Report: Heavy workload driving suicide, depression among Nigerian doctors

Heavy workload is driving suicide and depression among Nigerian doctors some of whom are leaving the country in large numbers, worsening the acute shortage of medical professionals in the country, a report says.

In April, Chris Ngige, minister of labour and employment said Nigeria has enough doctors to meet its medical needs. His claim was fact-checked and found to be false.

An investigation by The PUNCH revealed that though the exodus of doctors from the country is not new, it has been on the increase in the past two years with new migrations to countries like Saudi Arabia and Kuwait.

According to the report, the exodus has increased the workload of those who are still in government service, and many states have not been employing doctors.

Saliu Oseni,  chairman of Lagos state Nigeria Medical Association, said about 50 -60 doctors leave the services of the state hospitals every six months.

Oseni reportedly said the failure of the state government to replace doctors, who had left its service, and employ new ones was affecting the service delivery of NMA members in the state.

“It will be difficult to give a total figure of doctors that have left the service of the  Lagos State Government since 2017, but to be conservative, no fewer than 50 to 60 doctors left the system every six months,” Oseni was quoted to have said.

“Some of them leave for greener pastures abroad. Some of them take offers from the federal government and some retire. Not replacing such doctors is a big challenge to us.

“The situation is affecting our members as they are being overworked. Some of the hospitals have not employed or replaced doctors that have left the system in the last two years.”

WHY DOCTORS ARE LEAVING

The doctors listed poor remuneration, insecurity, inadequate welfare, poor health infrastructure, enormous workload , as reasons they are forced to leave. 

“The work that is supposed to be done by junior officers is being done by senior officers and currently in Lagos state hospitals, you see a doctor attending to close to 100 patients per eight-hour work in a clinic which is not good for the doctor and the patients,” Oseni said.

“The ideal patient-doctor ratio is supposed to 1:500, but what we have currently in Lagos state-owned hospitals is one doctor to over 5000 patients. 

“If I am going to see 80 patients in eight hours, there is no way I’ll follow the routine properly. By standard, a doctor needs 15 to 30 minutes to attend to a patient very well.

“Conditions of our work are overwhelming. That is why suicide and depression are common among those of us that are still in the system.”

According to the report, rural areas are the most affected.

A doctor was quoted as saying: “Who wants to be killed? or who wants to be stunted in terms of career progression?” 

Stephen Kache, Kaduna NMA chairman, said that of the 33 medical doctors recently employed by the state government, only eight reported for duty.

“The current exodus of doctors we have is over 60 per cent. They left between six months and one year. In 2018, we did a  survey in some hospitals within the state and in one of the hospitals as of January, there were 21 doctors and by August of the same year,  there were eight doctors remaining, “Kache said. 

“Recently, the state government tried to replace those that had left and 33 doctors were employed. I am aware that out of the 33 that were employed, only eight of them have reported.”

NIGERIANS RESORT TO QUACKS AS DOCTORS COMMIT SUICIDE

On his part, Obelebra Adebiyi, chairman of Rivers NMA, said if the situation is not addressed urgently, patients would be forced to patronise quacks.

Adebiyi said: “I don’t know how many doctors have travelled abroad and how many are remaining in Rivers state because we have not done a study to get the statistics, but a lot of doctors are leaving the country and a lot more are still planning to leave for myriad reasons.”

The doctors also disclosed that the heavy workload is making some of their colleagues commit suicide.

“The effects are so enormous that some of our doctors are now committing suicide because of the pressure of work,” Mingeh Tijo, ex-NMA vice president, was quoted to have said.

“Poor service delivery is imminent because we are overworked, and then the patents are the ones suffering for this.

 “Patient-doctor ratio is approximately 1:5000. The number of patients a doctor sees per day depends on the locality the doctor is operating from. Some see 70 patients in a day;  some 100, but in some tertiary institutions, the ratio may not be as high as that. Again, it depends on whether the doctor is practising in a rural or urban area. “

Ike Okwesili, Rivers NMA chairman, reportedly said the brain drain had reached an alarming level.

He said failure to implement the consolidated salary scale caused the migration of workers from state to federal jobs, which he described as “internal brain drain”.

THE WAY OUT

Okwesili said the problem could be resolved by identifying its magnitude. 

“This has to come by way of full implementation of the National Health Act. The National Council on Health in Section 41of the Act has the responsibility of identifying the human resource requirements of the health sector across all levels of care,” he said.

“Doing this will give a quantitative assessment of the cumulative loss. 

“The enforcement of these will help all of us improve the budgetary allocations to health in line with the Abuja declaration.”

The doctors also urged government at all levels to ensure a quick rehabilitation of the health sector by investing in infrastructure across the country.

They said if health facilities and wages were improved across the countries, doctors and other health workers “would have a rethink and stay back”.