(C) OpenDemocracy This story was originally published by OpenDemocracy and is unaltered. . . . . . . . . . . Nigerian nurses sue over effort to stem ‘brain drain’ [1] [] Date: 2024-04 Nigerian nurses are suing the Nursing and Midwifery Council of Nigeria (NMCN) after it took action to stop them leaving the country in search of higher wages and better working conditions. Until 1 March, a nurse or midwife wanting to leave Nigeria to practise abroad would simply ask the council to authenticate their qualifications – a process that took around a month. But now, amid fears of a ‘brain drain’ of health professionals leaving West African country, nurses are required to work in Nigeria for two years before they can apply for the qualification verification that allows them to work abroad. The application processing time has also been extended to six months and the cost of applying has increased to N300,000 (£150.17) from N68,000 (£44.04). Get our free Daily Email Get one whole story, direct to your inbox every weekday. Sign up now The Nursing Group Admin (NGA), a group of 153 Nigerian nurses around the world, has launched legal action against the NMCN over the new guidelines. Abiola Olaniyan, who left Nigeria in 2021 to practice in the UK, told openDemocracy the rules are “a total infringement of nurses” rights to migration and free movement”. Low salaries, high workloads and the deplorable state of most healthcare facilities are forcing Nigerian medical professionals to seek career opportunities in foreign countries. More than 42,000 nurses left Nigeria to work abroad in the last three years, according to Faruk Abubakar, the NMCN’s registrar, who is also named as a defendant on the NGA’s legal action. Many of the nurses migrated to the UK, where a sharp increase in the number of nurses leaving the National Health Service (NHS) has contributed to a record shortfall of nurses. “Inadequate pay, insufficient staffing to ensure patient safety, harassment and discrimination in the workplace, a lack of career progression, and unsafe working conditions” are among their reasons for leaving the NHS, according to a 2023 Royal College of Nursing report. While 42% of nurses in the UK earn between £27,055 and £32,934 a year – less than the average full-time salary of £34,963 – this is still far more than most nurses’ wages in Nigeria, where 48% earn between N25,000 and N50,000 (£14.67 and £29.34) a month, according to a poll by Nursing World Nigeria. openDemocracy previously reported that 50,000 of the nurses who registered to practise in the UK between 2017 and 2022 were trained in countries with too few of their own nurses to provide the standard of healthcare recommended by the United Nations – including thousands from Nigeria. Nurse Bassey Imoh began applying for a master’s course in nursing in the UK in January but has been forced to pause this process due to the revised guidelines. He told openDemocracy that the NMCN is not trying to improve working conditions for nurses in Nigeria. “They are just looking for ways to keep us in the country. It’s disheartening,” said Imoh. “If you really want your nurses to stay, improve [the healthcare sector].” Nigerian nurses already undertake seven years of training: five years at university, a one-year internship, and one-year mandatory national service. The new guidelines add two more years on top of this – and have sparked protests and peaceful demonstrations across the country. Most recently, on 16 April, nurses in Rivers State marched on the state’s Ministry of Health and then to the governor’s residence. Those protesting say the council is restricting their freedom of movement and that the longer verification process will affect their ability to seek international opportunities. Jude Chiedu, who founded Nursing World Nigeria, a consultancy focused on nursing education, training, and recruitment, has accused the council of “overstepping” in its duties. Chiedu said the NMCN’s role is to regulate the standards of nursing and midwifery education and practice in Nigeria, but “is not to determine the experience or whether they [nurses] will represent Nigeria well abroad. It should be the concern of the recruiting council.” Growing concern Some Nigerian nurses and midwives believe the NMCN’s revised guidelines may worsen actually their working conditions. The verification process introduces a new requirement for nurses to obtain letters of good standing from the CEOs, who are mainly senior doctors, of the last training institution they attended. Many fear this leaves them vulnerable to abuse, especially female nurses who made up 87% of the country’s nursing body as of 2018, according to data cited by the World Health Organisation. “Our work is interconnected but there’s a boundary,” nurse Florence Nwaobi told openDemocracy, referring to the fact that nurses don’t directly report to doctors. The doctors will submit the letters of good standing directly to the NMCN, without nurses seeing what they wrote about them – which Nwaobi worries may lead to instances of doctors “downgrading the image of nurses”. Philip Eteng, a nurse at Alex Ekwueme Teaching Hospital, also believes the requirement to obtain a letter from a doctor “is a breach of” the Industrial Arbitration Panel Award of 1981, which aimed to address trade disputes between the Federal Ministry of Health and the National Association of Nigerian Nurses and Midwives. The award states that nursing is an autonomous profession, “subject to no directions or control whatsoever by any profession” – meaning it functions without external control or approval. The NGA launched its lawsuit after sending the NMCN a pre-action notice on February 23, which gave the council three days to nullify its guidelines. The council did not take action. The coordinating minister of health and social welfare, the federal Ministry of Health, and the attorney general of the federation (who is also the minister of justice) are also named as co-defendants on the lawsuit. The National Industrial Court in Abuja has adjourned the case’s preliminary hearing to 20 May. Adelewa Williams, the managing partner of Adelewa Williams & Partner, the law firm representing the nurses in court, described the new guidelines as “restrictive” and “arbitrary”. He added that they are incompatible with “the International Labour Organization (ILO) convention [concerning migrant workers and their rights at work], which Nigeria is a signatory, and repugnant to [Nigeria’s] 1999 constitution”. Olaniyan agreed, saying: “We want this circular to be reversed completely [and] not amended.” The NMCN registrar did not respond to comments from the openDemocracy. 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