THE COST OF GETTING SICK (4)-BRAIN DRAIN

You can’t talk about the cost of getting sick in Nigeria without talking about the people who are no longer here.

Every crisis in our health system seems to sit on top of another one. But the quiet one, the one we don’t always calculate, is the exodus. The steady exit of the very people we spent years training.

They call it “Japa.” A soft word for a hard reality. Doctors, nurses, consultants packing up degrees earned in overcrowded lecture halls and walking into airports with one-way tickets. Not because they hate Nigeria. Not because they lack patriotism. But because at some point, patriotism doesn’t pay rent, and it certainly doesn’t restore your mental health.

We have roughly 24,000 licensed doctors serving over 220 million people. Do the math. One doctor to about 9,000 Nigerians. The World Health Organization recommends one to 600. That’s not a small gap.

So when you sit in a waiting room for six hours, when your appointment gets postponed for the third time, when the doctor looks exhausted before even greeting you, this is why. The few who remain are doing the work of many. One senior figure in the Nigerian Medical Association put it bluntly: they’re working several times harder than global standards. And yes, the system leans heavily on their sense of duty.

And duty has limits.

In September 2025, at Rivers State University Teaching Hospital, a resident doctor, Dr. Femi Rotifa, finished a 72-hour shift. Seventy-two hours. He went to rest in the call room. He never woke up.

It shook people for a week. Then the news cycle moved on. But inside hospitals, nothing really changed. The shifts are still brutal. The rosters are still thin.

In some teaching hospitals, entire specialties are running on fumes. Where you should have fifteen residents, you might find four or five. The pipeline is cracking because the people meant to train the next generation have already left. You can’t build capacity when your builders are boarding flights.

Then there’s the part we don’t like to say out loud. In some state institutions, doctors are owed salaries for months, in some cases for over a year. At places like Benue State University Teaching Hospital, arrears have stretched painfully long. When a state starves its doctors, it should not be shocked when those doctors start looking elsewhere for survival. And sometimes, the patient feels the ripple effects of longer queues, informal charges, and disengaged care. Not because doctors are villains, but because prolonged frustration corrodes even good intentions.

This is the uncomfortable truth: the cost of getting sick in Nigeria is rising not just because drugs are expensive or equipment is outdated, but because the human backbone of the system is thinning out.

When doctors leave, it doesn’t just create inconvenience. It creates vulnerability. It stretches response times. It increases error risks. It drains mentorship. It turns what should be manageable illnesses into prolonged battles.

We can argue about loyalty and patriotism all day. But maybe the better question is: what does a country owe the people it asks to save lives daily?

Because right now, the bill is being paid by everyone- the doctor who stays, the doctor who leaves, and the patient who simply hoped to get well.