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Amy Hagopian, Seattle, Washington Faculty, University of Washington
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Thank you to E. Monjok, a Nigerian physician in Houston, for his observations about the poor conditions under which physicians in his home country work, and the shockingly poor care low-income patients there receive. I did some of my dissertation research with medical schools in Nigeria, and have some limited understanding of his views. Dr. Monjok is right to be dismayed about the conditions of the Nigerian health care system, but to lay all the blame at the feet of the Nigerian government is to take too many other co-conspirators off the hook. US Vice President Dick Cheney, for example, was CEO of Halliburton when his company paid $180 million in bribes to Nigerian officials for the right to exploit oil reserves there (admitted in SEC documents). Nigeria is one of the top five oil suppliers to the U.S., and yet its ordinary people live in squalor and poverty. That happens with the collaboration of the multi-national oil companies with roots in the U.S., and with either the tacit support of U.S. policy makers, or at least their blind eye. There is plenty of blame to go around. Doctors making migration decisions are doing the best they can in a bad situation. But national and multinational policies can be changed if people, especially physicians, are willing to get involved, speak up, and get organized. Competing interests: None declared |
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Emmanuel M. Monjok, Houston TX ,USA IMG physician/HIV Research Fellow, University of Houston, TX USA
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I wish to contribute to your excellent article and question. Developed countries like the USA and the UK receive most IMG from my country, Nigeria. This physician migration from sub-Saharan Africa became more rampant in the early 1990's when the various military rulers did a great damage to the educational and health sector of the economy of Nigeria. It was during this time that hospitals had no materials, no drugs and equipments to care for patients with basic preventable illnessess. I have witnessed a female patient with a ruptured ectopic pregnancy die in an out-reach tertiary hospital because the hospital had no anesthetic drugs, no blood, and no surgical materials. Even when she was to be transported to the main hospital, the available ambulance car had no fuel and the husband who came with her to the hospital with his 3 yrs old son could not afford to hire a taxi because he has not received his monthly pay for 4 months. In another instance, the main teaching hospital wanted a woman and her husband to pay a deposit amount at 12 midnight on a Sunday for an emergency laparotomy to be performed. The husband wanted the surgery done so he could arrange for the payment later but it was turned down by the hospital. She would have died if I did not move her to a private clinic where I had an interest. The surgery was performed and the money was paid later, so she survived.
This is the typical scenario that occurs in the hospitals in Nigeria and all other countries in sub-Saharan Africa, especially in the rural areas and in the urban poor. Many of these countries, like Nigeria are able to afford this basic health needs with good governments. We all know that most governments in sub-Saharan Africa are corrupt and would prefer to carry out "white-elephant projects" instead of providing basic health and education to the population. This is the basic reason why physician migration is rampant.
Competing interests: None declared |
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