Protocols
INTRODUCTION
It is now a truism that the living condition of the average Nigerian is excruciating and appalling. It is a pathetic tale of economic hardship, insecurity and structural deficiency, amongst others. The Africa Polling Institute Report (2024) documented that no less than seven out of every ten Nigerians were planning to exit the country to North America, Europe, Australia or Asia. Suffice it to state that the migration desperation is not restricted to the continents mentioned in the Report, as it has been reported that Nigerians in their numbers troop into countries within Africa, including Sudan, Libya, Ghana, South Africa, Senegal, etc., sometimes with devastating consequences as usually chronicled by the Nigerians in the Diaspora Commission.
The Merriam-Webster Dictionary defines the word ‘exodus’ as “a mass departure of people; emigration” and defines “emigration” as “departure from a place of abode, natural home, or country for life or residence elsewhere”. In the Nigerian colloquial usage, the word “Japa” (a Yoruba word meaning “to flee and be free”) has assumed the same significance as “exodus. The use of this word reveals the core inspiration underlying the mass migration of Nigerians outside the country today. According to Professor Toyin Falola, Japa is a Yoruba word that does not mean to walk away, it is to flee from danger or a compromising situation. It means fleeing from an abusive relationship, an extremely demanding situation and life-threatening issues. In his words, “the king of the meanings is -Flee from Nigeria”. Just as the word ‘exodus’ represented liberation for the people of Israel, the word Japa has come to represent the escape of Nigerians from their home country to a perceived promise land flowing with milk and honey.
Human capital is the most critical resource for national development. Therefore, an investment in human capital would undoubtedly yield a simultaneous increase in innovation, social well-being, and productivity. Frederick Harbinson, the quintessential American Labour Economist aptly captured the tectonic impact of human capital on national development when he opined that “human resources constitute the ultimate basis for the wealth of nations. Capital and natural resources are passive factors of production; human beings are the active agents who accumulate capital, exploit natural resources, build social, economic, and political organizations, and carry forward national development agenda. Clearly, a country which is unable to develop the skills and knowledge of its people and to utilize them effectively in the national economy will be unable to develop anything else”. Put in another way, a country that allows her human capital to waste or be dissipated cannot be taken seriously either by the citizenry, or amongst the comity of nations, for it is the human capital that activates whatever other capital or resources any country is endowed with.
Since the early years of independence, Africa has witnessed varying degrees of migration-regular and irregular. Scholarships in African regional studies have mainly attributed this phenomenon to factors such as high poverty levels, rising unemployment, and the deplorable economies of most African countries, Nigeria inclusive. However, the post COVID-19 trend of mass migration of Nigerians to different countries of the world, especially the United Kingdom as Japa, is concerning with multi-faced implications. Unlike the early 1960s where the migration of human capital was usually replenished by the education and experience gained in the receiving country and repatriated to the home country, the present loss of human capital appears to have no prospect of being recycled home. Report evinced that a total of 141,000 Nigerians migrated to the United Kingdom between December 2022 and June 2023 and a total of 10,180 Nigerians obtained Permanent Residency in Canada between January 2023 and June 2023. There is a real likelihood that many of these individuals, unlike the early generations of the 1960s, may never return to contribute their quota to improve productivity and drive economic growth back home.
The implication of this continued loss of human capital on a developing country like Nigeria is economic regression and higher inflation, which wields the potential of plunging the country into a failed state. Furthermore, the current mass exodus is likely to replicate aftereffects of colonialism such as forced displacement, cultural assimilation and loss of heritage and identity. Therefore, it has become imperative to lift the curtain on the patterns and causes of this mass loss of human capital and the most effective methods of curbing the loss to save our country, Nigeria, before the giant of Africa dishonourably hits rock bottom towards a failed state.
UNDERSTANDING THE HUMAN CAPITAL EXODUS IN NIGERIA TODAY
Taking a cue from the States of Fragility Framework, the increased rate of migration from Nigeria can be viewed under three basic elements that affect any nation: economic, social, and political. In other words, the high level of poverty, unemployment, insurgency, political instability, insecurity, corruption, and stifling costs of living have significantly contributed to the ongoing forced economic migration trend. In effect, when a state fails in its social contract to guarantee basic security to its citizens, maintain the rule of law and justice, or provide good public amenities, it reverts the society to something in the similitude of the Hobbesian State of nature, characterized by the prevalence of criminalities, which in turn births refugees and leads to emigration (regular or irregular) of its population. The high rate of unemployment, lack of basic infrastructure, unwieldy bureaucracy, high cost of living, low standard of living, poor electricity and water supply, etc., constitute a breach of the social contract on the part of the Nigerian government and this has resulted in a loss of faith in the government and in the future of our dear country.
A Yoruba axiom goes thus: “işę´l’ògùnìşę´”, that is “hard work is the cure for poverty”. This principle represents the basis of the omoluabi concept in the Yoruba culture. It legitimizes the system of reward for hard work and provides the assurance of success for whoever is willing to work hard. However, the current social structure of Nigeria makes a mockery of this principle. The average Nigerian works tirelessly but earns scant reward, if any. This brings to mind an account of a Nigerian medical doctor who migrated to the United Kingdom and, whilst drawing a comparison with the compensation structure between Nigeria and the UK, noted that the amount he earns from working overtime far outweighs his total monthly package in Nigeria, although his bills will also be correspondingly higher. He noted that his decision to migrate was borne out of frustration from low pay, underappreciation of skills and the desire to secure a better future for his children as he is of the view that the current Nigerian structure makes no provision for the protection of future generations. The events and happenings around us nowadays reveal tension, pain, anguish, man inhumanity to man, torture, bloodletting, continuous and arrogant display of ethnic chauvinism, massacre, murder, assassination, kidnapping, systemic corruption, threat to peace and security, and the list goes on. The incessant kidnapping on our roads have succeeded in making road trips unattractive. The repeated tales of daylight robberies, several unresolved murder cases, both high and low profile, are constant reminders of the tales of insecurity in the land across every spectrum, including in the church, the school and even the home.
CAUSES AND EFFECT OF MASS EXODUS OF HUMAN CAPITAL IN NIGERIA
We do not need to enlist sorcerers or mystics to tell us with precision, exactitude and accuracy, the problems and challenges confronting the collective people of Nigeria today. From the hallowed chambers of the National Assembly complex to the sprawling offices of multi- nationals and corporate entities, and to the newspaper stands which dot the landscape of both urban and rural settlements in Nigeria, there is an unequivocal consensus on the precise nature of the challenges confronting our country. Acute misgovernance, absence of institutions that make any nation tick, contaminated constitutions continuing to parade itself as the wish of majority of Nigerians, mistrust amongst the ethnic nationalities, sycophancy in and around government at all levels, deifying holders of office as opposed to according them due respect, widespread intolerance, substituting the sovereignty of Nigeria for the whims and caprices of leaders in power, corruption, epileptic power supply, grueling unemployment, total collapse of infrastructure, insecurity, utter disregard for the sanctity of the life of the Nigerian, impunity and gross disregard for due process and the rule of law, comatose industries and institutions, to mention a few, are some of the ills we agree on as impeding, hampering and stifling our development as a nation.
While being mindful of the fact that the rot enveloping the Nigerian landscape started a longtime ago, and did not just begin with the present administration, government is a continuum, and Nigeria remains an experiment in continuity. President Bola Tinubu has been quoted to have expressed his worry about the ‘Japa’ syndrome which his administration inherited from previous administrations for obvious reasons. In his words: “Part of our commitment is that we want to reverse the ugly trend and ensure that we sustain and retain our medical experts within the country through several interventions and measures. There is no doubt that this Presidential Statement is very encouraging and should constitute a soothing balm to our youth. Howbeit, there is the need to back the assurances with commensurate actions. In this wise, government at all levels must always feel the pulse of the people, and ensure that there are no gaps between what government says at any level and the actual state of affairs.
STATISTICS AND TRENDS
Nigeria faces a severe shortage of skilled health workers as the country currently has a density of only 1·83 skilled health workers per 1000 people, which falls far short of WHO’s recommendation of 4·45 per 1000 people. With a population expected to reach 263 million by 2030 and a growing trend of medical professionals leaving the country, this problem is poised to worsen unless addressed effectively. Evidence abounds that at least one of every five extraordinary talents in any organization overseas is a Nigerian, and health professionals form a large chunk of these. While this syndrome is not novel at all, as there is evidence that as far back as 1988, the then Military President, Ibrahim Badamasi Babangida, did set up a Presidential Committee on Brain Drain, under the leadership of Professor Oye Ibidapo Obe, whose Committee reported that about 10,694 professionals had, at the time, been lost from our tertiary institutions alone; what is, however, of concern, is the meteoric spike the syndrome has taken in recent times. As individuals continue to flee the country in droves, so also are corporate entities, Multinationals and Foreign Direct Investments. The exodus of multinationals – Unilever, Guiness Nigeria, Bolt Food, Jumia Food, PZ Cussons, GSK, P&G, Shell Petroleum to mention but a few signaled a bad omen for Nigeria. According to the Nigeria Employers’ Consultative Association, Nigeria lost 15 multinationals between 2021 and 2023, leading to the loss of over 20,000 jobs.
Many hospitals, production and research centers in Nigeria are now without specialists and consultants, while Nigerians in the diaspora, are doing exploits and making global waves, and the list is long and endless. From our own Prof. Oluyinka Olutoye (the extremely gifted foetal surgeon) and Dr. Olurotimi Badero, the world’s first and only dual certified cardio-nephrologist to the thousands of Nigerian specialists practicing their trade in the various health institutions across the globe providing stability for the health systems of those countries. The reality staring us in the face is that many teaching hospital wards, clinics and academic departments (from LASUTH to OAUTHC to UITH) are shutting down due to shortage of nurses and doctors on account of their massive relocation abroad, and many more will still shut down unless something is done and urgently too to arrest the malady. The potential effect of this danger to our already feeble health system is better imagined than expressed, but the managers of our health system had always treated this with levity, at least until the very recent, as one past labour minister was publicly quoted to have said that the mass exodus of health professionals was good for the country as a source of foreign exchange and an incentive to continue to produce more professionals for the global market.
The current health minister has however acknowledged the crisis, remarking that the country currently faces a severe shortage of doctors, with only 55,000 licensed doctors serving a population of over 200 million. He stated that in the last five years, 16,000 doctors have left the country, and 17,000 have been transferred and expressed concern about the mass exodus of healthcare professionals and other skilled workers seeking better opportunities abroad, leaving Nigeria with a bare minimum of professionals to manage the healthcare system. Retaining and empowering skilled healthcare staff in our labour force is the only magic wand needed to change the Nigerian narrative to an enviable one. It will mark the beginning of the Nigerian health system reform. With all respect to the institutions of government, it has chosen to be incorrigibly myopic, while preferring foreign aids to chasing its own horses after they had all bolted. Had the stable lad (the Nigerian State/its government) not been negligent by failing to bolt the stable (providing an enabling environment) would the horses have bolted? It then behoves the same stable lad to recover the horses.
THE TRAJECTORY OF HEALTH WORKER MIGRATION IN NIGERIA
There have been at least 3 phases of exodus of health workers out of the country in recorded history. In the pre-independence and early post-independence era when the opportunities for and access to higher education in Nigeria were limited, Nigerians and other citizens of the British Commonwealth found it fashionable to emigrate out of their country to the United Kingdom and other countries of the West essentially to acquire tertiary education. Some went for undergraduate studies while others who had obtained their first degrees here went to acquire graduate (specialist) training. They spent variable number of years studying and working part-time to obtain their degrees and diplomas, often joined by their spouses to start a family and after a period of sojourn, returned to the country to take up positions in the fledgling public service while a few of them went straight into private practices of their own. This pattern continued into the early seventies, and most of our teachers in medical school followed this trajectory for their training and held foreign post-graduate qualifications, something that will later put them in positions of advantage for easy emigration a second time. They formed the nucleus of trainers in the first- and second-generation medical schools across the country in the 70’s and 80’s, as the expatriate professors and trainers of the 1950’s and 1960’s gradually withdrew their services and returned to their home countries. This in the real sense of the word cannot be described as mass exodus.
However, as the economy of the country took a downturn at the dawn of the structural adjustment programme (SAP) of the Babangida era of the late 80’s, the earning power of Nigerian professionals was grossly eroded while inflation and the cost of living took a flight. This period birthed the first ever true mass exodus of health workers, especially the medical consultants, who essentially built and managed the country’s health system that both Nigerians and the international community were once very proud of. As undergraduate medical students in the late 80’s, we literally watched our trainers flee the country in droves due to the very harsh economic climate of that era to take up contracts in the countries of the middle East (Saudi Arabia, Oman, Quarter, Kuwait e.t.c.) while others returned to the countries of the West where they had their undergraduate/graduate training to resettle with or without their families. They were left with very little options as the introduction of SAP literally wiped out the gains of the middle class from the country. Medical consultants and Professors could barely keep their cars functional on the roads. A number of them were already in their 40’s but either still lived in rented apartments or in houses built with loans that they could no longer seamlessly service from their salaries due to the prevailing levels of inflation.
One of such victim senior Professors aptly captured the situation in his autobiography when he narrated the circumstances that led him and his colleagues to flee the country to Saudi Arabia: “Some of us had taken the Federal Mortgage Bank loans to put up our buildings in the housing corporation of the government GRA. We were paying monthly mortgages without default until the advent of SAP. Due to the devaluation of the Naira and the unparalleled level of inflation, our salaries became so worthless we could barely meet the basic financial commitments to our nuclear families, let alone the extended. We started to default on our housing mortgage payments. By the third month, the Federal Mortgage Bank wrote that they were going to foreclose the mortgages and take over the properties. This meant only one thing – our families will become homeless. So, fleeing the country became a survival necessity rather than an option. Glad to inform readers that with the first month’s pay in Saudi Arabia, we were able to fully payout the balance on our mortgages and our spouses and children could sleep again with their two eyes closed, without the fear of becoming homeless while not minding our prolonged sojourn to foreign lands at huge costs to family cohesion”. The situation was so bad that some academic departments in our medical schools were at the brink of shutting down due to the mass exodus of professors or were left with only one-man standing armies who held forth while others were gone. Many of the emigrated professors stayed on till their retirements in foreign lands before returning home while a few others returned to the country to their old jobs or to help start new medical schools, but only after they had secured enough comfort to weather the storm of the harsh economic climate at home.
This trend continued through the 90s and almost led to the total collapse of the country’s secondary and tertiary health systems until the intervention of the Obasanjo civilian administration of the 4th Republic when the financial incentives given doctors and other health workers became significantly improved with the birth of the Medical Salary Scale (MSS) and others. This was not won on a platter of gold, but as a dividend of a prolonged industrial action by the National Association of Resident Doctors (NARD) from late 1998 through mid-1999 when the country transitioned into the 4th democratic republic. The MSS intervention significantly slowed down the mass exodus of doctors in the early 2000’s and the National Residency Training Programme once more became very attractive and competitive. Young doctors were now resigning their appointments from private and state-owned facilities to join the residency training programmes in federal hospitals for the sole reason of the financial package of the MSS. The young consultants coming out of training found some fulfillment in their careers as the middle class gradually crept back into existence in the country. They stayed on the job, rose on the academic ladder and became the leaders of the health system once more, taking charge and stabilizing the system. Once more, both young and senior doctors alike were able to attain some semblance of middle class living typified by the purchase of automobiles in fairly good conditions, decent accommodation that were either owned or rented and enrolment of children in decent schools.
However, things started to take a downward spiral again in the last 10-15 years as the Nigerian Naira once more entered a free-fall against the US dollar, a situation that has grown worse in successive years till date, and the country equally entered a new phase of rising insecurity of lives and properties. These adverse outcomes were also attended by rising inflation and an existential cost-of-living crisis. Basic public infrastructure like electricity, water, decent public transportation and good public schools for children of school age became a luxury that only a few could afford. Public universities were perpetually in crisis due to frequent industrial disputes between the government the academic staff unions. Road and train travels (when available) became difficult due to the activities of marauding kidnappers and bandits. Worse still, the health professional unions lost all sense of professionalism for a patient-centered care and progressively derailed into an era of unhealthy rivalry where everyone wanted the same level compensation and rewards irrespective of job description, degree of responsibility and intensity of training. All that the citizens, especially young professionals felt daily was a sense of impending doom. This has ushered the country into the third and worst phase of mass exodus of health workers and other professionals ever witnessed in the history of the country. The vulnerability of Nigerians, as those of several other nationals, were further exposed with the advent of the COVID-19 crisis and the accompanying national lockdown. As if this was not bad enough, the fiscal and monetary policies of the current administration at inception, however lofty for sustainability, has greatly compounded an already bad economic and social milieu for the citizens with the floating of the Naira and removal of the fuel subsidies. While every commodity is priced against the US dollar, the monthly net pay of a Nigerian Professor of Medicine and Senior Consultant only amounts to a few hundred US dollars, while his expected expenditure is in thousands of dollars. It is worse for younger doctors. Mass exodus of professionals (young and old) has therefore once more become the order of the day in search of better remuneration, job satisfaction, better public amenities and a secured living arrangement.
The current emigration crisis is the worst in the history of the country because it involves people of all ages and professional categories. Medical students, young medical graduates, resident doctors, young consultants, experienced professors and even retired professors are fleeing the country in search of one unmet need or the other. It’s never been this bad. Academic departments and units in our medical schools are at the brink of shutting down once again due to heamorrhage of doctors and other professionals almost on a daily basis. Young doctors are not holding any stable job positions in any establishment. They only want temporary appointments for the duration of their writing foreign examinations and making job applications before they exited the country. Our hospital departments are outrightly short of residents and the University departments comprise only Professors devoid of the rank and file. Nobody seems to know the way out of this on the immediate term, but government at all levels also don’t seem to appreciate the enormity of the crisis and are only applying tokenism as remedies.
THE NIGERIAN GOVERNMENT’S RESPONSE TO THE HEALTHCARE WORKFORCE CRISIS
In August 2024, the Nigerian government introduced a policy targeted at addressing the health sector workforce challenge. The new initiative, tagged: “The National Policy on Health Workforce Migration,” is reportedly aimed at tackling “the critical challenges facing the country’s health human resources, aiming to manage, harness, and reverse the emigration of healthcare professionals. The Coordinating Minister of Health and Social Welfare, Muhammad Pate, remarked that the policy aims to stem the exodus of healthcare professionals. He wrote: “This policy is more than just a response to the ongoing exodus of healthcare professionals; it’s a comprehensive strategy to manage, harness, and reverse health worker migration and envisions a thriving workforce that is well-supported, adequately rewarded, and optimally utilized to meet the healthcare needs of all Nigerians”. He further remarked that the policy would create an environment that encourages professional development and stability, and seeks to retain the best talent within Nigeria. This message cannot be more apt at this time and seems to strike all the right cords and make all the necessary optics. But what exactly are the details of the policy?
It is expected to introduce targeted incentives for health-care workers, especially those in rural areas and those setting up private facilities. It supposedly includes special programmes, improved medical supplies, mortgages for facilities, tax breaks, and regular salary reviews. The policy also aims to enhance training by expanding institutions, fostering international collaboration, and funding postgraduate education. It will support a one facility per ward initiative and includes measures for worker safety and wellbeing, with ongoing monitoring to track migration patterns and inform adjustments.
The policy’s emphasis is on Digital Health Infrastructure, including Electronic Medical Records (EMR), Telehealth, and a Comprehensive Health Workforce Registry that represents a major milestone towards a more efficient and data-driven healthcare system. These technological advancements are supposedly expected to simplify healthcare delivery, promote fair distribution of health workers, and guarantee access to quality care for all Nigerians. Capacity building is another cornerstone of the policy, focusing on continuous professional development through strategic partnerships and international training to equip healthcare professionals with cutting-edge skills, demonstrating a commitment to retaining and empowering the workforce. The policy, the Minister said, will facilitate the return and reintegration of Nigerian health professionals in the diaspora by simplifying registration processes and offering attractive incentives, leveraging their expertise to fill gaps in the health sector and strengthening the healthcare system.
Also, the policy is expected to champion reciprocal agreements with other nations to ensure that the exchange of health workers benefits Nigeria. These bilateral and multilateral agreements are designed to protect national interests while respecting the rights and aspirations of our healthcare professionals. It calls on recipient nations to implement a 1:1 match, training one health worker to replace every publicly trained Nigerian worker they receive. Recognizing the importance of work-life balance, the policy includes provisions for routine health checks, mental well-being support, and reasonable working hours, especially for younger doctors. These measures are aimed at creating a supportive work environment, reducing burnout and enhancing job satisfaction. The National Human Resources for Health Programme is expected to oversee the policy’s implementation in collaboration with state governments, ensuring responsible execution and alignment with broader health objectives. The decisive actions, expectedly, will secure the future of Nigeria’s healthcare system, catalysing transformation and ensuring access to quality healthcare for all Nigerians.
Although the policy has several strengths, such as its comprehensive approach and focus on improving conditions in rural areas, it also has notable pitfalls, even on arrival. Comparing Nigeria’s approach to other countries facing similar challenges reveals both similarities and differences. Many nations, including those in the Caribbean and sub-Saharan Africa, use incentive programmes to retain health-care workers in underserved regions. However, Nigeria’s policy is less detailed in terms of economic incentives compared with other countries that offer substantial salary increases and benefits. The absence of specificity regarding economic incentives and improvements in salaries could undermine its’ effectiveness on day 1. Nigeria’s focus on training and capacity building is also in line with global practices seen in countries such as India and South Africa. Additionally, potential disparities in state-level incentive programmes may not be able to address the ever-present uneven distribution of health-care workers. The policy also does not directly address the issue of reducing working hours, which is a substantial factor in worker satisfaction. Although, the policy incorporates systems for integrating returning diaspora health-care workers into the Nigerian health system, poor health worker remuneration and ravaging insecurity in the land are major elephants that continue to create the push factors that cause Nigerian health workers to want to flee the country and also keep the Nigerian diaspora health workers away from returning to the country. Countries such as the Philippines have more established frameworks for leveraging diaspora expertise that Nigeria can learn from. As Nigeria continues to refine its approach, learning from different models could enhance the effectiveness of its policy and better address the challenges faced by its health-care system.
THE WAY FORWARD
Besides the niceties of the National Policy on Health Workforce Migration and the inherent pitfalls already identified that may hinder its’ successful implementation, the current Nigerian administration has to take a number of unprecedented steps if the healthcare system must be preserved from imminent collapse due the ongoing health workforce mass exodus across the country. Some steps must be sufficiently bold and taken outside the health system, although all will snowball to positively impact the health system on the long run.
Entrenchment of Consequence Management
Truth be told, it is not everyone that has joined the japa train that has done so for economic reasons or only out of the quest to make ends meet. There are tales of successful doctors, bank executives, captains of industries, senior lawyers, top-notch businessmen and women, successful artists, etc., who have also fled the country for places they consider as saner climes. Afterall, everyone desires a working society. Every reasonable man, irrespective of his social status desires a free and fair election; does not want to wake up to the news of murder of hundreds by some monsters tagged as unknown gunmen, wants to sleep with both eyes closed. As it currently obtains in Nigeria, everyman is a government to himself, as he generates his own electricity, provides his own security, builds the road to his own house, provides water, facilitates his own healthcare and the education of his wards; and the list of the basic social responsibilities that should naturally be borne by the State goes on. With all due respect to the Nigerian State, this is symptomatic of a dysfunctional system and anyone with an option will opt for something better.
But the current chaos did not emerge from the abstract. It is a function of human actions and inactions which have, over the years, sedimented into the monster that it has become. Had our society been one that encouraged consequence management by ensuring there is consequence for every action and inaction, things would not have gone as awry as they now have. For instance, if every public officer is, by available empirical facts, aware that there is a timely consequence for embezzlement of public funds, dereliction of duty, or negligence, then, by human instinct, his daily activities will be guided by an elevated measure of responsibility and responsiveness. Man, by his natural configuration, is more likely to adhere to rules and regulations when propelled by the knowledge of the immutable consequences for recalcitrance.
Given the fact that the machinery of State is human driven, this utopian state can only be achieved through effective and timely dispensation of justice without fear or favour, affection or ill-will. The stability and quality of a society and its laws are often determined by the degree of importance the former attaches to the judiciary and the powers it gives to it. This is measurable in quite a number of ways, including whether the judiciary is independent, that is, if it is not beholden to any special interest or to either of the other two arms of government. The independence of the judiciary is desirable in any organised society that cherishes the idea of the rule of law and human freedom. The competence and integrity of the Bench is the second criterion. Judges must be competent, learned and of high integrity in order to command universal respect and approval. In essence, a functional society requires a balance of sound and reputable judges for an efficient dispensation of justice. While it is not in doubt that the loss of confidence in the judiciary is a recipe for anarchy, it must also be realised that same also plays an influential role in the tide of mass exodus of human capital from Nigeria.
Proper Funding of Educational and Health Institutions in Nigeria
Over the years, ASUU Strike has become an inseparable phenomenon in the Nigerian educational system. This is attributed to the fact that the Nigerian tertiary institutions are grossly underfunded. Students and lecturers have been leveraging on the various international scholarship windows to further their studies abroad and as earlier identified, this has led to a massive loss of valuable manpower to overseas countries. To overcome the challenges, therefore, our tertiary institutions must be well funded, while also ensuring adequate remuneration for the academics and health professionals. This is a call on the government, good spirited individuals and corporate organisations to organise and set up counterpart interventions and trust funds like the Tertiary Education Trust Fund (TETFUND) to provide supplementary support to health and educational institutions in the country. Truth be said, the government cannot adequately fund education and health interventions alone without the support of alumni, private individuals/corporations and foundations. I am a living witness to the power of the Alumni in the lives of global institutions, including our own College of Health Sciences. It is high time the bull was taken by the horns to rescue the great citadels of learning that made us proud citizens of the world. Corporate organizations should look beyond sponsoring students’ jamborees as CSRs and start to truly invest in sustainable interventions in our health and educational institutions.
Merit-based Upward Review of the Remuneration of Health Professionals
The salary disparity between Nigerian health professionals and their counterparts in other climes must, as a matter of urgent national importance be addressed. It goes without saying that the purchasing power of the Nigerian doctor is tremendously impaired, and this is a veritable recipe for brain drain. In August 2023, the Chair of the Committee of CMDS of Federal Tertiary Hospitals, Emem Bassey, while speaking before the Ad Hoc Committee of the House on employment racketeering in federal agencies submitted that even African countries were now poaching Nigerian medical specialists and other health professionals by offering them between $3,000 and $5,000 monthly salaries, something which is now five times or more than what they are paid at home. The Nigerian TAC was also recently in the news. Government at all levels must critically review their reward systems for health professionals and use the strategy of collective bargaining to arrive at a living and realistic wage that can give health professionals the basic comforts of family living and safety while they in turn concentrate on the healthcare of Nigerians.
Tactically Retrieving Experts and Academics of Nigerian Extraction in the Diaspora
The premier University of Ibadan had an international reputation as a leading centre of excellence in tropical medicine and news had it that the Saudi Royal family used to frequent the University College Hospital (UCH), Ibadan for medical treatment in the sixties. Many of the Nigerians who performed these feats returned from their overseas studies to develop their centres at home. We have many centres in the country today that are doing great exploits (open heart surgeries, brain surgeries, cardiac by-pass surgeries, renal transplants etc) but are poorly funded. Such centers cannot attract any of our diaspora talents to work in them because they will be simply lost and unable to understand how any system should work in such great lack. Our government must wake up from its slumber and learn with vigour how to adequately recognize and reward all Nigerian talents (home and abroad) who are poking the world with their ingenious touches and excellence, while we strive to re-enact the good old days when Nigeria was a pride to the world.
Building Stronger Institutions and Reviving the Value of the Naira
In the 1970s and the early 80s, the Naira was stronger than the US dollar and many other foreign currencies, often exchanging for one U.S. dollar to NGN0.75k. This provided a lot of incentives for other nationals/expatriates to take up appointments in Nigerian institutions and provided the needed diversity for sustainable growth and development. Today, however, the Nigerian Naira has not only completely lost its value against the dollar, but has become a nightmare to its earners, having totally lost its bargaining strength to other currencies. The characteristic instability in the exchange rate is a strong catalyst for mass exodus of health professionals and the operators of our fiscal and monetary policies must rethink and rejig those systems to give more market value to the Naira in order to gain international competitiveness and appeal.
Realistically Confronting the Plague of Corruption and Enthroning Transparency
Brain drain has been identified as a product of structural inequality in the ‘political economy’ of the country, where those who control political power aggregate economic power to themselves through corruption. Corruption is the abuse of public trust for private gain. It is about the fastest means of accumulating quick wealth in Nigeria today. Corruption occurs in many forms, and it has contributed immensely to the poverty and misery of a large segment of the Nigerian population. On the contrary, absence of corruption encourages investment and efforts to expand the pie rather than merely fight over its distribution. To this extent, improvements in governance in general and reduction of corruption, in particular, could be means to accelerate the process of development. Hence, enthronement of good governance anchored on the principles of the rule of law, high level of integrity, transparency, probity and accountability becomes imperative for us to curb the menace of brain drain.
Efficient and Effective Economic Management
Breaking the infamous spine of hasty generalization, there is hardly any country in the world that is naturally and irretrievably poor! The poverty of any country is largely premised on the particular method, structure and policy adopted by the country’s principalities and power in the distribution of its natural resources (being their common wealth) and human capital (being the currency to growth). The major challenge of developing countries is rooted in the mismanagement of the available resources, both natural and human. Like the voice of him that crieth in the wilderness, we will continue to urge the Nigerian government to take a cue from Lee Kuan Yew and disembark from their conventional and endless wasteful tours, curtail their corrupt chases, blot out the infirmity of ethnic chauvinism, resist the lure of personal aggrandizement and bring every perpetrator of misappropriation or embezzlement of public wealth to book. It cannot be gainsaid that infrastructural development is an essential ingredient of social and economic stability, and to buttress this assertion, the World Bank estimates that every 1% spent on infrastructure will lead to an equivalent 1% increase in GDP which gives a positive correlation between infrastructure and GDP. Unfortunately, Nigeria’s poor infrastructure has spiraled into a cancer. In the 1960s and 1970s, Nigeria, Malaysia, Indonesia, Taiwan, Singapore, and South Korea had similar GDP per capita, but today, these countries have by far exceeded Nigeria in growth due to increase in their infrastructural development and total productivity. They have also become countries of destination for our migrating health professionals.
An Overhaul of the Current Constitutional Regime
While successive National Assemblies of the 4th Republic have over the years attempted the birthing of a new workable constitution which has led to the first, second, third, fourth and now fifth alterations, all these still remain a window dressing, as the foundation/origin is very faulty. As you may all recall, what we currently call the Constitution of the Federal Republic of Nigeria was birthed by the Constitution of the Federal Republic of Nigeria (Promulgation) Decree No. 24 of 1999, which came into effect on 5th May, 1999; whereas, the 4th National Assembly was only inaugurated on 29th May, 1999, about 24 days after the Decree came into effect. So, the critical question remains: who are the “people” referred to in the preamble as “we the people…”? Could “we the people” be referring to the members of the General Abdusalam Abubakar’s Supreme Military Council or General Abdulsalam Abubakar himself? Afterall, the Yorubas will say “ẹnìkan kìí jé à̩wádé” loosely translated in English to mean “no singular person can assume the pronoun: ‘we’.” Therefore, if anything is to be done to what we currently refer to as the “Constitution of the Federal Republic of Nigeria”, then, it must start from righting the lies told against itself by the Constitution. With the benefit of hindsight, the 1999 Constitution was promulgated by the military regime of General Abdulsalami Abubakar after the Constitution Debate Co-ordinating Committee led by Justice Niki Tobi submitted its report. Besides the fact that this committee barely had two months to consult with Nigerians before submitting its report, its report was merely advisory and cannot by any means of argument answer the question “Who are the ‘we?”
A lot of untruths and misplacements abound in the present Constitution. For example, Section 2(2) of the Constitution describes Nigeria as a ‘Federation’. When in actual fact, it is a Unitary Constitution. How can a country be a Federation when all “the entire property in and control of all minerals, mineral oils and natural gas in, under or upon any land in Nigeria or in, under or upon the territorial waters and the Exclusive Economic Zone of Nigeria is vested in the Government of the Federation.” What is then left for the component units known as the States? The effect of this is that all States queue at the Federal Capital Territory on a monthly basis for handouts, rather than the States contributing to the center. This is the beginning of our economic woes which is sending Nigerians fleeing the country in their droves.
In terms of security, how do we have a Federal Government with federating States where the Governors do not have any jurisdiction or power over the security systems or apparati in their State; yet a Governor is casually labelled as the Chief Security Officer of his State! He does not appoint the Commissioner of Police in his State as all he hears is the deployment of a Commissioner of Police to his State. He has no say, even in the deployment. We should stop deceiving ourselves by sending Police Commissioners from any State in the North to the South-West or to the South-East or vice versa, when such Police Commissioners have never been to such places before or have any idea or knowledge of the language or dialect of the people. How then does he communicate or enforce security? Nigeria is too big and large a country for a Constitution to pretentiously foist on us a single Police Command under the aegis of the Inspector-General of Police. The last explosion at Ibadan as a result of house-waring and stocking of explosives meant for mining purposes should serve as an eye-opener. Several lives and properties were lost. The Federal Government issued the mining licenses without the knowledge of the Governor, but the Governor was/is the one being abused, accused and lampooned by the citizenry for the gory incident. Simply put, our own Federal Constitution/system is an aberration and it is high time we drafted a new constitution for the federating units by the people themselves.
CONCLUSION
All said, Nigeria as a country is the greatest loser in this narrative, while the citizens (those who flee to other countries and those at home) are also losers in diverse ways, including the fact that they are always situated between a rock and a hard place, oscillating between the devil and the deep blue sea. Yet, one is reminded of the words of Andrew Carnegie, that “East or West, Home is the best”. In our collective interest, our generation must make the home not only conducive, but also attractive for our children, nay, our youths, to remain focused and be fully engaged immediately upon leaving school. This was what obtained when a good chunk of those in government at various tiers left their various schools. We must never convey to our children and grandchildren the story of ‘a better yesterday’, making them think that we are rendering to them moon-light tales. Even in the olden days of ‘trade-by-barter’, countries exchanged products or goods produced by them for items of commensurate values which they did not have, and vice versa. Juxtaposing this old practice with the efflux or exodus of our human capital as represented by our youths today, the intriguing question arises, that is, what does Nigeria gain in this present narrative? Indeed, we gain diaspora remittances; whereas, we lose everything else! Our generation has inflicted this sordid situation on our children/youths, as well as ourselves, hence, it is imperative we halt the negative trend; otherwise, history will be harsh on all of us.
Thank you.
REFERENCES
1. Olanipekun W. Mass exodus of human capital in Nigeria: an anatomical analysis of the causes and effect. Being a text of a convocation lecture at the Olabisi Onabanjo University, Ago-Iwoye, January 31, 2024.
2. Olatunji G., Aderinto N., Kokori E., Abraham I.C. O (2024). Nigeria’s new policy: solution for the health-care workforce crisis? The Lancet.com, Vol 4, October 5, 2024:1303-1304.
