Hospitals Hit By Dearth Of Medical Experts

Posted on: Wed 11-09-2013

There is an indication that many hospitals are having a hard time coping with the dearth of medical specialists in the country.

Investigation by our correspondent shows that due to the prevailing brain drain, especially in the sector, only about 100 anaesthetists and specialists in pain management are available to attend to the needs of over 18 million residents in Lagos State alone.

Some states lack experts in sub-specialities, such as paediatrics, oncology, neurology and psychiatry, while the few left in the country prefer to practice in the urban areas.

Many of the specialists have left the country for better remuneration and incentives in foreign hospitals.

Nowadays, patients have to travel as far as three states from their residences to get medical attention, even for cases that should ordinarily be treated as emergencies. For example, some nursing mothers in Jigawa State, whose babies need special attention, are often forced to travel all the way to the Federal Capital Territory in search of treatment. There is no paediatrician in the state.

The situation appears to be worse in Taraba, Borno, Adamawa and other states in Northern Nigeria as they lack the same experts and other specialists in childcare.

In Lagos, a woman, Mrs. Fatima Yakubu, told our correspondent that she had been coming from her hometown in Jigawa State to seek treatment for her two-year old daughter, Aisha, at the Lagos State University Teaching Hospital in Ikeja.

Yakubu’s daughter has a hole in the heart. To keep their appointment with a paediatrician at the hospital, they have had to make the long journey to Lagos every month.

“I noticed that Aisha was not breathing and sleeping well and she was not adding weight at six months. I took her to the health centre and they told me she would outgrow it. But after six months, another doctor told me that we had to see a paediatrician. Since there was one in my home state, I was referred to either Lagos or Abuja.

“When my daughter’s condition was getting worse I had to come to Lagos because the specialist in Abuja gave us a two-month appointment. Apart from the cost of the prescribed drugs, we spend more than N50,000 on each trip to LASUTH every month,” Yakubu says.

Apart from the cost of accommodation and transportation, Yakubu says she is considering relocating to Lagos from Jigawa because of her daughter’s ailment. She says the move is to enable her daughter gain easy access to treatment in an emergency.

“Many times in the night, Aisha stops breathing. I need to rush her to a doctor who knows her history. But I cannot do so because her doctor is in Lagos and I live in Jigawa. It has been tough coping all this while. Many children are dying due to lack of specialist attention. When a child is sick and we can’t find an immediate cure, we just do it the traditional way,” she says.

Reacting to the development, some experts have expressed the opinion that it could lead to an increase in the number of deaths due to poor access to quality healthcare services. They called on the Federal Government to train more doctors and check the current exodus of qualified medical personnel from the country by introducing better incentives.

According to consultant paediatrician, Dr. Dayo Ajayi-Obe, Nigeria, with a population of 70 million children under the age of 18, has only 600 trained consultant paediatricians. About half of these specialists live and work in Lagos, Abuja, Oyo and Rivers states, while there are only about 10 in a few other states.

Comparing the paediatric workforce in Nigeria with that of the United Kingdom where she has practised for over 30 years, she says, “The United Kingdom has 3,084 trained consultant paediatricians and 1,184 associate paediatric specialists for its 20 million children. This does not include the 3,174 paediatricians currently undergoing training. But with 70 million children, Nigeria has just 600 trained consultant paediatricians. Most of them are in Lagos and Abuja. Some states do not even have a single one!”

Also, in addition to the cost of treatment, a major challenge that a cancer patient faces is the dearth of oncologists and specialists in cancer diagnosis or treatment.

A consultant oncologist and head of the radiotherapy and oncologist unit at the Lagos University Teaching Hospital, Idi-Araba, Prof. Remi Ajekigbe, notes that there are only 25 consultant oncologists to about 160 million Nigerians, while Canada, with a population of 35 million people, has 800 medical oncologists.

Ajekigbe says the specialists can be found in just eight states of the federation. For this reason, cancer patients in Osun, Ekiti, Abia, Kogi, Kebbi, Borno, Imo, Anambra, Kaduna, Kano and 13 other states have to travel to Lagos, Ibadan, Akure, Abuja or Zaria for surgeries in this specialty.

“We are seven in Lagos, seven in UCH, five in Zaria, one in Benin and Akure and three in Abuja. Sokoto also has one. Haematologists also treat cancer patients that deal with the blood but there are just about 20 of them also in the country.

“The incidence of cancer is on the rise in Nigeria and globally. With the current shortage of experts in Nigeria, more patients who need cancer care will not get it and they may not survive,” he says.

Ajekigbe identifies lack of facilities for training and incentives as the reasons for the dearth of experts in this crucial branch of medicine.

The consultant oncologist notes, “We have less than 12 cancer care facilities or hospitals. So, training specialists is a major challenge. Also, cancer care is not lucrative because most patients cannot afford the cost. It is not attractive at all to doctors. In other countries, doctors who specialise in this field are given incentives by government. We can do that too.”

Also, speaking on the dearth of specialists in Nigerian hospitals, Consultant Neurosurgeon, Dr. Biodun Ogungbo, says doctors who specialise in the diagnoses and treatment of conditions affecting the nervous system are very few in Nigeria.

According to him, there are just 50 neurologists and 40 neurosurgeons in the nation’s hospitals.

Ogungbo says, “The ratio is such that we have one neurologist to 3 million Nigerians and one neurosurgeon to 4 million Nigerians. Most of them are based in the urban areas, such as Lagos, Abuja, Ibadan and Sokoto.

“I once had a patient, who had seizures and had seen five different doctors without any diagnosis. Although they prescribed medications for her, they did not work till she came to me. This shortage of neurologists means that Nigerians do not have access to neurological services. Even if they do, it will be expensive and unaffordable to most people. This means they won’t get treated.”

Further investigations show that there is an acute shortage of psychiatrists in the country. A psychiatrist, Dr. Peter Ogunnubi, states that there are just about 180 of them in the country.

He says, “We used to be about 200. But not less than 15 psychiatrists have left the country in recent times. Many doctors shy away from this specialty because of the stigma and lack of facilities for training in the country.”

But the National President, Nigerian Medical Association, Dr. Osahon Enabulele, says Nigeria is witnessing a shortage of experts in the health sector because the government places little importance on the training of doctors and other health professionals.

Enabulele says, “The ratio of patients to doctors in Nigeria is appalling. It is about one doctor to 8,000 people. In the USA and UK, it is one doctor to 100 people. The total number of doctors in Nigeria is not more than 20,000. And how many of them are still actively practising? In Lagos State , there are less than 2,000 who are actively practising. When it is only one or two doctors that attend to hundreds of people in a day, there will be problems.”

To speedily resolve the looming crisis, he urges the government to increase the budgetary allocation to the residency programme for young of doctors and calls for improved salary and welfare packages to make those that are qualified stay in the country.

ABUJA: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED PORTHARCOURT: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED LAGOS: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED