I met Dr. Tunde in 2005, fresh out of medical school. Bright, humble, and driven, he had dreams of becoming a neurosurgeon and building a hospital in his home town in Kogi State, Nigeria.
Fifteen years later, I received a message from him. It was a photo—him in blue scrubs, standing in front of a hospital in Manchester, UK.
He captioned it:
“I waited. I hoped. But I couldn’t wait forever.”
His story is not unusual. It is the story of thousands of doctors, nurses, midwives, and pharmacists who leave Nigeria and other African countries to live and work in Europe, North America, the Middle East, and Australia. Many never return—not because they stopped loving home, but because home stopped loving them.
“We had to deliver babies by torchlight.”
Martha, a midwife from eastern Nigeria, recalls the night her generator failed during a complicated delivery.
“The electricity went off around midnight. We had no inverter. We used our phone torches to deliver the baby. The mother lost a lot of blood. We had no transfusion bags. I cried when I got home. I knew she could have died because of a system that doesn’t care.”
A few years later, Martha moved to Ontario, Canada. Today, she works in a hospital where every bed has a backup power source. She says she still cries—but now out of relief.
“I was earning ₦320,000 a month. That’s less than what I earn in a week now.”
Dr. Kunle, a general practitioner formerly posted to a semi-rural area in Oyo State, described his breaking point.
“They owed us three months’ salary. There was no electricity, no water, no equipment. One day, a pregnant woman came in seizing. We had no magnesium sulfate. I begged the local chemist for some, but they didn’t have. She died. I knew I couldn’t take it anymore.”
He now practices in Saudi Arabia and sends money home every month to support a school health program in his village.
The Pull and the Push
Contrary to what some believe, doctors and nurses don’t leave only because of higher salaries abroad. They leave because they feel pushed out by broken systems.
They leave because:
- Their hospitals are underfunded, sometimes without gloves, antibiotics, or even running water.
- Their salaries are delayed, or so low that it cannot feed a family.
- Promotion and training are politicized, not merit-based.
- Insecurity has become unbearable—kidnappings, violence, and attacks on hospitals.
- They are expected to perform miracles without tools, and when they fail, they are blamed.
And when they look abroad, they see systems—imperfect, but organized. They see respect for their work, regular pay, functional hospitals, and opportunities to grow.
“They treat you like a professional there. Here, you’re invisible.”
Dr. Amaka trained in Nigeria but relocated to Ireland after three years of working in a tertiary hospital.
“In Nigeria, I was yelled at by consultants, harassed by patients’ relatives, and once slapped by a grieving father. I didn’t blame him—he lost a child—but I had done all I could. There was no oxygen. No ICU. I begged the lab to release test results faster, but their machines were down.”
Now in Dublin, she works in a hospital where her input is valued. She’s enrolled in a family medicine training program.
“It’s not just about the money. It’s about dignity. I finally feel like I’m a doctor.”
Why Most Don’t Come Back
Many leave promising to return. Some even apply for temporary licenses with that hope. But they rarely come back. Why?
- They lose faith that things will improve.
- They fear being trapped again in a broken system.
- Their children start school, their spouses find work, and they start building lives.
- There’s no clear reintegration program—no support, no housing, no professional incentives.
“I wanted to return,” says Dr. Bayo, now in Canada. “But I realized I’d just be starting over—this time with more frustration. So I stayed.”
What We’re Losing
This brain drain is not just a statistic. It’s a slow bleeding of life from the very arteries of our health system.
- We lose teachers—those who should be mentoring the next generation.
- We lose surgeons, pediatricians, anesthetists, nurses, at a time of rising disease burden.
- We lose hope, as patients begin to believe quality care only exists abroad.
And worst of all, we lose trust in ourselves—in our systems, in our leadership, and in the dream of rebuilding.
What Can Be Done?
Doctors are not asking for mansions or medals. They are asking for:
- Basic tools to do their job
- Regular, fair pay
- Safety and security at work
- Opportunities for career advancement
- Respect and recognition
We can’t stop every doctor from going abroad—but we can stop them from feeling they have to escape to survive.
Final Thoughts: Not a Betrayal, But a Cry for Help
When a doctor leaves, it’s easy to call them unpatriotic. But the truth is: they left because they cared too much and hurt too deeply. They left because they couldn’t keep watching patients die needlessly. They left because their hands were tied, and their hearts were broken.
The real betrayal is not theirs.
It is ours.
Have you left, or are thinking of leaving, the health sector in Africa? Have you stayed despite everything? Share your story in the comments or write to us—we want your voice to be heard.
— Dr. Michael Okosa
Physician, Rural Health Advocate