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| LETTER TO THE EDITOR |
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| Year : 2022 | Volume
: 30
| Issue : 3 | Page : 135-136 |
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Ophthalmologists’ Brain Drain: A Health Catastrophe in Nigeria
Kehinde Fasasi Monsudi1, Tajudeen Mustapha2, Joshua F.A Owoeye3
1 Department of Ophthalmology, Federal Medical Centre, Birnin Kebbi, Nigeria
2 Departmentof Ophthalmology, Modibbo Adama University Teaching Hospital, Yola, Nigeria
3 Department of Ophthalmology, UITH Ilorin, Kwara State, Nigeria
| Date of Submission | 17-Sep-2022 |
| Date of Decision | 30-Oct-2022 |
| Date of Acceptance | 01-Nov-2022 |
| Date of Web Publication | 09-Dec-2022 |
Correspondence Address:
Kehinde Fasasi Monsudi
Department of Ophthalmology, Federal Medical Centre, Birnin Kebbi
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/njo.njo_19_22
How to cite this article:
Monsudi KF, Mustapha T, Owoeye JF. Ophthalmologists’ Brain Drain: A Health Catastrophe in Nigeria. Niger J Ophthalmol 2022;30:135-6 |
Brain drain is the exodus of highly skilled professionals including medical practitioners from developing countries to developed countries. The movement of Nigerian medical practitioners including ophthalmologists for “greener pasture” which started in late 1980s to early 1990s[1],[2] became worst following COVID-19 pandemic.
The dearth of health care workers including ophthalmologists during COVID-19 pandemic and near total collapse of health institutions in the developed countries lead to aggressive recruitment of Nigerian doctors including ophthalmologists from Nigeria by the agencies of British, Canadian, American, Saudi Arabia, and the United Arab Emirate. They recruited both young (trainee) and old (trainer) ophthalmologists.[3]
Currently in Nigeria the ratio of ophthalmologists to one million population is far below the VISION 2020 recommendation.
VISION 2020 recommended four ophthalmologists per million population. Nigeria with a population of about 216 million[4] will require about 864 ophthalmologists to tackle eye needs of the country. Presently there are about 700 ophthalmologists that are registered with the Medical and Dental Council of Nigeria (MDCN) but half of them are working outside the shores of the country.[5] The present number of ophthalmologists is less than the VISION 2020 recommendation. The mass exodus of ophthalmologists poses a great challenge to achieving WHO and Nigeria VISION 2022 eye care targets for the country.
Anecdotal reports suggest that most of the Nigerian doctors including ophthalmologists who have left the country are practicing in Saudi Arabia, United Kingdom, United States of America, Canada, United Arab Emirate, and Australia.[3]
| Possible causes of ophthalmologists’ brain drain include: | |  |
- Poor health policy by both Federal and State government: threatening health workers with no work no pay, not honoring Memorandum of Understanding (MOU) with health workers.
- Insecurity of life and property (daily attack from bandits, kidnapping, and Boko Haram insurgency).
- Poor remuneration compared to their colleagues in developed countries.
- Lack of eye equipment at health facility and poor funding of hospital by all level of government (Federal, State, and local).[6]
- High tax on remuneration.
- Inadequate manpower and lack of recruitment of new staff to replace those who have relocated leading to heavy workload on the few available staff left.
- Poor social amenities (electricity, water, road, transportation, etc.).
- High cost of residency training in Nigeria (cost of revision courses and examinations are borne by the trainees).
- Minimal/non career advancement prospects.
- Poor working and living conditions.
- Desire for better life style.
Possible effects of ophthalmologists’ brain drain on Nigeria
Ophthalmologists’ brain drain has a negative effect on the health, social, and economic indices of the country.
Economic effects
It results in loss of human capital and lost income from the loss of tax of the migrated manpower to foreign countries, increase in out-of-pocket spending by the populace seeking eye care outside Nigeria (medical tourism), and with overall decrease in government earning.
Health system effects
It endangers the development of future human resources for eye health.
It may result in increased in mortality, burden of blindness, and vision impairment in Nigeria.
Social effects
It may lead to the loss of societal norms or cultural practice in Africa that bind us together (e.g., group gathering, interaction, mentoring, partying together during naming, and burial ceremonies).
Programmes of the Ophthalmological Society of Nigeria (OSN) may be indirectly affected through reduction in the number of participants and less advocacy in demanding for change in government policy for improvement in eye care service delivery in the country.
| Suggested solutions to discourage ophthalmologists’ brain drain | | |
Problem identification is one of the steps to the solution. Government has a vital role to play in this regard by:- Increasing the eye care health budgeting by the all levels of government (Federal, state, and local).
- Promulgating a law that makes eye care service delivery free to all citizens.
- Provision of equipment, and employment of more eye health workers (mass employment).
- Provision of social amenities (basic infrastructure).
- Fighting corruption head on.
- Rehabilitation of eye health facilities nationwide.
- Increasing eye health workers remuneration.
- Tax exemption on call duty allowance of eye care workers.
- Others including: honoring MOU with health workers, accessibility of National Health Insurance Scheme (NHIS) for all citizens, rewards for diligence, regular interactions with eye health workers, and making the ophthalmology residency training program free.
| Conclusion | | |
Ophthalmologists’ brain drain is a part of the global phenomenal that may in long run affect the eye care service delivery in Nigeria. All levels of governments should work with eye care stakeholders to mitigate the impact of Ophthalmologists’ migration out of the country.
Financial support and sponsorship
Nil.
Conflicts of interest
The authors report no conflicts of interest.
| References | | |
| 1. | |
| 2. | Adetayo JO. “A study of factors influencing brain drain among medical personnel in Nigeria”. Niger J Health Biomed Sci 2010;9:60969.  |
| 3. | |
| 4. | |
| 5. | Monsudi KF, Ademola-Popoola DS, Ayodapo AO. Ophthalmology in Nigeria: challenges and Success. Niger J Ophthalmol 2019;27:100-01. [Full text] |
| 6. | |
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