Editorial
Better Conditions For Health Workers
Deeply worried about the brain drain in Nigeria’s health sector, the House of Representatives has called on the federal government to strongly discourage the migration of health workers to other countries. The House specifically urged the Ministry of Labour, Employment and Productivity to review the salaries, allowances and welfare of medical practitioners in the country.
The Representatives equally urged the ministry to quickly expand the rapidly shrinking size of medical workers to create employment for the unemployed and develop a functional strategy that would captivate Diaspora medical personnel to work at the nation’s teaching hospitals and other health institutions.
The resolution followed a motion of urgent public importance moved by Hon. Ganiyu Johnson during the plenary. Moving the motion, Johnson said that despite Nigeria being among the highest producers of Diaspora doctors in the world, the nation faces a critical shortage of medical practitioners. He blamed the brain drain in the sector on poor remuneration and working conditions.
“Nigeria has over 90,000 qualified medical doctors practising abroad, and in fact, an average of 50 doctors who had their primary medical education in Nigeria are said to be registering for practice every week in the United Kingdom (UK), United States of America (USA), Canada and other oil-rich countries”, said Johnson.
We share the concerns or apprehension of the Representatives. The exodus of medical practitioners in Nigeria is worrisome and has particularly gone out of control, contributing to acute shortages of specialised and experienced health professionals in the country. If not curbed, it will be very tough for Nigeria to tackle the increasing poverty rate given that health is wealth.
At independence, this nation built a health system structured basically along with the model of the colonialists. From the 60s through the mid-80s, the health system was anchored and led by seasoned health administrators who coordinated the health manpower comprising pharmacists, doctors, nurses, laboratory scientists, physiotherapists, radiographers and other cadres of health workers.
The University College Hospital (UCH), Ibadan, since the 1960s through mid-1970s, was the ‘Mecca’ of medicine in Africa and indeed medical tourism. It ranked the fourth best university teaching hospital in the Commonwealth where Saudi kings came for treatment; queens were delivered of princes and princesses. By 1975, it was a designated Centre of Excellence in medicine.
However, by mid-1980s, the finest medical teachers started leaving for the Middle East and the West and the young physicians they trained moved to the West mostly for postgraduate trainings. Human capital, quality research, medical education and patient care suffered greatly while infrastructure decayed from poor funding and management. The few decades that followed witnessed a continued downturn in both human capital and infrastructure, resulting in human capital flight, brain drain and medical tourism.
Brain drain is a major challenge facing the Nigerian health system, leading to a dramatic reduction in the number of doctors and medical practitioners in the country. According to the Organisation for Economic Co-operation and Development (OECD), Nigeria is one of the three leading African sources of foreign-born doctors and general medical professionals. This is unacceptable and doesn’t tell well of the country.
The exodus has led to a drastic drop in the quality of health care services following the absence of skilled personnel. It is scandalous that despite the severe nature of this provocation and how it has badly affected the health sector, the Nigerian government is unable to reverse the trend, largely for lack of concern. Curiously, Nigeria was the only African country listed among the 20 top exporters of doctors in 2004, with a loss of 5, 499 doctors up from 1, 519 in 1991.
Clearly, at this rate, health indicators may keep declining in the absence of aggressive interventions to stop the trend. More doctors leaving the country will eventually lead to a depletion of Nigerian medical doctors. This, in turn, will add to the stress and dissatisfaction among those remaining. The poor will not be able to access health care while the rich will travel out of the country for medical attention.
A reason doctors and other health professionals leave for greener pastures is impoverished pay. Apart from abysmally low pay packages, the actual payment of salaries is often irregular. An equally major driver is miserable working conditions. This includes having to work extra hours due to inadequate staff, lack of diagnostic facilities and sometimes the need to support monthly incomes.
These problems emanate from the government’s low funding of the sector. Surprisingly, in the 2020 budget of N10.33 trillion, the health sector received only 4.14 per cent, that is, N427.03 billion out of the total budget. This is much lower than the estimated 13.5% of South Africa’s national expenditure dedicated to health. The lack of funding has brought about insufficient remuneration, the dearth of medical facilities and inadequate infrastructure in the sector.
To reverse the brain drain, the Nigerian government should rejig the entire health care system in the country. The introduction of a workable national health policy is imperative at this time. A renewed health care system will certainly create the required environment for medical practitioners to function. This includes the provision of basic equipment and infrastructure.
We support the call by the House for a review of our health workers’ pay. It is also our opinion that they be given a special salary scale. There is a need for an extension of their retirement age since at 60, when they are expected to disengage from service, many are often still fit and active. If judges, lecturers and of recent teachers could be granted such consideration, health practitioners who perform the all-important duty of saving lives must not be denied similar largesse.
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Editorial
That Oshiomhole’s Call On FG’s Road Projects
There are moments in the life of a legislature when plain speaking becomes a public service. Senator Adams Oshiomhole provided such a moment on the floor of the Senate when he accused the Minister of Works, Senator David Umahi, of manifestly neglecting critical federal arteries in Edo and Delta States, and implored his colleagues to prevail on the Minister to adopt a more equitable and genuinely national approach to road infrastructure delivery. It was blunt, it was uncomfortable, and it was necessary.
The specifics of his complaint deserve restating. Drawing attention to the recent approval of some 20 new road projects despite the parlous state of existing ones, the former Edo State governor lamented that Nigerians cannot travel from Benin to Warri, Benin to Asaba, Benin to Auchi, or Auchi to Okene without encountering severe distress. He alleged a deliberate omission of these corridors from the national budget in the last three years, save for palliative interventions directed by President Bola Tinubu through tax credit arrangements. His question — “What have we done wrong?” — resonates far beyond the chambers of the National Assembly.
We lend our full and unequivocal support to that call. The Auchi-Benin Road, for instance, has been in a deplorable and near-impassable condition for several years, turning what should be a two-hour journey into an all-day ordeal of broken axles, extortionate fares, and despondent commuters. The media have, on multiple occasions, chronicled the suffering of motorists, traders, and students who ply that route. To describe it as a federal road today is to stretch the meaning of the term beyond recognition.
This pattern of sidelining is not confined to Edo or Delta. Even here in Rivers State, the disposition of the Federal Ministry of Works has left much to be desired, particularly along the Eleme axis of the East-West Road. That road, which ought to be a flagship of federal presence in the Niger Delta, has remained in a wretched state for long. Those who use it daily — workers at the Eleme Petrochemical Complex, the two refineries, Onne Port, and the countless ancillary industries — can attest to its deterioration. Work has proceeded in fits and starts without the sustained urgency such a strategic road demands.
The Eleme stretch is not a mere intra-state byway. It is the gateway to the nation’s economic jugular. According to the Federal Ministry of Works and Housing’s 2023 Highway Condition Survey, only about 35 per cent of the country’s 36,000 kilometres of federal roads are rated as being in good or fair condition, with the remainder classified as poor or very poor. The East-West Road, conceived in the 1970s to bind the entire Niger Delta, remains unfinished in critical sections more than four decades after. If it had been treated as a priority, the perennial gridlock, carnage, and economic loss on the Eleme-Refinery junction would have long been consigned to history.
The irony is as painful as it is glaring. The Niger Delta remains the goose that lays the golden eggs. Data from the Nigeria Extractive Industries Transparency Initiative [NEITI 2023 Oil and Gas Audit] show that the region still accounts for over 78 per cent of Nigeria’s federally collected export earnings and about 65 per cent of total government revenue. The National Bureau of Statistics [NBS Foreign Trade Report Q4 2024] similarly confirms that crude oil continues to dominate export receipts. By every metric of equity and economic logic, a region that sustains the national purse deserves first-rate consideration in the allocation of infrastructure, not afterthoughts and tokenism.
Road infrastructure is not largesse to be dispensed by favour; it is the skeleton upon which commerce, cohesion, and citizenship hang. When contracts are concentrated in one geopolitical zone while other zones are left to contend with craters, it erodes trust in the federation itself. The World Bank’s Nigeria Development Update [June 2023] estimated that poor transport connectivity inflates the cost of moving goods by up to 40 per cent and costs the Nigerian economy an estimated $1.5 billion annually in lost man-hours and vehicle maintenance. If we profess to be one country, then equity must be the compass that guides key institutions before any project is executed. Development must spread round, not pool in one place as though other regions do not matter.
There is also a grave security dimension that can no longer be ignored. The deplorable condition of federal roads has become a veritable enabler of criminality. The NBS Crime Experience and Security Perception Survey reported over 2.5 million incidents of kidnapping-related occurrences nationally, with transport workers identifying bad road spots as prime ambush points. When vehicles are forced to crawl at 10 kilometres per hour through failed sections at Auchi, Sapele Road, or Eleme, they become sitting ducks for armed gangs. Fixing bad roads, therefore, is not merely about convenience; it is about safeguarding lives.
By his intervention, Senator Oshiomhole has hit the nail on the head and reminded Minister Umahi of a fundamental constitutional truth: public office is held in trust. The Ministry of Works is not a personal estate where contracts are awarded according to whim or political convenience. It is a national institution funded by the collective resources of Nigerians, including the oil and gas rents from the very communities whose roads are now neglected. The Minister must demonstrate balance, transparency, and a pan-Nigerian outlook in the distribution of projects that impact the daily existence of citizens. Selective neglect breeds suspicion, and suspicion is corrosive at a time when the nation is preaching unity, oneness, equity, and justice.
Consequently, the National Assembly must go beyond rhetoric and assert its oversight powers with vigour. Sections 88 and 89 of the 1999 Constitution [as amended] empower the legislature to investigate and expose any maladministration in the execution of federal projects. If an office holder is not acting rightly, it is the duty of the Senate and the House of Representatives to call him to order. Oversight must not be reduced to budget approval ceremonies; it must translate to field verification, public hearings, and insistence that the Federal Character principle, as enshrined in Section 14(3) of the Constitution, reflects in road awards.
Let the Auchi-Okene, Benin-Warri, Benin-Asaba, and Eleme East-West gangways be restored to motorable dignity. Let priority be given to completing existing, economically vital roads before embarking on new ones. If those who, through their resources, sustain the federation are sidelined in the distribution of tangible dividends, it tells poorly of our nationhood. Bad roads must be fixed, and they must be fixed now, with fairness as the guiding standard.
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