Nigeria’s Healthcare Industry: Fuji House of Commotion

If you stop any random passenger in an airport and ask, ‘What are you doing here?’ His reply will most likely be, ‘I am going to so and so state’. If you ask, ‘Who will take you there?’, His reply will most likely be ‘The pilot of course’.

The passenger does not know or rather conveniently forget that for the pilot to take him to his destination, the staff of the airline, aero engineers, technicians, cabin crew, and even the airport staff have to work in synergy for that one pilot (or two) to fly him to his destination.

At any given time, if you stop a random patient in any hospital and ask, ‘what brings you here?’, the answer will always be “To see the doctor”. Similarly, he forgets the nurses who take his vital signs, the radiographer who takes his Xrays, the phlebotomists who takes his blood samples and the pharmacist who sorts out his drugs. Most of us forget that for that one doctor to make a diagnosis and manage the patient well, the other health workers play their parts.

Not long ago, Resident Doctors downed their tools in protest. The nation braced for impact, as it always does when the engine room of clinical care goes on strike.  Barely had the dust settled when JOHESU (Joint Health Workers’ Union) embarked on its own indefinite strike. The residents have since returned to work but JOHESU remains adamant. And once again, the Nigerian health sector finds itself caught in an endless cycle of industrial disharmony.

I don taya.

I have been a doctor long enough to understand the frustrations that fuel these tensions. But I have also worked closely with nurses, pharmacists, laboratory scientists, and community health workers long enough to appreciate the richness they bring to the table. Healthcare is not a solo performance. It is an orchestra, each instrument distinct, each essential. Yet our system continues to pit these instruments against one another in a needless scramble for power, recognition, and remuneration.

As the world shifts, the healthcare workforce is shifting with it. In the United States today, nurse practitioners run clinics. Nurse anaesthetists manage patients independently and, in many states, earn more than physicians. Allied health professionals are more ambitious than ever: better trained, more specialised, and more determined to claim their space in a health ecosystem that is expanding beyond traditional hierarchies. This is not an accident; it is evolution.

So, the question is not whether Nigeria should adapt. It is how and whether we can do so without tearing ourselves apart.

Nigeria’s healthcare sector is underfunded, overstretched, and hemorrhaging talent at an unprecedented rate. There are too few doctors, too few nurses, too few pharmacists and far too many patients. Instead of facing this crisis collectively, we retreat into professional silos and fight for whatever crumbs fall from the government’s table.

Salary structures become weapons. Cadres become battlegrounds. Roles and responsibilities become territories to be defended with the rigidity of medieval kingdoms.

Underneath all the rhetoric is one painful truth: we are fighting each other because the system has failed to fight for us.

Globally, the health workforce has shifted from a rigid pyramid to a more flexible, collaborative model. In the US and UK, nurse practitioners, physician assistants, clinical pharmacists, and advanced practice professionals are part of the frontline workforce, expanding access to care in rural, underserved, and highly specialised settings.

These transformations did not diminish the role of doctors, instead they strengthened the system. Doctors evolved into supervisors, consultants, and leaders of multidisciplinary teams. They moved toward complex decision-making, high-end procedures, and specialised care.why should a doctor be doing basic antenatal care when a midwife can do so excellently well?  Allied health workers have taken on expanded roles based on regulated training pathways, national competency exams, and clearly defined scopes of practice.

What made this possible was not ambition alone, it was structure.

Nigeria, by contrast, is trying to adopt the ambition without building the structure.

The truth is our health system is dependent on hierarchy rather than teamwork. Roles are defined emotionally, not operationally. Titles matter more than competencies. We are dragging consultant title. Years of mutual suspicion have poisoned the waters of collaboration.

Another issue is our regulatory bodies. Instead of them to work in harmony, they often clash instead of complementing one another. Without clear frameworks, every profession fights to expand its role without corresponding training requirements or oversight systems.

Likewise, we have weak postgraduate pathways for allied health professionals. Where other countries have structured, competency-based programs for advanced practice, we have fragmentation and inconsistent standards.

And then, to add salt to injury, we have a government that likes to sit on the fence and play Russian roulette with us all: You NMA come here, I dash you this. You,  JOHESU, Oya go there, here is your share. Where are those hot-headed doctors? Why are you raising your voices? Ehen NARD, come here, we have promised to look into your matter. Is it not just 19 items? We agree to ten, the other nine will come later. Abi?Ah-Ahn now, are we not friends? Think of the patients! Your reward is in heaven.

Yauwa! Where are my friends, NANNM? Come and take your share- what do you want? To be called a consultant? Okay, we will give you the title. But wait first- is it for every nurse or just BSc Nursing? What about the almighty “matron” and “in charge”? Oh! you don’t like that one again? I am sorry, we will change it immediately!

Physitherapists, Optometrists and Pharmacists- what is your problem again? Shey I have given you ‘Dr’ title, what else do you want? Oh! You want ‘consultant’ too? Take I dash you!

We are jokers in this country!

Equity does not mean equality. It means fairness. A nurse practitioner who undergoes advanced training should have a pathway to earn more. A resident doctor who trains for 4 to 6 years should also have a remuneration structure that reflects this.

Shey you know that a house divided cannot heal its patients?

Imagine, your child is on admission in a government hospital at this moment. The doctors are working, the nurses are working, but there is no one to take blood samples. The doctor has to take samples himself and hand it over to the parent to take it to a lab OUTSIDE the hospital. When drugs are prescribed, the parent again has to go OUTSIDE the hospital to purchase them.

Haba Jama’a!

Many of the battles in our hospitals are not about money. They are about respect.

Every doctor knows the indispensable value of a skilled nurse. Every nurse knows the critical role of a competent doctor. Every lab scientist, pharmacist, physiotherapist, and CHW contributes to the patient’s outcome.

Harmony begins with humility.

The Nigerian healthcare system is bleeding. Patients are caught in the crossfire of professional wars they never enlisted in. As we mark yet another season of strikes, we must confront a truth we have avoided for too long:

Our enemy is not each other. Our enemy is the system that keeps us all under-resourced, undervalued, and overworked.

Doctors cannot fix the system alone. Nurses cannot fix it alone. Allied health professionals cannot fix it alone. But together, in an environment where roles are clear, respect is mutual, and the government invests in real reform, we can build a system that works, one that meets the ambitions of its professionals and the needs of its people.

Our patients deserve nothing less.

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