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People with O blood group more prone to cholera –Expert

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Dr Samson Shonowo, a general practitioner, tells ALEXANDER OKERE about the complications and treatments of cholera, a common but deadly infection

What is cholera?

Cholera is an infectious disease which is transmitted through contaminated water and food; it is usually of sudden onset and characterised by passage of loose watery stools, fluids, electrolytes and subsequent dehydration. Despite being easy to treat, it is a disease that can lead to death, especially in children, if not quickly and properly attended to at a medical facility. It is an epidemic.

What are the causes?

Cholera is caused by a bacterium known as vibrio cholerae. It was discovered in 1883. It is common in Asia, Africa and some parts of Latin America. The bacteria thrive in damp, dirty linen, moist earth and in the stools of patients with the disease. Vibrio cholera bacteria live in shallow salty water. They can also exist as colonies that coat the surfaces of the water, plants, shells, stones and similar items and they can also live among the eggs of flies which can also serve as a good reservoir for cholera bacteria. Once inside the human intestine, the toxic strains of the cholera bacteria produce poison that immediately leads to violent passage of loose or watery stools in humans. Once the bacteria enter where humans live, they can quickly lead to a severe epidemic.

What are the risk factors for cholera?

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Everyone is susceptible to cholera except infants who got their immunity from their nursing mothers who have previously had cholera. However, certain risk factors can make you more likely to contract the disease or more likely to have severe signs and symptoms. Some of those risk factors are poor sanitary conditions, reduced or non-existent stomach acid, household exposure, Type O blood group, and contaminated food.

Cholera is more likely to thrive in areas where a sanitary environment, including a safe water supply, is difficult to maintain. Such conditions are common in refugee camps, places with public wells, overcrowded areas, and impoverished countries – areas ravaged by war, famine, natural disasters and drought.

Cholera bacteria can’t survive in an acidic environment and ordinary stomach acid often acts as a defense against the infection. So, people with low stomach acid, such as children, older adults or the elderly, people who take antacids, H2 receptor blockers(cimetidine, ranitidine), proton pump inhibitors (omeprazole, rabeprazole) lack this protection, so they are at greater risk of having cholera.

You are at increased risk of coming down with cholera if you live with someone who already has the disease. For reasons that are unclear, people with type O blood group are twice as likely to have cholera as other blood groups. Eating raw or undercooked seafood, especially shellfish, from certain places can expose you to cholera bacteria.

Also consuming raw, unpeeled fruits and vegetables are a frequent source of cholera infection in areas where there is cholera. In developing countries, uncomposted manure fertilisers, irrigation water containing sewage can contaminate produce in the field. In regions where cholera is widespread, grains like rice and millet that are contaminated after cooking and kept at room temperature for several hours can grow cholera bacteria.

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There have been reports of infection and deaths caused by cholera across the country, including the reported deaths of 24 persons in Bayelsa State. How prevalent is this infectious disease in Nigeria?

Between 2010 and 2019, the most severe cholera infections occurred in 2014 and 2018, with an annual infection rate of 58 and 22 cases per 100,000 inhabitants, respectively. The reported cases and deaths have increased a great deal since then.

The consumption of sachet water is common among Nigerians with concerns about hygiene. Can this type of packaged water put one at risk of being infected?

Yes, it can. We all know how people and businesses try to make more profit by cutting cost. This leads to a drop in the standard of safety and hygiene. Ideally, water should be properly treated, the workers should be screened for diseases, hygiene should be strictly enforced in water companies and bodies and agencies that are supposed to monitor these sachet water-producing companies should do their jobs thoroughly.

A lot of people eat fruits already peeled or sliced by roadside sellers. Should this be a concern?

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Yes, it should. It is obvious that roadside sellers have little or no hygiene. And it is also difficult to ascertain if they have cholera or live with someone who has cholera since they don’t go through the food handlers screening that major restaurant operators go through. Fruits bought from the roadside should be washed with clean water before they are consumed.

Can you explain the basis of diarrhea in cholera disease?

When the cholera bacteria get into the intestine, they release a poison or toxin that causes the cells that line the inside of the intestines to release or secrete more fluids than they are supposed to. This then leads to severe diarrhoea that can cause death in an otherwise healthy adult, if not treated properly and quickly. This type of diarrhoea is known as secretory diarrhoea.

How long does it take someone who has been infected with cholera to start having diarrhoea?

The time between when the cholera bacteria get to the human body and when symptoms, including diarrhoea, develop is from two hours to five days. This period is also known as the incubation period. About one in 10 people who get infected with cholera bacteria will develop severe symptoms.

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Apart from diarrhea, are there other symptoms?

The signs and symptoms of cholera-related diseases are watery or loose stools (diarrhoea) which contain patches or flecks of whitish materials. These whitish materials consist of mucus and the cells lining the inside of the intestines. The size of these patches is about that of rice grains, hence the name ‘rice water stools’ and the stool also smells fishy. Although many bacterial infections can cause diarrhoea, the volume of that caused by cholera can be enormous. About 10 to 18 litres of fluid can be passed in the stool of an adult in 24 hours. People go on to develop other symptoms and signs like rapid heart rate, which is as a result of volume depletion through diarrhoea and vomiting.

There is a loss of skin elasticity, which is usually obvious especially on the hands. It gives an appearance similar to that of the hands of a washer man, hence the term ‘washer man’s hands.’ Other symptoms are low blood pressure, dry mouth and mucous membranes, thirst, muscle cramps, restlessness and irritability, especially in children, unusual sleepiness or tiredness. Other signs that may occur, especially with more severe disease, include abdominal pain or cramps, fever, rectal pain, dehydration, severe vomiting, low urine output, weight loss, seizures, shock and death.

Is dehydration during severe diarrhoea and vomiting a serious problem for those infected with cholera?

Yes, it is. Those infected immediately require rehydration to prevent these symptoms from continuing because severe vomiting and diarrhoea indicate that the person is becoming or is already dehydrated and may go on to develop severe cholera. People with severe cholera can develop severe dehydration which can lead to sudden onset of kidney failure, severe electrolyte imbalance and coma.

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People who are prone to severe cholera include five per cent to 10 per cent of healthy people who got infected, a population that has been compromised by poor nutrition and a population with a lot of children or elderly.

How long does it take for dehydration to result in the death of an infected person if left untreated?

If untreated, severe dehydration can rapidly lead to shock and death. Severe dehydration can often occur four to eight hours after the first liquid stool, ending with death in about 18 hours to a few days in poorly treated or untreated people. In epidemic outbreaks in developing countries where little or no treatment is available, death or mortality rate can be as high as 50 to 60 per cent.

What are the other complications of cholera?

Cholera can quickly become fatal. In the most severe cases, rapid loss of large amounts of fluids and electrolytes can lead to death within hours. In less extreme conditions, people who don’t receive treatment can die of shock and severe dehydration hours to days after first symptoms of cholera appear. Although shock and dehydration are the worst complications of cholera, other problems such as low blood sugar (hypoglycemia), low potassium levels (hypokalemia) can occur, kidney failure

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Dangerously low level of blood sugar or glucose, which is the main energy source of the body, can occur when people become too ill to eat. Children are at the greatest risk of this complication which can lead to seizures, unconsciousness and even death. People with cholera lose large amounts of minerals, including potassium, in their stool. Low levels of potassium interfere with heart and nerve functions and are life-threatening. When the kidneys lose their ability to filter, excess amounts of fluids, electrolytes and waste accumulate in the body, which is also a life-threatening condition. In people with cholera, kidney failure often accompanies shock.

When then should an infected person seek help?

The risk of cholera is slight in developed nations. Even in areas where it exists, you are not likely to become infected if you follow food safety regulations. Still, cases of cholera occur throughout the world. If you develop a case of severe diarrhoea after visiting an area with active cholera, see your doctor. If you have diarrhoea, especially severe diarrhoea, and you think you might have been exposed to cholera, seek medical treatment right away. Severe dehydration is a medical emergency that requires treatment right away.

What will a doctor look out for in an infected person?

Not all cases of cholera infection exhibit symptoms. Although signs and symptoms of severe cholera are unmistakable in places where it is common, the diagnosis can only be confirmed by testing for the bacteria in stool. Rapid cholera district tests enable doctors in remote areas to confirm the diagnosis.

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What are the common ways of treating cholera?

Cholera is easy and straightforward to treat. The treatment, however, depends on the level of dehydration, whether it is no dehydration, some dehydration or severe dehydration. Medical agencies worldwide use the same or similar protocols – rehydration with either oral rehydration solutions or intravenous solutions (drips). Antibiotics are reserved for those people with much more severe cholera infection. Examples of antibiotics include tetracycline and ciprofloxacin. Antibiotic sensitivity should be done because different strains of the bacteria respond to different antibiotics.

In what ways can cholera be prevented?

Cholera can be prevented using several methods. Developed countries have an almost zero incidence of cholera because they have widespread water treatment plants, food preparation facilities that usually practise sanitary protocols and most people have access to clean toilets and hand-washing facilities. Although these countries have occasional lapses and gaps in these protocols, they have prevented many disease outbreaks, including cholera.

Individuals can prevent or reduce their risk of getting cholera by thorough hand washing, avoiding areas and people with cholera, drinking clean water or similar safe fluids, and eating clean, well-cooked food. In addition, there are vaccines that help prevent cholera that are 50 to 90 per cent effective. The vaccines are oral because the injectable have been shown not to be effective. The oral vaccine only works for two years. Oral cholera vaccine is available in Nigeria.

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Health

Enugu, health partners commit to sustain gains of 5-year IntegratE family planning project

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The Enugu State Government and key health sector partners have pledged a commitment to sustain the gains of the IntegratE Project.

The IntegratE Project is a five-year family planning initiative that expanded access to reproductive health services through Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) within the state.

The Commissioner for Health, Prof. George Ugwu, gave the commitment on Wednesday during the dissemination of the Enugu State Private Sector Family Planning performance under the IntegratE Project, which ran from Oct. 2021 to July 2026.

Ugwu said that the project had significantly improved reproductive health services and positive outcomes for women in the state over the past five years.

He described family planning as a sensitive but essential service, assuring that the government would continue expanding access while ensuring responsible use.

Ugwu said that Gov. Peter Mbah’s administration remained committed to strengthening primary healthcare outcomes in all ramifications

He revealed that more than 100 new primary healthcare centres would become operational before the end of the year.

The commissioner said that the state government’s commitment to innovation would continue to position the state as a leader in modern healthcare delivery.

Speaking, the representative of the Pharmacy Council of Nigeria (PCN), Mrs Ifeyinwa Ohiaeri, described the project as a major intervention that strengthened family planning services through pharmacy practice.

Ohiaeri stressed that “family planning remains critical” to reproductive, maternal and adolescent health.

She said that the dissemination provided an opportunity to review achievements, challenges and strategies for sustaining the project’s impact, while reaffirming its commitment to professional ethics and quality service delivery.

The representative of the Enugu State Primary Health Care Development Agency, Mrs Maureen Nwankwo, said the agency would sustain the gains achieved.

Nwankwo noted that the programme had helped reduce unintended pregnancies, maternal and child deaths through improved access to family planning services.

Group Director of Donor-Funded Programmes at the Society for Family Health, Mr Emeka Okafor, said the national project tested the pharmacy-led delivery model for family planning in Enugu State.

Okafor noted that while about 70 per cent of residents patronise private health providers, much of the state’s routine health data comes only from the public sector, leaving a significant gap.

He said that according to the project’s implementation report, 29,262 women accessed family planning services through trained PPMVs in Enugu State, while 14,541 referrals were made to public health facilities.

He said that the project also exceeded training targets, introduced digital supportive supervision and contributed to the institutionalisation of the Tiered Accreditation System for PPMVs.

The Pharmaceutical Society of Nigeria (PSN) and the National Association of Patent and Proprietary Medicine Dealers (NAPPMED) also pledged continued support for the initiative/project at the grassroots.

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20,966 Nigerian Health Workers Migrated Abroad in One Year – Report

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No fewer than 20,966 Nigerian health workers relocated abroad within one year, according to official figures contained in the State of Health of the Nation Report 2025, obtained by Saturday PUNCH.

The mass exodus comprised 3,919 doctors, 7,487 nurses and midwives, 6,861 medical laboratory professionals, 702 pharmacists, 658 physiotherapists and hundreds of other healthcare specialists.

The growing migration came under the spotlight following the relocation of a Senior Consultant Neurosurgeon at the University of Ilorin Teaching Hospital, Dr Salamat Aliu-Ibrahim, to the United States.

Aliu-Ibrahim, a renowned neurosurgeon, now serves as Medical Director, Paediatrics, at Freeman Children’s Clinic, a facility under Freeman Health System in Joplin, Missouri.

Data obtained from the United Kingdom’s General Medical Council showed that 4,691 Nigerian-trained doctors joined the UK medical register between May 2023 and April 2026.

According to the GMC register, 15,896 Nigerian-trained doctors are currently licensed to practise in the UK, comprising 9,664 males and 6,232 females.

However, President Bola Tinubu, on Friday, appealed to Nigerian medical professionals in the diaspora to encourage more Nigerians abroad to return home and contribute to the country’s development, stressing that there is no place like home.

20,966 Nigerian Health Workers Migrated

An analysis of the State of Health of the Nation Report 2025 showed that only 60,551 of Nigeria’s 95,456 registered doctors currently hold active practising licences, representing 63 per cent. Only 51 per cent of licensed doctors are actively employed within Nigeria’s health system.

The nursing and midwifery workforce, Nigeria’s largest health profession, has also suffered substantial losses, recording the highest level of migration among health professionals.

Although Nigeria has 267,951 registered nurses and midwives, comprising 73,130 nurses, 21,031 midwives and 173,790 nurses with post-basic qualifications, only 113,123 currently hold active practising licences, representing an effective licensing ratio of 42 per cent.

Of those with active licences, 78 per cent remain employed in the country.

The report further showed that 658 physiotherapists have migrated, leaving only 852 of the country’s 8,642 registered physiotherapists with active practising licences.

Similarly, 21 occupational therapists have migrated, while only 11 of the 176 registered professionals currently hold active licences.

There are 257 registered occupational therapist assistants, but only 51 currently possess practising licences.

The report also showed that 431 optometrists have migrated abroad. Of the 6,975 registered optometrists, only 2,156 hold active practising licences, while 66 per cent remain employed locally.

Among opticians, only 307 of the 2,976 registered professionals currently hold practising licences, while 18 have migrated abroad.

UK, US, Canada, Saudi Arabia Top Destinations

The United Kingdom remains a leading destination for Nigerian health workers, particularly doctors and nurses, due to easier professional registration, better remuneration, structured specialist training and persistent workforce shortages within the National Health Service.

Although international recruitment has slowed since 2025, Nigeria remains one of the major source countries for overseas-trained nurses practising in the UK.

A breakdown of data obtained from the UK GMC register showed that 7,875 Nigerian-trained doctors were licensed to practise in the UK in 2020, rising to 9,976 in 2022.

In 2023, the number rose further to 12,198, making Nigeria the third-largest source of foreign-trained doctors in the UK, behind India, with 38,228 doctors, and Pakistan, with 27,739.

Figures from the UK Nursing and Midwifery Council also showed a sharp rise in the number of internationally educated nurses and midwives on its register, driven largely by recruitment from countries including Nigeria, India, Ghana and the Philippines.

According to the council, the number of Nigerian nurses and midwives in the UK has risen above 16,000.

Beyond the UK, the United States and Canada have also become increasingly attractive destinations for Nigerian healthcare professionals.

As of 2020, a total of 3,895 Nigerian-trained doctors were licensed to practise medicine in the US.

Australia has also intensified recruitment of overseas-trained doctors and nurses to address shortages in regional and rural health services, while Saudi Arabia and the United Arab Emirates continue to attract Nigerian healthcare professionals with tax-free salaries, subsidised accommodation and other employment benefits.

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Four Unlicensed Private Hospitals Sealed by Govt in Enugu 

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The Enugu State Government, through the Ministry of Health, has sealed four private health facilities in Enugu North Local Government Area for operating without valid licences and failing to meet regulatory requirements.
The ministry’s Public Relations Officer, Mrs. Chidiogo Ugodu, disclosed this in a statement issued on Thursday in Enugu, noting that the enforcement action was carried out on July 8.
According to the statement, the ministry has intensified the monitoring and supervision of private health facilities across the state to ensure quality healthcare delivery and strict compliance with regulatory standards.
The renewed enforcement exercise was initiated by the Commissioner for Health, Prof. George Ugwu.
As part of the exercise, the Director of Medical Services, Dr. Chinyere Ezeudu, led a team of senior ministry officials on an unscheduled inspection of private health facilities in Enugu North LGA.
The ministry explained that the exercise was aimed at ensuring that all private hospitals and healthcare providers operating in the state comply with statutory requirements, including the renewal of operating licences and the registration of facilities yet to be captured by regulatory authorities.
During the inspection, the team visited seven private health facilities, assessing their operational status, licensing documentation, and compliance with established healthcare standards. Four of the facilities were subsequently sealed for regulatory violations.
Speaking on the exercise, Commissioner for Health, Prof. George Ugwu, reaffirmed the commitment of the state government, under the leadership of Governor Peter Mbah, to protecting residents by ensuring the delivery of safe, effective, and quality healthcare services.
He stressed that the monitoring and enforcement exercise would continue across the state to ensure that only duly registered and licensed healthcare facilities operate.
Ugwu also urged operators of private health facilities to regularise their operations by renewing expired licences and registering facilities that are yet to be approved.
“The ongoing monitoring exercise is not only a regulatory measure but also a critical step towards strengthening the health system and safeguarding the lives of citizens,” he said.
The latest enforcement follows a similar operation carried out a few weeks ago, during which the Ministry of Health sealed three illegal health facilities in Enugu South Local Government Area for operating without valid licences.

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Jim Nwobodo Commissions Newly Re-equipped Special Babies Ward at Parklane 

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Elder statesman and former Governor of old Anambra State, Senator Jim Nwobodo, has commissioned the newly renovated and re-equipped Neonatal and Special Babies Ward at the Enugu State University of Science and Technology Teaching Hospital (ESUTH), Parklane, Enugu.

The commissioning formed part of the activities marking the 2026 Children’s Day celebration which was attended by top government officials, healthcare professionals and stakeholders in the health sector.

Governor of Enugu State, Dr. Peter Mbah, who was represented at the event by the Secretary to the State Government, Prof. Chidiebere Onyia, commended the intervention and described it as a major boost to healthcare delivery and neonatal care in the state.

He also praised the former governor for coming out to honour the unveiling of the project despite his busy schedules, saying his love for the people of the state would continue to resonate with the administration.

The project, which was facilitated through the Cecilia Oyebola Foundation founded by the Governor’s Special Adviser on Health, Dr. Yomi Jaye, was equipped with modern incubators, infusion and syringe pumps, phototherapy equipment, autoclave machines, baby monitoring devices and upgraded nursing facilities aimed at improving neonatal care and reducing infant mortality.

Speaking on behalf of Governor Mbah during the ceremony, Prof. Onyia lauded Dr. Jaye for his dedication and personal sacrifice towards advancing healthcare delivery in Enugu State.

According to him, the intervention reflected the culture of service and collective responsibility encouraged by the Mbah administration, where public officials contribute beyond their official responsibilities towards the development of the state.

He described Dr. Jaye, who also marked his 51st birthday, as a committed and exemplary public servant whose dedication continued to strengthen confidence in the administration’s healthcare transformation agenda.

Prof. Onyia further stated that the Mbah administration had transformed ESUT Teaching Hospital from the condition it met in 2023 into a modern and rapidly improving medical institution capable of competing with leading healthcare facilities across the country.

He reiterated the commitment of Governor Mbah’s administration to building a world-class healthcare system through sustained investments in infrastructure, equipment and manpower development.

Performing the commissioning and ribbon-cutting ceremony alongside his wife, Dr. Patricia Nwobodo, Senator Nwobodo expressed admiration over the quality of facilities installed at the neonatal ward.

He praised the governor for what he described as unprecedented transformation in the health sector and insisted that the governor deserved overwhelming support for re-election in 2027.

According to the former governor, the facilities and standards at the ward compared favourably with what is obtainable in advanced countries, stressing that the development further demonstrated that the current administration was delivering tangible results across critical sectors.

In his remarks, Dr. Yomi Jaye explained that the project was inspired by his lifelong commitment to children’s welfare and dedicated to the memory of his late mother, who was a teacher.

He disclosed that the renovated ward was designed in line with modern infection prevention protocols critical to newborn survival, recalling the painful loss of his almost twin brother due to infection-related complications.

Dr. Jaye noted that the intervention aligned with Governor Mbah’s vision of transforming healthcare delivery through preventive and patient-centred care, adding that ongoing investments in hospitals, primary healthcare and medical training had continued to reposition Enugu as a leading healthcare destination.

Earlier, the Chief Medical Director of ESUTH Parklane, Prof. Bethrand Ngwu, expressed gratitude to Governor Mbah and Dr. Jaye for their interventions and support towards improving healthcare services in the hospital.

He stated that the administration’s investments had significantly improved healthcare delivery and staff morale, assuring that the newly installed facilities would be properly maintained and maximally utilised for the benefit of newborns and other vulnerable patients requiring specialised care.

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Japa: Nigeria needs 300,000 doctors but has only 40,000

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Nigeria’s already fragile healthcare system is facing a critical manpower deficit, as the number of licensed doctors has dropped to about 40,000, far below the estimated 300,000 needed to adequately serve a population of over 220 million, PUNCH HealthWise can authoritatively report.

In 2024, the Minister of Health and Social Welfare, Prof. Muhammad Pate, revealed that Nigeria had about 55,000 licensed doctors.

Speaking during an interview on Channels TV’s Politics Today, Pate disclosed that no fewer than 16,000 doctors had left the country in the past five years, while about 17,000 others had been transferred out of active service.

Worrisomely, a new revelation by the Lagos State Commissioner for Health, Prof. Akin Abayomi, indicates that the number of practising doctors in Nigeria has declined from 55,000 to 40,000 within just one year.

In his presentation at a one-day leadership dialogue in Lagos themed “Strengthening PHC Systems: A Joint Leadership Dialogue,” Abayomi identified manpower shortage as one of the most critical challenges facing the health sector.

The dialogue, organised by the Lagos State Primary Health Care Board with support from development partners, addressed barriers hindering PHCs from meeting expectations and proposed practical solutions for building sustainable PHCs with lasting impact.

Abayomi stated that Lagos currently has only 7,000 doctors serving an estimated 30 million residents, far below the number needed for optimal care delivery.

The commissioner raised concerns over the acute shortage of health workers in the state, disclosing that the state requires an additional 33,000 doctors to meet the healthcare demands of its growing population.

“Nigeria currently has about 40,000 doctors against an estimated need of 300,000, while Lagos alone requires about 33,000 doctors but has only about 7,000,” he said.

According to him, Lagos’ doctor-to-population ratio remains far below what is required for optimal healthcare delivery, noting that the state’s doctors are serving an estimated population of nearly 30 million people.

To address the shortfall, Abayomi said the state government is investing in its newly established University of Medicine and Health.

“Within five years, UMH will produce about 2,500 healthcare workers annually, including laboratory scientists and other essential cadres,” he stated.

The mass exodus of healthcare professionals popularly known as japa syndrome, especially doctors, nurses, and pharmacists has remained a major concern in Nigeria.

A 2017 survey conducted by a Nigerian polling organisation in partnership with Nigeria Health Watch revealed that about 88 per cent of Nigerian doctors were seeking job opportunities abroad at the time.

Healthcare leaders have attributed the worsening brain drain to poor funding, dilapidated infrastructure, harsh working conditions, insecurity, and weak policy implementation.
According to the General Medical Council of the United Kingdom, the number of Nigerian-trained doctors practising in the UK has climbed to 11,001.

The President of the Nigerian Medical Association, Prof. Bala Audu, recently warned that Nigeria has moved beyond passive brain drain and has become a direct recruitment hub for foreign governments seeking skilled medical professionals.

In an interview, Audu revealed that international recruiters now visit Nigeria to directly hire doctors—particularly specialists such as obstetricians, gynaecologists, and paediatricians—offering them superior working conditions, remuneration, and infrastructure.

He lamented that while Nigeria’s population continues to grow and mortality rates remain high, the country is losing specialists at an alarming rate.

“Many of our doctors are not even going abroad to look for jobs. Foreign governments now come into Nigeria to pick doctors and take them away,” Audu said.

“We are still having more births, yet maternal deaths remain high because the skilled birth attendants who should care for these women are reducing every day.”

Audu added that in some specialties, the number of Nigerian doctors practising abroad may already exceed those still working within the country, a situation worsened by the government’s failure to significantly improve doctors’ welfare despite existing policy frameworks.

Experts have warned that with the current pace of emigration, it would be impossible for Nigeria to produce enough health workers to meet its growing healthcare demands. They estimate that it would take at least 20 years to train the over 400,000 health workers required to close the gap.

A former President of the NMA, Prof. Mike Ogirima, described Nigeria’s doctor-to-patient ratio as “horrible,” noting that the country currently has about one doctor to 8,000 patients—far below the World Health Organisation’s recommendation of one doctor to 600 patients.

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