By Dr Najeeb Maigatari
Your Excellency, I hope this letter finds you in good health. As I do not have the means through which my message could reach you, I am compelled to write this open letter to draw your attention to a menace threatening our healthcare system. That is the well-known Japa syndrome that has recently plagued our dear State.
I want to extend my heartfelt condolences to you and the good people of Jigawa State over the tragedy that befell the people of Majia a few weeks ago. This unforeseen event led to the loss of lives of over a hundred people and left several others with varying degrees of injuries. My heart goes out to the bereaving families of all those affected, and I pray that Allah repose the souls of the deceased and heal the injured. Amen.
Returning to the purpose of writing this letter, Your Excellency, I would like to provide some details about how our dear state used to be. It was undoubtedly one of the states with the best healthcare systems and the highest number of practising medical doctors in Northern Nigeria. At one point, it was akin to a medical hub attracting patients and medical professionals from neighbouring states due to its subsidised healthcare, efficient service delivery, and overall welfare of health workers and patients.
Since its creation in the early 1990s, the State has made giant strides in providing its citizens with effective and reliable healthcare services. To mention a few, various successive administrations have invested heavily in training Medical doctors and other health professionals, within and outside the country, in varying capacities to ensure effective healthcare delivery to the good people of the state.
Similarly, Jigawa State has awarded scholarships with bond agreements to local and foreign medical students since time immemorial. It has produced medical graduates from various reputable institutions within and outside the country. In addition, it was one of the pioneer states among its peers to implement the sponsorship of medical doctors through postgraduate medical training programs to further their studies, a policy several other states would later adopt.
Your Excellency, I can say with immense pride that our healthcare system performance score was impressive overall. It used to be one of the best in the country. The services rendered were affordable and accessible to the masses, and the welfare of patients and healthcare professionals was optimum. For instance, at some point, healthcare workers in Jigawa State were earning more than their federal counterparts.
Unfortunately, things have now taken a turn for the worse. Our healthcare system is not only ‘underperforming’ below standard by all measures but also one of the worst in the country. We are now a shadow of our past. Jigawa State has a patient-doctor ratio of 1:35,000, far exceeding the WHO recommendation of 1:600, making it one of the states with the worst healthcare systems in Nigeria. This is indeed a troubling situation.
Over the past few years, Jigawa State has witnessed an unprecedented mass exodus of medical doctors to other neighbouring states owing to poor welfare, overburdening workload, and inadequate health facilities in hospitals, among other factors. Regrettably, this internal Japa syndrome ravaging the state continues to overstretch our already fragile healthcare system.
To put things into perspective, according to data obtained from the Nigerian Medical Association (NMA) Jigawa State branch from 2013 to 2024, of the 264 doctors who reported back to the state for bonding agreements, only 40 stayed after completing their terms. This is to say that more than 220 medical doctors have left to continue their careers elsewhere because Jigawa is fast becoming a nightmare and a difficult place for medical doctors.
It is worth noting that the state produced over 500 medical doctors (both foreign and locally trained) during the same period. Still, only 214 are on the state payroll, of which only 77 are currently manning the state’s primary and secondary institutions. They are about to round up their bond agreements by the end of the year; 89 are in training as either house officers or doing national service. The state has less than ten consultants and only 12 doctors in residency training. Altogether, fewer than 100 doctors attend to a population of over 7.5 million.
This data suggests that while the state is doing a good job at producing medical doctors (both local and foreign), its retention capacity is very poor. The State will be left with no Medical doctors in the coming years if things continue at this pace. It has to either employ doctors from neighbouring states or overwork the few that stay to death if at all there would be! Your Excellency, this is only the tip of the iceberg as far as this crisis is concerned. This menace has no end.
As a citizen concerned about the interests of Jigawa State, I implore you to declare a state of emergency on health in Jigawa State and engage with relevant stakeholders to find a way to end this worsening Japa syndrome, which is wreaking havoc in our dear state.
The most crucial step to addressing this issue is the urgent need for the improvement of the overall welfare of the few Medical doctors and other healthcare professionals left in the state who are already struggling with chronic fatigue due to overwhelming patient workload. This singular act will not only boost the morale of these weary Medical professionals but relieve them of their burden. Still, it will also attract others from various States to compensate for the acute shortage of Medical doctors in the state. It will also improve the effectiveness of healthcare services delivered to the people. In other words, we can go back to our glory days.
Various States have already employed this strategy. Your Excellency, Jigawa State can not afford to lose the doctors it invests heavily in. This could amount to a work in futility!
In addition, the government should seriously consider domesticating the Medical Residency Training Fund (MRTF), which will help train experts in various medical specialities in the state. This would help address the shortage of registrars and consultants in our tertiary facilities and provide an avenue for a healthy and excellent research environment in the State.
Other measures include equipping our already existing hospitals with state-of-the-art facilities and subsidising healthcare services, especially to women, young children and those suffering from such chronic debilitating conditions as sickle cell disease and chronic liver and kidney diseases. Your excellency, I believe these are some ways that could help end this menace threatening our very existence, help revitalise the State’s healthcare and improve its delivery to the citizens of Jigawa State.
Najeeb Maigatari is a Medical doctor. He writes from Dutse, Jigawa State, via maigatari313@gmail.com.