Each year, on May 1st, Nigerians celebrate Workers’ Day. The iconic line from the national anthem—“The labour of our heroes past shall never be in vain”—rings out with solemn pride and expectation. It is a time to reflect not just on the contributions of labourers in all sectors but also on the enduring sacrifices made by Nigeria’s most essential workforce: its medical doctors and health professionals.
In the context of Nigeria’s struggling health system, these words are far more than ceremonial—they are a call to conscience. As we honour Nigerian workers, we must turn our attention to the doctors and healthcare workers who continue to stand between life and death every day, often under unbearable conditions. Their labour, sacrifices, and resilience must not be in vain.
The Backbone of Public Health: Nigerian Medical Doctors
Medical doctors form the backbone of Nigeria’s health sector. From general practitioners in rural clinics to surgeons in tertiary hospitals, they are the frontline defenders of public health. Yet, their working conditions are often appalling. Many doctors work without adequate equipment, adequate staff, or reliable power and water supplies. The doctor-patient ratio in Nigeria remains dismal—averaging about one doctor to over 4,000 patients, far below the World Health Organization’s (WHO) recommended ratio of 1:600.
Despite these challenges, Nigerian doctors continue to display remarkable dedication. During pandemics, outbreaks, and conflicts, they have remained at their posts, often risking their own lives. The COVID-19 pandemic, for example, underscored their irreplaceable value to the nation. Yet, despite their sacrifice, the system offers little in return—many go months without pay, face poor hazard allowances, and suffer from burnout and emotional stress.
The Exodus: A Nation Losing Its Best
The term “japa” has become synonymous with the mass migration of skilled Nigerian professionals, and among the most affected sectors is healthcare. According to reports by the Nigerian Medical Association (NMA), over 40,000 Nigerian doctors have emigrated in the past decade. They choose better working conditions, fair remuneration, and career growth abroad—mostly in the UK, US, Canada, and Saudi Arabia.
This brain drain is not merely a loss of personnel; it is a hemorrhaging of national capacity. These are doctors trained at great cost by Nigerian institutions, often subsidized by public funds. Every doctor who leaves represents years of investment and a gaping hole in the already strained health infrastructure.
Why are they leaving? The answers are not far-fetched—unpaid salaries, dilapidated hospitals, insecurity, lack of equipment, and a general sense of abandonment by the state. Without systemic reforms, the trend would continue, if not accelerate.
Heroes in White Coats: A Legacy of Sacrifice
When referring to “the labour of our heroes past,” we often recall political freedom fighters and nationalists. However, Nigeria’s history is rich with medical heroes too—men and women who toiled not for wealth, but for the health of the nation.
Think of Dr. Stella Adadevoh, the physician who helped curb the spread of Ebola in Nigeria in 2014 by quarantining patient zero, even at the cost of her life. Think of countless unnamed rural doctors who serve in isolated communities, with no spotlight or applause, simply because their people need them.
These are the heroes whose labour we must not allow to be in vain. Their dedication is a sacred trust, passed down to today’s generation of doctors who continue to fight for a healthier Nigeria—often without the tools they need.
Signs of Hope: Is Change Possible?
Despite the grim realities, there are glimmers of hope. Various state and federal governments have acknowledged the need for healthcare reform. New medical schools and teaching hospitals are being built, while older facilities receive face-lifts. Telemedicine initiatives are slowly taking root, and public-private partnerships (PPP) are beginning to bear fruit in certain regions.
The National Health Insurance Authority (NHIA) has also been reformed to offer better coverage to Nigerians, though implementation remains patchy. The Basic Health Care Provision Fund (BHCPF) has begun to channel funds directly to primary health care centers, bypassing bureaucratic bottlenecks.
In April 2024, the Federal Government approved a special hazard allowance increase for frontline medical workers—a policy many see as long overdue but welcome. Moreover, discussions around better residency training, medical research funding, and reverse brain drain policies are gaining momentum.
However, hope must be matched by action. The Nigerian government must go beyond policy announcements and ensure that reforms reach the grassroots. Investment in infrastructure, welfare, and training is not just desirable—it is essential.
What Needs to Be Done?
To truly honour our medical professionals and make their labour worthwhile, a multifaceted approach is necessary:
Adequate Remuneration and Welfare: Doctors must be paid promptly and adequately. Salaries, hazard allowances, and pension schemes should reflect the importance of their work.
Improved Infrastructure: Hospitals must be equipped with modern facilities. It is unconscionable for doctors to perform surgeries by flashlight or refer patients for simple blood tests due to lack of equipment.
Retention and Motivation Policies: The government must create conditions that encourage doctors to stay. This includes career advancement opportunities, continuous medical education, and housing incentives.
Security and Working Conditions: Healthcare workers must be protected, especially in conflict-prone regions. No doctor should have to work under the threat of violence or kidnapping.
Community and Stakeholder Engagement: Civil society, private sector, and international partners must collaborate with the government to rebuild trust in the health system.
Reverse Brain Drain Initiatives: Programs that incentivize Nigerian doctors abroad to return home—even temporarily—can help transfer knowledge and skills.
A Nation’s Health is its Wealth
There is a direct correlation between the health of a nation and its development. No country can progress if its citizens are not healthy, and no health system can thrive without empowered medical professionals. As we mark this year’s Workers’ Day, we must remember that honouring our doctors goes beyond mere words—it requires intentional, sustained action.
The true test of a nation’s gratitude to its workforce lies in how it treats those who serve. If Nigeria is to fulfill the dream embedded in its anthem and national psyche, then the labour of our medical heroes—past and present—must not be in vain.
Conclusion
Nigeria stands at a critical junction. We can either continue to ignore the plight of our doctors and risk a total collapse of the health sector, or we can rise to the challenge and begin to build a system worthy of their dedication. The choice is ours. But whatever we do, let it be driven by the hope that one day, Nigerian medical professionals will no longer be forced to leave home for survival, but will stay—and thrive—because their nation finally chose to value them.
May the labour of our heroes, in scrubs and white coats, never be in vain.
Happy New Month and Happy Worker’s Day
Dr Benjamin Oluwatosin Eno-Obong Olowojebutu
First Vice-President
Nigerian Medical Association
