends 10 per 10,000. The gap is filled by overworked, underpaid, demoralized professionals who are constantly recruited by countries that value them more. A Nigerian doctor earns in a month what a UK doctor earns in a week. A Nigerian nurse works shifts that would violate labour laws in Canada. The math is not complex.
To be fair…
Let me give the government its due. Brain drain is a global phenomenon. The Philippines loses nurses to the US. India loses engineers to Germany. Every developing country faces the same pull factors. And the government cannot force doctors to stay. That would be slavery.
But here is where that defense fails. Other countries have responded to brain drain by improving conditions, not by complaining about it. Ghana has increased health worker salaries. Rwanda has invested heavily in training and retention. Even within Nigeria, state governments that pay better and provide housing lose fewer doctors. The federal government has the tools. It lacks the will.
Doctors are not leaving Nigeria because they hate Nigeria. They are leaving because love does not pay rent.
The human cost
I waited four hours at a Lagos teaching hospital last month to see a doctor for a relative. Four hours. For a consultation that lasted seven minutes. The doctor was exhausted. She had seen 50 patients before us. She had three more hours of clinic ahead. She was polite. She was competent. She was also looking at job postings from the UK on her phone during a break. I did not blame her. I wanted to help her pack.
The patients left behind will suffer. Longer waits. Fewer specialists. Higher mortality rates. The government will promise to train more doctors. But training more doctors does not help if they all leave. You are not filling a bucket. You are filling a sieve.
What needs to change
Salary increases alone will not stop the brain drain. The UK and Canada offer more than money. They offer predictable work hours. They offer respect. They offer safety. They offer functioning equipment. Nigeria cannot match all of that overnight. But it can start. Dedicated housing for doctors. Loan forgiveness programs. Clear career progression. Protection from violence in the workplace. These are not impossible demands. They are basic decency.
The government must also negotiate bilateral agreements with recruiting countries. The UK should not be allowed to recruit Nigerian doctors without contributing to Nigerian medical education. A tax on recruitment fees. A quota system. Something that acknowledges that taking a country’s trained professionals has a cost.
Here is where we land. Our best doctors are leaving. And honestly, I do not blame them. I blame the country that made them feel they had no choice. The question is not how to stop the brain drain. The question is how to build a Nigeria where leaving is a choice, not a necessity. Until then, I will keep waiting four hours at the hospital. And I will keep understanding why the doctors are looking at their phones.
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