Dear Jigawa governor, we’re losing our doctors

BY NAJEEB MAIGATARI

Your Excellency, I hope this letter finds you in good health. As I do not have the means through which my message could reach you, I am compelled to write this open letter to draw your attention to a menace that threatens our healthcare system. That is the well-known japa syndrome that has plagued our dear state in recent times.

I would like to extend my heartfelt condolences to you and the good people of Jigawa over the tragedy that befell the people of Majia a few weeks ago, an unforeseen event that led to the loss of lives of over a hundred people and left several others with varying degrees of injuries. My heart goes out to the bereaved families of all those affected, and I pray that Allah repose the souls of the deceased and heal the injured. Amen.

Coming back to the purpose of writing this letter, Your Excellency, I would like to throw in some details about how our dear state used to be in the past. It was inarguably one of the states with the best healthcare system and the highest number of practising medical doctors in northern Nigeria. It was at some point in time akin to a medical hub that attracts both patients and medical professionals from neighbouring states owing to its subsidised healthcare, efficient service delivery and overall welfare of health workers and patients.

Since its creation in the early nineties, the state has made giant strides in providing effective and reliable healthcare services to its citizens. To mention a few, various successive administrations have invested heavily in training medical doctors and other health professionals, within and outside the country, in varying capacities in a bid to ensure effective healthcare delivery to the good people of the state.

Similarly, the state has commendably been awarding scholarships with bond agreements to both local and foreign medical students since time immemorial. It has produced medical graduates from various reputable institutions within and outside the country. In addition, it was one of the pioneer states among its peers to implement the sponsorship of medical doctors through postgraduate medical training programmes to further their studies; a policy that would later be adopted by several other states.

Your Excellency, one could say with immense pride that our healthcare system performance score was overall impressive. It used to be one of the best in the country. The services rendered were affordable and accessible to the masses, and the welfare of both patients and healthcare professionals was optimum. For instance, at some point, healthcare workers in Jigawa state were earning more than their federal counterparts.

Unfortunately, things have now taken a turn for the worse. At the moment, our healthcare system is not only ‘underperforming’ below standard by all measures but it’s one of the worst in the country. We are now a shadow of our past. With a patient-doctor ratio of 1:35,000 as against the WHO standard of 1:600, Jigawa state sits at the top of the chart of states with poor health systems in Nigeria. And this is a sad development.

Over the past few years, the state has witnessed an unprecedented mass exodus of medical doctors to other neighbouring states, owing to poor welfare, overburdening workload, and inadequate health facilities in hospitals among other factors. Regrettably, this internal japa syndrome ravaging the state is continuing to overstretch our already fragile healthcare system.

To put things into perspective, according to data obtained from the Nigerian Medical Association (NMA) Jigawa state branch from 2013 to 2024, of the 264 doctors that reported back to the state for bonding agreement only 40 doctors stayed after completing their terms. This is to say more than 220 medical doctors have left the state to continue their career elsewhere, due to the fact that Jigawa is fast becoming a nightmare and a difficult place for medical doctors.

It is worth noting that during the same period, the state has produced over 500 medical doctors (both foreign and local trained), but only 214 are now in the state payroll, out of which only 77 are currently manning the primary and secondary institutions and are about to round up their bond agreements by the end of the year; 89 are in training as either house officers or doing national service. The state has less than 10 consultants and only 12 doctors in residency training. Altogether there are fewer than 100 doctors attending to a population of over 7.5 million people.

This data suggests that while the state is doing a good job at producing medical doctors (both local and foreign), its retention capacity is however very poor. The state will be left with no medical doctors in the coming years if things continue at this pace. It has to either employ doctors from neighbouring states or overwork to death the few that stay if at all there would be! Your Excellency, this is only the tip of the iceberg as far as this crisis is concerned. There is no end in sight to this menace until a proactive measure is put in place to curtail it.

As a concerned citizen, who has the interest of Jigawa at heart, I would implore you to please declare a state of emergency on health in the state. Engage with relevant stakeholders to find a way to put an end to this worsening japa syndrome wreaking havoc in our dear state.

The most important step to addressing this issue is the urgent need for the improvement of the overall welfare of the few medical doctors and other healthcare professionals left in the state who are already struggling with chronic fatigue due to overwhelming workload. This singular act will not only boost the morale of these weary medical professionals and relieve them of their burden but will also attract others from various states to compensate for the acute shortage of medical doctors in the state. It will also improve the effectiveness of healthcare services delivered to the people. In other words, we can go back to our glory days.

Various states have already employed this strategy. Your excellency, Jigawa state can not afford to lose the doctors it invests heavily in. This could amount to a work in futility!

In addition, the government should seriously consider the domestication of the Medical Residency Training Fund (MRTF) which will help in the training of experts in various medical specialties in the state. This will also help address the shortage of registrars and consultants in our tertiary facilities. It will also provide an avenue for a healthy and excellent research environment in the state.

Other measures include equipping our already existing hospitals with state-of-the-art facilities, and subsidising healthcare services, especially to women, young children and those suffering from such chronic debilitating conditions as sickle cell disease, and chronic liver and kidney diseases. Your excellency, I believe these are some of the ways that could help put an end to this menace threatening our very existence, help revitalise the state’s healthcare and improve its delivery to the citizens of Jigawa.

Najeeb Maigatari, a medical doctor, writes from Dutse, Jigawa state. He can be contacted via [email protected]