General decries brain drain as NSA urges FG to equip hospitals, others



… Seeks technological advancement in anaesthesia practice

By Chimezie Godfrey

The Nigerian Society of Anaesthetists (NSA) in collaboration with the World Federation of Societies of Anaesthesiologists (WFSA), has called on the Federal Government to equip various hospitals, provide adequate infrastructure and improve the emoluments of doctors to foster the technological advancement in anaesthesia practice in the country.

Also while presenting the keynote address, Major General (Dr.) Obashina Ogunbiyi (Rtd) decried the brain drain bedeviling the health sector.

The President, NSA, Prof. Elizabeth Ogboli Nwasor made the call during NSA’s 30th Anniversary Conference & General Meeting with the theme,”Technology for the Advancement of Anaesthesia”, held on Wednesday in Abuja.

Nwasor decried massive brain-drain prompting many healthcare practitioners including anaesthetists leaving the country in large numbers, in search for ‘greener pastures’.

She pointed out that the issue of middle-level workforce who have obtained the postgraduate, the Medical and Dental Council of Nigeria (MDCN), noting that the secondary and tertiary hospitals in Nigeria are not employing or putting up adverts for the employment of Diploma in Anaesthesia or Membership Certificate holders.

Nwasor frowned at the fact that Diploma in Anaesthesia or Membership Certificate holders were not recognized entry cadre in the workforce.

She also revealed that there was no financial renumeration on upgrade in level attached to the acquisition of the Postgraduate Diploma in Anaesthesia certificate.

According to her, this was not the case in the past as persons with those qualifications used to enjoy upgrades , promotions and adequate career progression as appropriate.

She stressed that these factors are big disincentives and completely go against the against the policy of both National and West African Postgraduate Medical College to encourage middle-level manpower development in Anaesthesia.

In the light of the foregoing, she therefore called on the federal government to address these challenges through provision of adequate equipments and infrastructure for hospitals.

She urged the government to improve the emoluments of doctors, encourage and fund the training of Anaesthesia Specialists in the country.

She said,”We call on the Federal Government of Nigeria, through the Federal Ministry of Health , all the various State governments and Federal Capital Territory Health Authorities to equip our various hospitals, provide adequate infrastructure and improve the emoluments of doctors and especially encourage and fund the training of Anaesthesia Specialists as we look forward to further technological advancement in anaesthesia practice.

“This is a passionate appeal to the government to encourage the employment, training, MODCN Registration, and give due recognition and career progression of this cadre of anaesthetists in order to add value to these certificates and justify the huge amount paid by the residents in order to seat for these examinations and acquire these certificates. These measures will hopefully stem the tide of brain-drain and mitigate the massive exodus of our health workforce especially among the anaesthetists.”

The NSA President also disclosed that another topical issue on the front burner is the non inclusion of Anaesthesia, Intensive Care and Pain Management in the National Health Insurance Act as operated by the National Health Insurance Agency (NHIA), adding that as such medical doctors, practitioners in Anaesthesia, Intensive Care and Pain Management are not adequately remunerated when they provide services in the private sector under the NHIA.

“This has been a lingering problem for which we call on the NHIA and all key stakeholders to look into this problem with a view to bringing lasting solutions to this festering problem.

“There has been heightened concerns over the security challenges we face in our dear country . The problems of banditry , kidnapping ,herdsmen and the general insecurity and crime is a call for action. Specifically , the kidnapping of doctors,nurses and other healthcare workers is a big discouragement to the drive for professionalism in medical practice in general and anaesthesia practice in particular.

“We hereby use this medium to call on the Federal Government , all security operatives, all law enforcement agencies and all persons involved in maintaining the security of our great country to do all that it takes for us to have a secure working and living environment, while we strive towards the goals of advancement of technology in anaesthesia practice,” Nwasor said.

The Minister of State for Health, Hon. Joseph Ekumankama ably represented by his Senior Technical Assistant and Director for Health, Federal Ministry of Health, Dr. David Atuwo, said the theme of the conference “Technology for the Advancement of Anaesthesia,” was quite apt as it showcases the peculiar requirements  of the Anaesthesiologist in this post COVID -19 pandemic era.

Ekumankama noted that since the Novel Corona Virus SARS COV-2 was discovered in December 2019 in Wuhan, China- the world has been held spell-bound with different very challenging experiences, with many new problems coming in the face of the whole world globally.

The Minister therefore promised that the Federal Ministry of Health would look into the issues raised by the NSA with a view to addressing them.                     

He said,”Going through the issues raised by your  association, the Ministry will look  into  them with  a view to finding lasting solutions to the problems of placement caste and career progressions of persons with those qualifications like Diploma and Membership in Anaesthesia of both National and West African Postgraduate Medical Colleges as a way encourage middle-level manpower development in Anaesthesia.

“We have  noted the call to equip our various hospitals, provide adequate infrastructure and improve the emoluments of doctors and especially encourage and fund the training of Anaesthesia Specialists. Regarding MDCN Registration, we will advise the Society to approach the relevant authorities to address the issues raised. Government is concerned about the tide of brain drain and suggestions on ways to mitigate the massive exodus of our health workforce especially among the anaesthetists is welcomed.

“We note the non inclusion of Anaesthesia, Intensive Care and Pain Management in the National Health Insurance Act as operated by the National Health Insurance Agency (NHIA).  The ministry is willing to work with the NHIA and all key stakeholders to look into this area of need.”

He added,”In conclusion permit me to dwell on a very important but often forgotten responsibility you owe to yourself and humanity:  SELF-PRESERVATION. To this end l have drawn a similitude to some of the incredible features of a Marine/aquatic wonder the OCTOPUS.

“The octopus is the most intelligent invertebrate in the ocean, with its mesmerizing limbs with which it executes incentivized tasks. In spite of this enormous capabilities, the octopus is fantastically fragile and both internal and external stressors can threaten its existence.”

He pointed out that anesthesiologists a special breed of physicians leading some of the most incredible team of healthcare professional at the core of the healthcare delivery system have equally mesmerized the world at the most trying times of human history in the wake of the COVID-19 pandemic and continuously in the complex meshwork of OPERATING ROOMS, EMERGENCY ROOMS, CRITICAL CARE UNITS and other demanding arena where and whenever human existence is threatened.

“The world indeed acknowledges such immeasurable contribution aimed at preservation the stable milieu of life.

“While you CALIBRATE and RECALIBRATE your knowledge, skillset, attitude and the multitude of equipment like the limbs of the octopus for excellent outcome, you most often forget to calibrate and recalibrate your own health indices. You have forgotten that you are equally threatened by both internal and external stressors of life.

“Today degenerative diseases, depression, burnout and suicide is threatening a critical mass of these specialists and their team. I pause for a minute silence in honour of those who died in the line of duty. May their souls rest in peace. Amin

“As you celebrate and deliberate do remember to CALIBRATE your health indices and take from this conference that even the OCTOPUS NEEDS CALIBRATION AND REJUVINATION,” he advised.

Delivering the 4th Professor Christopher Famewo’s Memorial Lecture, with the tittle,”The Turning Point to Anaesthesia Workforce, the nexus between Anesthesia Workforce and Research in Nigeria”, Major General, Dr. Obashina Ogunbiyi (Rtd) decried the menace of brain drain that has bedeviled the country’s health sector.

Ogunbiyi said the challenge of brain-drain can be addressed by the government via the provision of conducive workplace, good welfare packages for doctors and other healthcare providers, and tackling of insecurity, among others.

He said,”Essentially what is trending now is the “Jakpa” syndrome where professionals actually doctors and nurses emigrate outside the country, for greener pastures, I enumerated the effects of this on the healthcare facilities of this country using data that was supplied through NME.

“Also, I tried to create a nexus between this brain-drain and research in anesthesia and we do have more people now involved in research in anaesthesia particularly and who are remaining in the country. They are able to attract grants to their various institutions and also we are calling on the Federal Government to increase the funding of research grants in our tertiary institutions.

“Of course, we are aware of the TETfund, theTETfund has been very active in this light, but they can do better going by the example I gave, these are people who are remaining here, they are not going out anywhere. If they can be encouraged with increased funding in the research, I mean they would remain here. And that is the nexus that we are trying to create between the brain-drain as well as the research in anaesthesia, and by extension research in other specialties of medicine as well.”

“One is the fact that if they have conducive workplace, two welfare packages through incentives, three if the insecurity can be addressed at all levels. We had in the news recently about a professor who was kidnapped on Lagos Ibadan expressway, I’m sure all of us, we all knew about this. And despite that, people are still remaining in the country. And, of course, what to do is one, governments should at all levels address the insecurity which I can tell you the present government is trying his best to do, maybe I can add, they can do better.

“And once this one is captured, to a large extent, they may want to remain in the country, of course workplace is being better with incentives as it were and of course the fact that we have a lot of consultants who are making waves in the diaspora, some of them are back, I don’t want to mention names, some of them are back home to come and contribute their quota.

“I mean, last week or two weeks ago, there was a open heart surgery in Anambra state. People are coming back. I know a facility in a way too, I don’t want to mention the name, so here is a consultant, physician based in the United States,but he came home to establish a critical care facilities, neurocritical care facility in Owerri and is doing wonders there. I mean, I have been there, as President of critical care, I saw the facility. So people are coming home. It’s just that the amount of doctors and nurses that are immigrating fast supersedes those that are coming in.”