Nigerian doctors on strike again: Overstretched and underpaid, many have left for overseas

Despite being Africa's largest economy, the healthcare system has remained underfunded

ABUJA (AP) — Resident doctors in Nigerian public hospitals on Wednesday launched their second strike this year to protest unpaid salaries and demand improvements in pay and working conditions.

The Nigerian Association of Resident Doctors declared a “total and indefinite strike” following unsuccessful attempts to engage with the government, the group’s president, Dr Innocent Orji, said in a statement issued after the group met Tuesday night.

Strikes by doctors in Nigeria are common, and the latest one could shut down some healthcare services in critical wards across under-staffed public hospitals in Africa’s most populous country. The resident doctors are graduate trainees who help provide urgent and critical care at the public hospitals.

An average of 200 resident doctors in Nigeria have relocated abroad every month over the last two years, seeking better pay, Dr Orji told The Associated Press. Their positions are left vacant, further worsening the relatively affordable healthcare services in public hospitals in the country of more than 210 million people.

“We are having a massive brain drain in the health sector,” Dr Orji said. “It has never been this bad.”

The World Health Organization reports that Nigeria has a ratio of four doctors to 10,000 patients as of 2021. However, the Nigerian Medical Association told The Associated Press their records show a ratio of two doctors to 10,000 patients generally, and one to 10,000 in some rural areas, which would make Nigeria’s doctor staffing one of the worst globally.

Salaries for resident doctors have not increased since 2009, Orji said, and the value of the local currency against the US dollar has fallen by 480 per cent since then. At the same time, inflation has surged and gas subsidies have been ended, he said.

A highly qualified senior doctor earns less than $900 a month while those with about five years of experience earn between $400 and $600.

At state-owned Abia State University Teaching Hospital, resident doctors say they are owed 24 months’ salary in arrears. Out of the seven months so far this year, they have been paid only for June, said Dr Erondu Nnamdi Christian, the head of the resident doctors’ association at the facility.

Although Nigeria is Africa’s top oil producer and has the continent’s largest economy, the country’s public health sector has been underfunded for many years. Doctors often resort to strikes in order to get the government to the negotiating table.

“We cannot do without resident doctors (and) what they are asking in order to be able to provide the services that people require in Nigeria is not much (but) the federal and state governments do not prioritize healthcare,” said Ifeanyi Nsofor, of the US-based Atlantic Fellows for Health Equity, who has conducted extensive research on healthcare delivery in Nigeria.

The United Kingdom is the preferred choice destination for many Nigerian doctors moving abroad, the local doctors’ association said. In the year leading to September 2022, Nigerian nationals were the second-largest category to receive theUK “Skilled Worker - Health and Care” visa, accounting for 8,520, or 14pc of the total, government statistics show.

At the Federal Medical Center in Nigeria’s Abia state, Dr Chigozie Ozurumba said doctors can only hope that things get better for them, with the strike seen as a last resort.

“The Nigerian doctor is an unhappy doctor,” said Dr Ozurumba. “It is an existential threat.”