OBSERVATION: How Not To Address JAPA Syndrome

• ADEMOLA YAYA

JAPA is a Yoruba word that means ‘flee’ to gaining freedom from bondage of Nigeria. ‘Ja’ means run and ‘pa’ is an emphasis and import to an expression – Ja. Simply put, ‘japa’ is a colloquial expression of mass movement of people, especially the young and professional, out of Nigeria to seek greener pasture.

When I saw a news with the headline, “Japa: Tinubu Issues Executive Order on Health Workers Leaving Nigeria”, I breathed a sigh of relief, thinking that health matters were being addressed by the ruling elite, after all. By the time I read the details, I was downcast as the government was only scratching the surface while leaving the issue unaddressed. During his visit to Neuro-Psychiatric Hospital, Aro in Abeokuta, Ogun State, on Saturday, March 9, 2024, the Minister of State for Health, Tunji Alausa, said Mr. President had issued an executive order as part of drastic steps to combat the challenge of brain drain confronting the health sector.

The Minister said, “You cannot eat your cake and have it. If you are going, just resign your appointments with the Federal Government, rather than applying for leave of absence, that is the presidential executive order that has been communicated to all the Chief Medical Directors of Federal Government owned health facilities to implement. The problem with the leave of absence is that such a fellow is out there in the UK or Australia working, making money but his name still appears on the payment roll of the government and so to replace him is difficult because he is still being considered as a staff whereas he has left the country.

So, to solve this problem, the President has directed that health workers going abroad to work should just resign their appointments and not apply for leave of absence. This way, you won’t be blocking others who want to work and of course piling burdens for your colleagues that you left behind. The government is not unmindful of the japa effect on our manpower in the health sector and the President has ordered for massive production of manpower such that when people go, there will always be replacement. It is against this background that we are working intensely on the enrolment of our nurses. What used to be 28,000 is now 68,000 and our intention is to take it to 120,000 by the end of the year, so there will always be abundant skilled manpower to take over from those leaving the job.”

At the Medical and Dental Consultants’ Association of Nigeria (MDCAN) 13th Biennial Delegates meeting and scientific conference in Kano in September, 2023, the President of the association, Prof. Muhammad Muhammad said, “Medical education is under threat, mainly due to the large number of specialists and trainers migrating to other climes. A number of universities presently have less training quota than the manpower and infrastructure the institution can effectively train.”

He lamented that no fewer than 500 specialist doctors with speciality in teaching and training had migrated saying, “They are the ones that are involved in teaching and nurturing of new generation doctors from both medical schools and training specialist in Nigeria.” He went further, “With the alarming rate of japa, some departments are closing or left with one or two doctors who render services that were supposed to be rendered by 10 of them. It will take the country almost 10 years to replace the number by the rate at which we are producing.” And he concluded, “If there is no improvement in current condition in terms of infrastructure, working condition and security, it will be difficult to prevent people from moving out. Concerted efforts should be made by the government to motivate its available human resources for health in order to sustain and improve on the quality of undergraduate and postgraduate medical trainings in Nigeria.” As I write, statistics shows that Nigeria has lost 16,000 Doctors to Japa in the last five years.

With the available facts and statistics, what is required is not an ‘executive order’ of ‘just resign your appointments and not apply for leave of absence’ but a declaration of a state of emergency in the health sector and allocation of significant votes to it. These votes must be monitored and supervised by responsible agencies and stakeholders in the health sector so that the funds won’t end up in private pockets. Medicine is same everywhere in the world; what makes difference are the infrastructures, equipment, remuneration, incentives, working conditions, among others. Our health system – primary to tertiary – is in a state of comatose. Revival of the sector and making it optimally operational and attractive to health workers should be government priority.

Furthermore, there should be immediate full implementation of the Mental Health Bill which had been signed into law by President Muhammadu Buhari in January, 2023, the first legislative reform adopted since the country’s independence, a replacement of Lunacy Act of 1958, especially at this period of socio-economic disorder that is dragging people into mental disorder vis-a-vis disturbances due to over-thinking on how to make ends meet, leading to anxiety and depression, among others. As of 2022 when things were relatively better than now, Dr. Adebayo Adebisi, Head of Department of Clinical Services in Federal Neuro-psychiatric Hospital, Kware, Sokoto said, “The generally known estimate is one in four Nigerians has some form of mental health problems. If you say we are 200 million, that gives to about 50million Nigerians with mental health issue.” 

Conclusively, all efforts must be made to address the state of insecurity in the land as it is a singular factor that has negatively affected every sector and everybody. Insecurity has become a thriving big business that has refused to evaporate. Or how does one explain bandits who kidnapped 16 people in Kaduna demanding N40trillion, 11 Hilux and 150 Motorcycles as ransom for the release of their captives? Even the entire Federal Government 2024 budget which is the biggest in history is N28.7trillion! Although, security agencies are doing their best but their best is not good enough. The government knows sponsors of terrorism and should go after them as they seem to have compromised some few bad eggs among security operatives who make job difficult for their loyal and committed majority colleagues. And time is of essence.

• The opinions expressed in this publication are those of the author. They do not represent the opinions or views of OSUN DEFENDER.