In the chic Oriental Hotel in Lagos, Nigeria, dreams come and go with Adeyoyin Adesmoyo's little phrases. If the Canadian, a private immigration consultant, launches a definitive "Sir, you are too old" a 48-year-old engineer, on the other hand, with doctors, he changes his tone.
When a practitioner, in his thirties, comes to him, he stands up and adopts a more engaging speech. "I can assure you one thinghe says. With your profile, by the end of the year, you will have a permanent residence in Canada. " Words make their immediate effect. On the other side of the table, Dr. Adekola Adekunla is smiling. If he came here, it's because he wants to leave.
His wife does not find a job in Nigeria where the unemployment rate is at 23%, and their working conditions are difficult in the economic capital. "I wish to go to Canada. There, I will have a higher salary, I will be more respected and the future will be brighter for my daughter ", he explains to World Africa. Dr. Adekunla is not alone in this reasoning. In Nigeria, health professionals often dream of emigrating.
"An alarming trend"
A survey conducted in 2017 by Noipolls, the largest polling institute in the country, showed that nine out of ten doctors planned to go into exile because of poor wages – about 500 euros per month – and terrible working conditions, mainly because of lack of medical equipment in hospitals. According to the Residents' Association, some twelve professionals would leave the country each week. A massive exodus, especially to countries where English is the official language of Nigeria, is the majority, as in Canada, the United States and the United Kingdom.
"It's really an alarming trend"says Dr. Francis Adebayo Faduyile, president of the Nigeria Medical Association and general practitioner for almost 25 years. According to him, security issues also push doctors to leave. He says that many of his colleagues are kidnapped by criminal groups, who believe – wrongly most often – that they are very rich. "The media do not report them all, but we hear abduction stories every week", insists Mr. Faduyile. To curb this brain drain, he is campaigning for the federal government to spend 15% of its budget on health. But for now, the share devoted to this ministry represents only 4% of the expenses.
This underfunding, added to the outflow of doctors, is leading to a shortage and degradation of care across the country. There would be 5,000 patients for a doctor in Nigeria. This is eight times less than the ratio recommended by the World Health Organization (WHO). And the needs are even more acute in remote areas. In some places in the state of Zamfara, in the north-west of the country, there are only 46 doctors in public hospitals for the three million inhabitants, local media reports.
"Almost all" promotions
Sandra Jboneme, 24, who has just finished her training in general medicine at the Faculty of Medicine at the University of Lagos, prefers to stay in the largest city in Africa. An exception in its promotion since the "Almost all" students in his class want to live and practice elsewhere than in Nigeria. "Out of 250, we are barely 10 to consider staying"she observes.
WhatsApp groups for overseas admission exams abound, but Sandra Jbonneme has struggled to find one for those wishing to take the Nigerian professional tests. "They all dream of being doctors elsewhere. I feel like we are training doctors for other countries "the young woman, whose choice is so strategic because she thinks that by staying here, it will be easier for her to work one day as a specialist doctor.
On Friday, April 5, President Muhammadu Buhari lamented the departure of doctors abroad and invited them to " return ". According to him, the weakness of the health system and medical tourism, which concerns Nigerians preferring to seek treatment abroad, would lose about 1 billion euros to the government. The president does not have lessons to give. In 2017, the head of state had made three medical trips to London, including a 104-day trip.