Brain Drain In Health Sector Double Jeopardy For Nigeria - Prof. Chris Bode, CMD LUTH


Posted on: Sat 12-09-2020

Professor Chris Bode is a paediatric surgeon and the Chief Medical Director of the Lagos University Teaching Hospital (LUTH). In this interview with Saturday Sun, the art enthusiast gave reasons why he is not better than a carpenter and how the government could curb the brain drain in the health sector, among other issues.

How would you describe your growing up?

I grew up in Ejigbo, a big town in Osun State. In the ‘60s, it was a typical rural setting and an ideal place for bringing up children. We were brought up in a strict setting, with parents from distant places sending their kids to learn at the feet of dedicated teachers who made our school a place to be. There was community participation in parenting; everybody was a parent.  When we were young, the greatest fear was doing something wrong somewhere and someone reporting it to our parents. They didn’t spare the rod. We were therefore forced to behave properly. Later in life, they explained to us that they were very strict and afraid to show love so as not to spoil their children. They said that they would rather be stern disciplinarians than spoil us. I made good grades in secondary school then and I  was admitted into the Obafemi Awolowo University.

Why did you choose to be a doctor?

I was ill and travelled to Ogbomoso in company of my dad to see a doctor. I was highly impressed by the respect accorded this young doctor by my father and I knew then that I wanted to be a doctor, so I would earn such high regards from people as I witnessed my father according the young fellow. I knew I wanted to be like that young man. Let me hasten to add that, in those days, if you were smart in school,  you would opt for medicine, engineering or law. For me, it was medicine because I loved Biology and other science subjects.

Have you ever treated your dad and got the same respect from him?

It is only a foolish doctor that treats himself and his relations, as such, I have never had to treat my father. Rather, other doctors who are my colleagues treat him whenever he requires medical attention. Concerning respect, one has outgrown such childish crave for parental approval. He is highly regarded in his community and I doff my hat to him for being relevant to our people, even at the age of 93 years. Our status as his children has added more to his stature within and around his domain. We his children are his friends now and that is more than I could wish for.

What is your biggest challenge on the job?

The sad part of this job is the current trend where we use scarce national resources to train young doctors and other healthcare workers, only for them to end up traveling to other climes.  They go to other places and root there, with the nation losing both our investments and dividends; that dismays me. There is this parable in Yoruba that says when fire dies, its face is enshrouded in ash, the banana tree dies to be replaced by its offsprings. At this rate, we are losing our best and young brains. I worry about who will replace us as we are not growing  any younger. I wonder how long we would continue to lose capable hands. I will like to see Nigeria robustly develop a medical economy. I used that word deliberately because the business of medicine, if properly conducted,  will grow and retain very capable hands and enable them to contribute meaningfully to the national economy.

It takes a lot of money to train a medical doctor up to specialist cadre. Some researchers have said it costs more than N70m to train one specialist doctor in this country. All these structures in a teaching hospital are primarily there to train them, the government pays salaries to all workers and trainers. But when  we finish training them with our meagre resources, these new specialists who we need, are quickly harvested by industrialised, richer countries. It is double jeopardy and it has been likened to ‘reverse aids’; taking from the poor and giving to the rich nations. It means we are aiding those who should be assisting us.  These countries don’t pay a penny on our medical manpower investments. In a normal situation, after training such a doctor, you expect the doctor to pay back the money the government spent on them, plus interest, all by serving here. But alas, they soon journey out to greener pastures. Then the country gains next to nothing, it worries me, it truly does.

Who is to blame?

It is not a matter of blame but what should we do better. As a manager, I don’t often blame people, I look for what can be done differently to achieve better results. The colonial masters brought orthodox medical practice to Nigeria as a welfare package. For many years after independence, we continued in like manner. Over the past several years, it has transformed into a business. The government can no longer pay for the medical needs of everybody. We therefore require innovative ways to finance our medical needs through a self-sustaining, private sector-led formula. We should squarely address the problem of ‘who will pay the bill’ for healthcare. The National Health Insurance Scheme (NHIS), if properly run and made compulsory, with universal coverage,   will be a veritable answer to most of these problems. Presently, only about 10 percent of Nigerians are covered under the NHIS scheme. Imagine what could be achieved if up to 80 percent of Nigerians pay for health insurance. It will be cheaper and it wii create a deep pool of funds from which everybody can be covered. Such a system will grow and improve facilities and health will truly be wealth. That kind of fund will not only provide health care but also encourage people who work in the health care system to work more and get better paid. All the empty general hospitals would be populated with adequate manpower employed to work there. Workers in the sector  would be happy to work and get paid close to what their counterparts earn in other lands. It is what I am waiting to see. As I understand it, majority of our people outside Nigeria left to achieve financial security yet unobtainable here. Many would gladly come back because, truth be told,  life is not rosier for many of those who flee here in droves. They silently suffer discrimination, they are less paid than their contemporaries there and are separated from family and loved ones. Yes,  the grass is always greener on the other side, but it is also possible to make the grass green here too.  If we do,  they will come back. All that is needed to achieve this is the political will and a well planned system. I want to see that happen in my lifetime.

It seems you picked more managerial knowledge from the street than on the job?

You are on point. Outside this place, I don’t regard myself as a doctor. When I get out of LUTH compound, I see myself as another human curious about how  people in many spheres of life achieve excellence in what they do. As a child, I used to sit down with blacksmiths just to see how they turned a lump of iron into a knife or cutlass. I still visit the cane weavers under the Maryland Bridge just to see how they do it. I go on art excursions. I am a builder and I love going to construction sites to see how they turn sand, cement and gravel into bricks and mortar. The process is always fascinating and they tolerate me and my many questions when they know you are genuinely interested in their work. I love watching people solving problems because I don’t like excuses. I may be a professor of surgery but I am not better than a carpenter who is also an accomplished master at his craft. If we remove that garment of superiority, then we can learn a thing or two from him.

What is the biggest lesson you learned in marriage?

The biggest lesson I have learned is that a person who marries his or her friend is indeed a lucky and happy one. You must be friends with the person you are marrying. Friends share so many interests and passions. Friendship is by choice and you have a lovely companion to share your stories with. The rise in spousal abuse during lockdown showed the disadvantage of not marrying a friend. If I didn’t marry my friend, life would have been agony. My wife and I cook and watch WWE wrestling together. When I am not around, my wife would record all the episodes of the WWE I missed and we have so much fun while the children laugh at us. She recoils at watching snakes with me on NatGeo and we struggle to switch channels.  We rejoice in each other’s successes and engage in many fruitful intellectual discussions, rather than gossip. We share many passions but the greatest of it is mentoring youngsters who choose to stay under our roof.

If you were not a doctor, what would you have been?

I would probably be a builder; either a structure engineer or be at construction sites working as something.

Source: thesun