Date: 2017-02-21

Mike Ogirima, a professor of Orthopaedic and Trauma Surgery, is the President of the Nigerian Medical Association, NMA, and President of Nigeria Orthopaedic Association. In this interview he speaks on critical issues in Nigeria's health sector and doctors' perspective of the way forward.

A major problem facing the medical sector in Nigeria is brain drain where most of the doctors after completion of study leave the country for greener pastures abroad. What is NMA doing to curtail this, as most hospitals complain of shortage of medical personnel?

The number one reason why doctors and other health workers run away from the country is the working environment. When you are trained as a specialist in your field and you are left empty handed, there will be frustration. No equipment to work with. There are lots of doctors now roaming the street and there is general embargo on employment of health workers. This is a country that cannot boast of enough number of health workers to manage our system.

For example, the doctors on register in Nigeria are about 35,000. That is doctors registered under the Medical and Dental Council of Nigeria. In total it is 87,000, but practically maybe out of this figure, 5,000 are in the UK, another 10,000 in Saudi Arabia or United States. Then in the Far East, we see Nigerian doctors.

We don't have enough doctors to patients ratio. It is not enough, yet the ones we are training are not being employed as at when due. Even when they are employed, they don't have up to date facilities to work. We all know the situation of our public hospitals.

These are the salient reasons why you have doctors looking for greener pastures. Apart from that, though the government tried to favour doctors' entry into the salary scheme. In those days, a graduate will enter at Grade Level 8, while a doctor will enter at grade level 10 or 12, because there was no 11. In as much as there is a structure like that on ground, it is not enough package to turn back the tide of brain drain.

The only thing one as an association can do is to plead with the government to rehabilitate our hospitals. Make the working environment of a doctor conducive.

If you enter any doctor's office in any of these hospitals, you will be shocked by what you see. You will enter some public hospitals where you don't even have wash hand basin. It could be as bad as that, where a doctor has to share toilet facilities with so many other people, they have to leave the office for conveniences. That's how the working environment is.

In places where you have cases of surgery, there is a waiting time. You have to wait until it gets to your turn. You pray it's not an ailment that will kill the person, but that is the reality on ground. Government should try and train more, make sure our training institutions are up to date in terms of facilities to train. Make sure the ones you train are engaged and reabsorbed back into the system.

Yes, some fraction will still find a way of looking for greener pastures but if you keep on training, going by global standard I think the brain drain will be there but we will have enough to take care of the population. What is the NMA doing on the issue of quackery How many have been arrested and what has been done with them?

NMA is not a law enforcement agency but just a professional body that advocates and would cry foul if we find quacks.

But as an association, anytime we have a case, we report to the law enforcement agents. And we also advise the law enforcement agents that when they catch a quack, they should not label that quack a doctor until they have gone to MDCN to establish whether that person has a licence from MDCN.

We have numbers, I know my file number with MDCN. That is why NMA has a strategic plan which is going to bring a lot of innovations to checkmate a lot of excesses. Every doctor will have his own stamp just like the engineer.

We are doing a lot, in as much that there is internal discipline among ourselves, we are going to go out fully. I am sure that in the last three months you heard that NMA came heavily on some members. As long as you register with MDCN as a doctor in this country, you are automatically a member of NMA and if you are not obeying our constitution, we will discipline you.

So we will start with house cleaning, then we will extend it outside. Slowly we will get there, quacks will be identified and prosecuted. It has been noted that consultants refer patients from government hospitals to their own private hospitals.

It is an abuse of the system. The MDCN allows a consultant to own a clinic. What we mean by clinic is a small place where you can see a patient and recommend treatment plan. MDCN code of ethics states that if you are working in a public hospital, you cannot