Even though brain drain of medical doctors has been cited as one reason for the inadequate number, another is the refusal of most doctors to accept posting to the rural areas generally, and the northern regions in particular. It does not appear that these reasons are going to abate any time soon. What are the remedies? Is the government and other stakeholders going to fold their hands and bemoan the fate of the nation, especially considering the number of years that has been predicted for Nigeria to meet up with WHO standard?

This is not forgetting the fact that Nigeria is a fast growing population and has been predicted to be one of the world’s populous countries by 2030. What modalities are in place towards tackling the challenge or will the citizenry sheepishly continue to call itsself a middle income country? The United States has a doctor-patient ratio of about 390 or thereabouts. It calls for deep thinking in and outside the health box of so-called political leaders who suck the nation’s resources dry and have nothing to show for the jamboree they they enjoy.

In neighbouring Ghana, the late Professor Atta Mills government’s showed some mettle in that direction, when it dispatched 250 students to be trained as doctors in Cuba, but bonded them to be stationed in their regions and district assemblies of their origin on their return. In the field of gynaecology and obstetrics, only 1500 are registered members of the association as revealed by Prof Brian Adinma, the president of the Society for Gynaecology and Obstetrics (SOGON). This invariably means that from the statistics given by SOGON, a doctor is expected to attend to 133,334 patients.

He compared Nigeria’s population to its doctor and patient ratio with that of other countries and advised that with proper distribution and realisation that people in rural areas also have rights to good health, several deficiencies will be solved. He laments that even with such a poor number, the government is not living up to its responsibilities in engaging the few hands that are available. “A Jordanian told me that the country has 5,500 obstetricians and gynaecologists in a country of about 5 million people. Compare that with 1,500 people in a country with about 170 million people. The proportion is horrendous. But we have to start from somewhere. We cannot be said to effectively articulate our manpower needs when we have not created vacancy or created jobs for them.”

“There are many doctors that are going all over the place unemployed and yet we don’t have the medical capacity to service our people. We don’t even have enough in the urban centres not to talk of the rural areas. How do we begin to distribute properly? We can do that when we begin to put in incentives which will make people work in the rural areas. We can distribute properly when we begin to realise that most people in the rural areas also have a right to good medical services. Think about them and fend for them in that direction.”

Remarkably, countries like Cuba, Belgium, and Belarus lead countries that have adopted and even gone beyond WHO standard in the doctor to patient ratio which is 1:170, 1:220, 1:200 respectively, while countries like Tanzania, Malawi and Mozambique are down the ladder with the doctor/ patient ratio at 1:50,000, 1:50,000 and 1:33,500 respectively. The least of the countries are still better off than Nigeria with a very huge margin.

This has become worrisome especially in these present days when ‘sorting’ is in vogue and has come to stay, thereby forcing students from less privileged backgrounds to compromise decency and decorum on the altar of certificates, while students from affluent homes but not academically sound will pay their way through, thereby producing doctors with deficiencies in competence. It is a welcomed idea that the government has seen the need to review the medical curriculum after which it will set a benchmark as the minimum standard in the study of medicine, in order to compete favourably with other parts of the world. The new curriculum is expected to include the teaching of ICT, herbal medicine and enterpreneural skills among others.

It will also look into quota system, strict adherence to required necessities in terms of clinical colleges, especially in private and state-owned universities, infrastructural deficiencies in terms of laboratories in order minimise pressure and the establishment of more medical schools. However, as laudable as the plans may be, and as much as competency skills will be stressed upon, they will amount to void without scholarships and grants which must be given in order to encourage students, as well as parents as medicine is about life and does not understand the language of elitism.

Adequate funding must also be invested into the field of medical sciences as well as strict compliance to the implementation of set standards. It can also be recommended that working in rural areas for at least five years be a pre-condition for full medical scholarships. If necessary, admission into medical schools be segmented into regional quotas for the purposes of the bonding.

It is not enough to compare Nigeria with other developing countries that have been caught in this quagmire and as such remain in our present state. Nigeria is regarded to be the giant of the continent and must set an example for sister nation’s to emulate. Refusal to do this simply puts the nation in the status of a sleeping giant of the feet of clay, hence the need for a quick and purposeful action which has become a long walk which the government must tactfully engage in, and the time to start is now.

Source: Leadership Online