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Brain drain in mental health: Robbing Peter to pay Paul: Part II

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LAST week’s story centred on the experience of Dr Tunde who had worked hard for all of 15 years through medical school, internship, NYSC and residency; but having qualified as a Consultant Psychiatrist, suddenly found himself in the unemployment market for going on a year.

He had started contemplating the attractive option of travelling abroad, as he was no longer able to cater for his family and his frustration was making him very upset and irritable. Happy reading, as the story continues this week.

Tunde decided to visit an accomplished Professor of Psychiatry who had travelled around the world but has been based in Nigeria all these years. He narrated his ordeal and the choices he was contemplating, before seeking Prof’s advice. The following conversation ensued.

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Prof: Well, thanks for coming to see me and for discussing your concerns and the options you are considering with me. I must admit that it is sad that we are at this crossroads, especially when one considers that we are so grossly under-resourced in terms of all cadres of health care workers generally, not to talk of mental health workers.

It is akin to criminal negligence and a disservice to the country to have spent so much time and resources to train specialist consultants like you, Tunde, and then fail to provide employment opportunities to absorb and retain them. I just can’t understand it, yet our people need your services.

I am sure you are aware that the World Health Organisation world mental health surveys showed that only 20 per cent of Nigerians with mental health problems receive any care. The treatment gap is huge, and will only worsen when people like you leave out of frustration.

Of course, you also know that this problem is not just a problem of psychiatrists or doctors alone. We have pitifully few clinical psychologists, nurses, speech therapists, you just name it. And we are refusing to employ the ones we have trained.

Tunde: Thank you Prof. I never imagined that I could be jobless for up to a year as a Consultant, or that I would be worrying about how to pay my rent and my children’s school fees because I don’t have a job.

In fact, Sir, another colleague of mine who was (un)lucky to get a job with a State Teaching hospital has not been paid his salaries for the past eight months. He left for Saudi last month.

Prof: And to imagine that those other middle-income countries such as Brazil are doing far better than we are doing, by retaining their professionals and providing incentives for them to work with standard facilities and good remuneration packages.

Tunde: Really?

Prof: Yes indeed. Do you know that Brazil which is also a middle-income country like us, with a population of about 210 million people, has about 7000 psychiatrists working in the country? Whereas we are nearly 200 million too, we only have about 200 psychiatrists in Nigeria…and we are refusing to employ young ones like yourself that we have trained.

In any case, we only manage to train 10  to 20 consultants per year, but less than half of them are able to secure employment. The others end up travelling abroad. And some of the older ones are also resigning and relocating abroad.

So, it is more of a dynamic equilibrium where we train more and several relocate but there is no net gain in numbers. In fact, it is a net decline that we are witnessing. Is that not a pity?

Tunde: Indeed Sir. If Brazil can employ and retain 7000 psychiatrists for the same population, why can’t we employ and retain even 500? Sir, this brings me to my sad conclusion.

Nigeria does not need or appreciate the need for my services. I am on my own, so I might as well just travel out and chart my own pathway where I am needed.

Prof: Well, in all honesty, I cannot look at you and tell you not to explore your travel plans and seek an environment where your services will be appreciated and better remunerated. You can also improve your skills and gain invaluable exposure. But I have one recommendation for you.

Tunde: What is that Sir?

To be concluded next week

The post Brain drain in mental health: Robbing Peter to pay Paul: Part II appeared first on Tribune Online.

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