Health Worker Migration, Repressive Measures & Rank-And-File Nurses Fightback

Nurse A.O. Thomas addressing the Naija Nurses Forum demonstration on 12 February

Rank-and-file nurses in Nigeria rose to challenge new regulations issued in a 7 February circular by the Nursing and Midwifery Council of Nigeria (NMCN) in the second week of February. This has brought national attention to two important issues: health worker migration and the government’s repressive measures to stop it, rather than addressing the underlying problem. 

The new guidelines the NIMCN wanted to enforce from 1 March would require that registered nurses who want their certificates verified by nursing boards and councils in other countries for employment abroad have at least two years of post-qualification working experience in Nigeria. They would also submit a letter of good standing from the chief executive officer of the health facility where they are working and the last nursing training institutions they attended to the NIMCN.

Rank-and-file nurses began mobilising to resist immediately after the circular was released. This was through the Naija Nurses Forum (NNF), an online platform of over 40,000 nurses constituted to facilitate unity and exchange of views between nurses across the country. The first in a series of demonstrations which they organised took place in front of the NIMCN offices in Lagos and Abuja on 12 February. The following week, demonstrations took place in several other states including Bayelsa, Ondo and Oyo states.

Speaking on behalf of the NNF at the demonstration in Lagos, Nurse A.O. Thomas, a member of the SWL and Take-It-Back movement demanded an immediate reversal of the guidelines. Speaking on behalf of the NNF at the demonstration in Lagos, Nurse A.O. Thomas, a member of the SWL and Take-It-Back movement, questioned the argument of the NIMCN that its verification guidelines were implemented due to the shortage of nurses in the country. She highlighted that there are thousands of unemployed nurses in Nigeria and emphasised that even the employed ones receive low wages. 

And here lies the crux of the matter. Health worker migration does pose a challenge to fragile health systems like that of Nigeria. The country has far less than the number of healthcare workers required to ensure universal healthcare. And the situation is getting worse. The World Health Organisation has projected a global shortage of 18 million health workers by 2030. Over 80% of these will be in low- and middle-income countries like Nigeria, from where the inadequate health and care workforce is further depleted with outward migration. 

But can anyone in their right mind blame health workers who choose to japa? Is the solution to the problem one of repressive measures by the government? The straightforward answer to both questions is NO!

Health workers in Nigeria are underpaid and overworked. They lack basic working equipment and materials. The level of workplace safety is nothing to write home about. While politicians in executive and legislative offices go home with millions of naira every month, health workers are left with pittances as salaries. The federal and state governments have failed to provide adequate funding for the health sector. 

Instead of putting impediments in the way of migration for nurses and other healthcare professionals, the Nigerian state should ensure the root causes of japa for health workers and indeed the mass of Nigerians fleeing the country in a bid to have better lives. The government should address unemployment, poor salaries and working conditions, poverty, disillusionment, generalised insecurity and social frustration. Without doing this, no amount of regulations will stop japa. People will find other ways if the legal routes are blocked. 

However, the government will not simply address these issues. Government officials are only interested in feathering their nests. Nurses, and other working-class people delivering health care and indeed across all sectors will need to fight to win these concessions. The rank-and-file nurses of the Naija Nurses Forum have shown us the way. Their protest led to a resolution of the House of Representatives suspending implementation of the guidelines.

This is yet another confirmation of the fact that if we dare to struggle, we dare to win. We can organise ourselves as rank-and-file workers and carry forward the struggle for our liberation. We must not let anything hold us back from fighting for our rights. No gree for anybody: rise and fight to win! 

by Muda OGIDAN



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