…Nurses say N576 call rate insulting
…One doctor attends to 30-40 patients daily
…FG engages in active talks with nurses as patients are stranded
At a public hospital in Zamfara State, Dauda Haruna (not real name) came to work on a Friday morning in September 2024 and went home the following day.
Before Haruna, a general physician, left the hospital on Saturday morning, he had attended to 37 patients.
“I am attending to patients, but I am sick myself,” he said.
“I do not sometimes have rest when I need some.”
Nigerian health workers are increasingly facing burnout as they spend long hours attending to patients even when they also need medical attention.
Read also: FG disburses ₦20 billions to 4,000 primary health centers in Northern Nigeria
A study entitled, ‘Physician burnout in Nigeria: a multicentre, cross-sectional study,’ carried out by Arinze Nwosu and other researchers found that 75.5 percent of physicians complained about burnout as of 2020.
“Major medical errors in surgical practice have been reported to be strongly related to the surgeon’s degree of burnout. Self-reported suboptimal care of patients by physicians has also been attributed to burnouts,” the survey said.
Experts blame brain drain for burnout among health workers. The Nursing and Midwifery Council of Nigeria said over 42,000 nurses have left Nigeria for jobs overseas in the past three years.
About 16,000 medical doctors left Nigeria to practice abroad in the last five to seven years, said Muhammad Ali Pate, coordinating minister of Health and Social Welfare.
Africa’s most populous nation has merely 25 consultant oncologists to cater for cancer patients in Nigeria.
There are only 50 neurologists and 40 neurosurgeons in Nigeria to cater for patients with nervous system issues, and 600 consultant paediatricians to provide support for children.
There are currently 9,000 gynaecologists in Nigeria, according to the Society of Gynaecology and Obstetrics of Nigeria. The Medical Research Foundation says there are merely 250 psychiatrists to cater to over 50 million mentally ill Nigerians.
Wasiu Lanre Adeyemo, professor and chief medical director, Lagos University Teaching Hospital (LUTH), said the situation is unhealthy for the sector.
Adeyemo expressed deep concern over the severe impact of the ongoing brain drain. With increasing numbers of doctors and nurses emigrating in search of better opportunities abroad, he said the staffing crisis is at a tipping point.
“Lagos is especially affected. We are coping, but only just coping. This is not sustainable,” he warned.
He called for an urgent government action not only to recruit more healthcare personnel but also to retain those who are still in the country. “Infrastructure has improved, yes. But we need people to run the systems we are building.”
A medical doctor, who works at a public hospital but spoke on the condition of anonymity, said: “Previously, we took calls once a week. Now, some of us do three 24-hour calls per week because there are not enough hands to rotate among.”
He said after completing a 24-hour call, doctors are still expected to resume their regular 8:00 am to 4:00 pm duty without rest, leading to fatigue and increased risk of errors.
“I have seen colleagues faint on duty. Some have even died. This is not just stressful, it is life-threatening.”
Read also: Nigeria’s healthcare crisis: Systemic failures undermine Nigeria’s economy
A senior doctor who spoke with BusinessDay under anonymity corroborated this, saying that burnout is becoming rampant and dangerous.
“We should expect more misdiagnosis and errors in treatment. Fatigue compromises care, and the patients will suffer for it,” he warned.
The doctor emphasised that unless the government starts massive recruitment across public hospitals, the situation will deteriorate further. He noted that Nigerian doctors, who often earn around N200,000 monthly, are severely underpaid compared to their counterparts abroad earning between $4,000 to $7,000.
“Even if taxes cut that by half, they are still making over 100 percent more than us. That is why doctors keep leaving,” he added.
Charles Okeke, an Abuja-based surgeon, said the situation is hurting the health sector.
“Several doctors earn less than N400,000, which is just $260. Yet they work ceaselessly for hours without incentives. The government must engage more workers and pay those who are here well enough,” he said.
Nurses’ strike
Nurses, under the umbrella of the National Association of Nigeria Nurses and Midwives (NANNM), have begun a seven-day nationwide warning strike after the expiration of a 15-day ultimatum.
Nurses want improved remuneration, better working conditions and increased recruitment.
As a result, patients across government hospitals in Abuja, Lagos, and other states are stranded owing to the absence of nurses to attend to them.
Speaking with BusinessDay from Maiduguri, where he was attending a meeting of chief medical directors, Adeyemo, earlier quoted, noted that the federal government is engaging in active negotiations with the striking nurses.
He disclosed that Muhammad Ali Pate, minister of Health, had earlier visited before heading back to Abuja for urgent talks.
“We can’t afford a prolonged strike, not now. As a hospital, we must continue with emergencies, ICU patients, and those already admitted,” Adeyemo stated.
Morakinyo Olajide Rilwan, national chairman of the Federal Health Institutions sector under National Association of Nigeria Nurses and Midwives (NANNM), said: “Nurses are compassionate people. This is a calling. But compassion has been taken for granted.”
He expressed outrage at the federal government’s recent circular on call duty allowance, which increased rates by a mere N500 to N2,000 for most nursing staff.
“Imagine earning N576 per call unit as a professional. That is N23,040 a month for 40 units. It is insulting,” he said.
Read also: FCTA to enforce mandatory Hepatitis screening for Abuja food vendors to boost public health
Rilwan explained that many nurses now handle 30 to 35 patients per shift, when the World Health Organization (WHO) recommends a one-to-four nurse-to-patient ratio. “Burnout is inevitable,” he said.
Despite producing over 10,000 nurses annually, he noted that many remain underemployed or are kept on temporary contracts for years. “We asked for staffing, retention allowance, modern tools but nothing changed. This strike is our last resort,” he declared.
Backing the nurses’ demands, Tope Osundara Zenith, president of the Nigerian Association of Resident Doctors (NARDs), said the concerns raised are not only legitimate but shared across all medical professions.
Zenith noted that the government has until August to fulfil promises made to doctors.
“Doctors are overworked, underpaid, and unappreciated. Salaries have been wiped out by inflation. There are no incentives, no housing schemes, no car loans. Yet, we are expected to perform miracles daily,” he said.
He also stressed that many doctors in training are being forced to prioritise patient care over education and research, a shift he described as dangerous to long-term professional development.
Few skilled personnel
While the government has invested heavily in hospital infrastructure, including the commissioning of cancer centres in Lagos, Enugu, Katsina, and Benin, the absence of skilled personnel to operate them remains a major obstacle. Adeyemo noted that the Ministry of Health has now been granted a waiver to recruit directly, bypassing the usual bureaucratic hurdles. He also disclosed that medical and nursing schools have been given approval to double admissions, as part of an effort to reverse the trend of workforce depletion.
But Rilwan argued that recruitment alone is not enough. Retention remains the core issue. “Many of us don’t want to leave. But insecurity, poor pay, and lack of tools make it hard to stay.”
He called on the government to improve health workers’ salaries significantly to make staying in Nigeria worthwhile. “There is no place like home. But right now, home doesn’t feel safe or liveable,” he added. (BusinessDay)
