Lagos: Emem Isong, who had her foot run over by a car and had two of her toes broken, screamed in agony while seated on a trolley outside the hospital's accident and emergency department in Nigeria's largest city.
The 33-year-old was told to wait by a nurse at the Ebute-Metta federal medical centre in Lagos because there were only three of us on duty. “The alternative is for you to go to another hospital.” Nurses finally attended to Isong's wounds after a five-hour wait.
Isong explained that she had two options: wait for her turn or be referred to another hospital that would reject her.
As wealthy nations woo underpaid but skilled professionals, Nigeria, like many other African nations, is witnessing a talent exodus from its precarious health care sector. Nigeria's government hopes to address this issue with new legislation.
More than 11,000 of the union's 150,000 members have left the workforce since the COVID-19 pandemic, according to Michael Nnachi, president of the Nigerian Nursing Union, in search of better pay and working conditions abroad.
The economic downturn in Nigeria has only boosted the trend, said the nursing union’s chairman, Olurotimi Awojide.
"Food, transport, and rent are expensive, and the money they currently pay cannot cover our needs. According to him, nurses believe they must leave the country in order to live better lives.
Nigeria has been included on the WHO's list of nations with a shortage of healthcare workers since 2020. Two-thirds of the states on the list this year are African nations, which deters foreign employers from hiring nurses from them.
However, the list has not been able to stop the exodus, and Nigerian hospital administrators claim that patient care is suffering because there aren't enough new nurses to replace those who are leaving to work abroad.
While managing Lagos University Teaching Hospital for more than ten years, Wasiu Adeyemo claimed that he had never experienced staff shortages as severe as they are right now.
Four wards with greater than 90 beds remain shut at the facility, one of Nigeria’s biggest experts hospitals, with no nurses to function them.
Adeyemo told the Thomson Reuters Foundation, "Everyone talks about doctors leaving, when the real problem we're facing is nurses going daily.
Are we saying we're going to hire nurses from Cuba or Sudan at this point? he questioned. "Very few nurses apply for jobs, and of those we do hire, about half leave after three months to work in the UK.
Nigerian nurses frequently travel to Britain.
7,200 Nigerian nurses registered with the Nursing and Midwifery Council, a professional organisation in Britain, last year. In Britain, the Philippines and India had the most nurses.
On what it refers to as the "red list" of nations where the WHO claims there is a shortage of healthcare workers, the British government advises employers not to actively seek out candidates from places like Nigeria. However, candidates from those nations are still eligible to apply for positions posted in Britain.
According to the British Home Office, Nigerians received 12% of the skilled health and care worker visas issued last year. Josephine, a nurse from Nigeria, is about to increase the total. The 28-year-old claimed that after receiving a UK visa last month, she left one of Nigeria's top cancer treatment facilities.
Before starting her new job as a critical care nurse in the private sector in Britain, her husband sold their car, and she is selling furniture and appliances.
The mother of two said it was getting harder and harder to make ends meet on her 100,000 naira ($135) monthly salary.
"I'm working all weekend at the hospital, away from my kids, for peanuts at the end of the month," Josephine said. According to her, her British employers will pay 20 times what she currently makes.
Zimbabwe was the top African country receiving skilled health workers' visas from the UK last year, accounting for 16% of all visas, despite being considerably smaller than Nigeria.
Tendai made about $200 a month as a senior nurse in Zimbabwe before moving to the UK. The mother of three relocated two years ago in search of a better job and a brighter future for her kids.
She earns more than ten times as much money at a hospital in the south of England than she does at home. She must spend half of her income on rent and other expenses due to the high cost of living, but she is exempt from paying for her daughters' education.
"The cost of living in the UK is high, but you can still afford the necessities. In comparison to back home, I am aware that my children have the essentials in terms of food and clothing, Tendai said.
Since 2021, more than 4,000 medical professionals have left Zimbabwe, according to the country's Health Services Board.
For the first time in March, Zimbabwe was added to the WHO's list of nations where health workers shouldn't be hired. According to Tendai, many nurses who paid to take English-language tests and process travel documents were dissatisfied because it made finding jobs abroad without the assistance of recruiters more difficult.
Because they had done all of these things, "some nurses have lost a lot of money," she said. People take two years to prepare to move to the UK, and just when you think you're about to make it, the red list appears.
According to local media, Zimbabwe's Minister of Health, Constantino Chiwenga, plans are in the works to make hiring foreign medical personnel illegal in order to keep local workers on the job.
Back in Nigeria, lawmakers approved a bill preventing physicians and dentists from receiving licences until they have worked there for five years. Even though the president has not yet signed the bill into law, one legislator already wants to impose the same limitations on chemists and nurses.
In response, medical professionals threatened to go on strike.
Jesse Otegbayo, a professor of medicine at the University College Hospital in Ibadan, in southwest Nigeria, called it a "lazy approach." Instead, he said, the government ought to address the worries of healthcare professionals.
Richer nations should pay countries that had trained health workers, according to James Avoka Asamani, a WHO expert in Africa, to make the process beneficial for both parties.
Asamani stated, "It is only morally justified that you also invest in that health system to prevent it from collapsing if another country has used their public resources to train health workers, and you are recruiting them.
However, Otegbayo claimed that hospitals in Nigeria were currently in danger of collapsing due to the burnout of many nurses. Any health administrator should be concerned about this serious situation, and so should the general public. The patients will suffer as a result of the overworked state of the few remaining nurses, he warned.