The Japa Percentage: And Then There Was None…


“Would you be traveling out or staying back in Nigeria to practice. If you are planning to ‘Japa’, what steps were you able to take towards that during housejob?”

Believe it or not, 100% of the respondents to the quick survey said they desire, are planning and/or are already working on traveling out. And, trust me, people are not joking with or sleeping on this issue. Whether a Housemillionaire or not, many of these doctors already took serious, definite steps towards getting out of here. IELTS written and passed, registration done for PLAB, USMLE, tutorials signed up for, textbooks and past questions purchased, elders contacted for advice and direction.

Recently, I saw on social media some article on how traveling out won’t solve financial problems. Alright. Let’s take a deep breath and calm down, because not only is that statement hilarious, it is, in the face of Nigeria’s current state, quite irritating.


A lot more than finances

The average medical doctor is leaving because… urgh, where do I even start this from? How do I convey this the right way… to represent my people and their intentions correctly? Without some random fellow out their taking it up and twisting things to something else? Without some poor fellow doctor getting insulted for wanting to leave or even beaten up by patient relatives? Oh, without one or two of them getting kidnapped? Without one team of healthcare professionals having to face some panel on the death of a patient which was due to …uhm… lack of equipment, poor infrastructure, power outage, severe financial constraint… some other thing beyond the team?

I don’t know if you get it, but in the above paragraph, I have touched on some of the reasons why doctors are leaving and I have not even mentioned finances.

Or have I mentioned the fact that comfortable living is the best we can be offered in this profession and even that is not guaranteed. By the way, comfortable living just means if thieves accost you, you’d have at least N50 to give them. Many of us cannot even afford the medical care we offer our patients. Many times I look at myself, my family and all I can think of is, “If any health crisis should come up, based on my salary alone, are we not finished?” “If one of us should go and born baby via CS and I’m asked to foot the bill… hehe, am die.”

Or have I mentioned the inconsistency of pay? The fact that you cannot even be sure that by so and so date of the month, I should have my salary in my account. You have to be carrying out combinations and permutations on possible periods within which the pay may or may not come in. And as a doctor, you really should not complain because… Are you not… a doctor?!?!!?!

Furthermore, I am sure I have not touched on the assumption that doctors, at the swearing of the Hippocratic Oath, shed off their human skins and take on some other skin that makes them immune to everything out there.

Fall sick? No way. Have mental breakdowns? Nah, seriously? Get seriously fatigued? Blessed Jesus, nope! Need stress reliefs like books, social media, games, date nights? Are you kidding? Have families that need them? Impossible! Some things are just no more to be thought, talked or heard of about doctors. No more.


Others before self…?

A father cannot even be excused to go see his own sick daughter. And so long as he is not the one taking the delivery, a doctor does not need to be with his wife when she needs him the most. And even if her husband may lose his arm following the accident, the doctor can only send him hastily made voice-notes of comfort while waiting for the next patient to come in.

I, for one, already fixed these last parts in my head… the fact that some other aspects of my life would have to be shelved to be able to give my best to my patients and to my team members. It’s more like the natural sacrifice to make and I am pleased to willingly do that. And more. I know that medicine entails putting others before myself and going out of my way for them because they have entrusted their health and lives to me. It is a huge trust and a great responsibility, but I am prepared for that. In fact, I am pleased to be at your service. And for most of my colleagues, this holds true.


Mainly doctors are blamed!

What we do not like is to be robbed of our own needs… just because… and then be vilified if/when we demand for our rights.

Yes, doctors outside Nigeria face SOME of these struggles but they have rewards that can overwhelm those struggles. They have the satisfaction of more living patients and actual progress in the fight against diseases.

Remember, we still are entitled to our basic human rights. By all means, other professions have their problems and have places that ache them real bad. Of course, it’s not only doctors that are leaving the country. In fact, as I was made to know, nurses are in this Japa business more than doctors.

The question is, how often are these other professions accused of being without human feelings , how often are they dragged on social media for being insensitive and unprofessional, how often are they reported to be threatened, beaten, stripped naked… all because of their profession? And how often do they get to know their worth only after they are dead?


Why we ‘Japa’…

Yes. We want to leave. Us wants to leave. Nous voulons partir! Because…

  1. Healthcare is not meant to be a joke but when the allocation to health in Nigeria is nowhere near the minimum WHO percentage, healthcare becomes a huge joke. And guess who the clowns are. Yes, doctors. Guess who the joke is on. All of us. But who gets blamed for the bad jokes? The clowns of course. They did not write the jokes or the scripts but they are the ones available. So, blame them please.
  2. Some of us actually want to practice medicine at the level it is right now in saner climes. We pride ourselves in being able to make diagnosis from history and examination alone, being able to get intravenous access without the vein finder, being able to take blood samples with improvised glove rim tourniquets… but, deep down, we want to experience the technical advancements of the medical field which, due to obvious reasons, are absent in our nation.
  3. We want to be valued for who we are and for what we can offer. A prophet is without honor in his hometown has never been truer than it is in this situation. “Nigerian doctors are incompetent, not skillful, without the know-how, this and that“. Lol. A video came out of some foreign doctors resuscitating a newborn baby, with some soulful music in the background and suddenly, some very ‘enlightened’ fellows were very sure Nigerian doctors didn’t even know what was going on in the video. I mean, can your doctors ever? Excusez-moi? C’est ne pas amusant… I cannot re-rant this aspect.
  4. It is tiring, physically and emotionally, to keep losing patients because of mundane things. Do you really think people put on these emotional masks for nothing? We have cried up our tear glands. Those glands are tired of being milked day in, day out for patients that should otherwise have lived. Patient cannot afford this, patient dies. Mr. XYZ can afford this but it is currently not available, he dies. The child of Deaconess ABC can afford this and it is currently available but not in this location, she dies. That 65 year old retiree can afford this, it is currently available in this location but just as you are about to start, something gets exhausted, something goes off, something stops working, patient dies. Then, you are left wondering why you even bother. Why do I do all these running around and shouting and threatening to save these patients when it takes just one thing to ruin it all?
  5. Some of us thought we could save Nigeria’s healthcare system but… we realized that redemption can only come from the redeemed, the blind can lead the blind but it should not be so because the pit awaits them both and when all is said and done, we just want to live. We also don’t want to be dead in the pursuit of saving Nigeria. Martyrs will rise again, trust me, but maybe not from this generation.
  6. Should I go on? Or you now understand why this vicious cycle may not end anytime soon? More and more people are leaving. The pressure is mounting higher on the few that are left. They are reaching their elastic limits too and if they are to not snap, they would also start considering the Japa option. The bitterness and outrage rises and the very few left would wonder if they can really handle all these and when they can’t take it anymore, UK, US, Canada, Arab Emirates and the likes gain more doctors. Meanwhile, your countrymen continue to lash out.


And then there was none. To Jesus be our glory.

Not all of you would be able to leave.

Would all be able to survive out there?

Do you think all of you would make it?

And then there was none. Praise Be.

What of your family members left in Nigeria?

Would you be able to raise families there?

Would you be able to handle the loneliness?

And then there was none. Jah bless.

Forgive the blurry picture but the truth in it can’t be clearer… We are losing our doctors. Even the 100 level medical student is already setting eyes on the possibilities beyond the Nigerian borders.

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