AT a time when Nigeria is grappling with a critical shortage of medical professionals due to the Japa syndrome, three Nigerian consultant doctors were dismissed from National Hospital Abuja without clear explanation. 

Inside the radiology unit of the National Hospital Abuja (NHA), Jonah Wachap gathered his personal belongings in early January after receiving a dismissal letter that offered no reasons for his termination.

Two other consultant doctors, Akinnagbe Akinbola, an obstetrician and gynaecologist, and Nweke Clinton, a urologist, were also affected.

The trio, along with twelve other medical specialists, had been employed as locum consultants  (temporary consultants) in March 2022 by the former Chief Medical Director (CMD) of the hospital, Jaf Momoh, whose tenure ended later that year. 

Six months later,  another set of twenty post locum consultants were employed with subsequent addition which brought the number of local consultants to 42 by 2023.

 “Our appointments were expected to be regularised following a probationary period, in line with National Hospital Conditions of Service,” Akinbola said.

The ICIR reports that it was the same year that the Nigerian Medical Association reported a staggering shortfall of 315,426 doctors, indicating that Nigeria would need over 360,000 physicians to adequately meet the healthcare needs of its population.

Dismissal without explanation

Following Momoh’s departure, the hospital had two acting CMDs, Aisha Umar and Abba Badamasi, before Muhammad Raji Mahmud who is currenlty the CMD was appointed.

Out of the forty-two consultants, only ten had their appointments regularised at the discretion of the management, while two resigned voluntarily, leaving 30 others, including Wachap, in limbo with only short-term appointments as locum consultants.

However, in January, during their most recent application for renewal, Jonah, Clinton, and Akinbola, in isolation from the 30 others, were issued a notice granting a three-month extension, after which their contracts was terminated for reasons known only to the management.

“We became shattered as we have stayed back in the country to provide services when most of our colleagues have left for greener pastures because of the JAPA syndrome, instead of our three years service regularised we were rather disengaged,” Akinbola added.

Dearth of doctors in Nigeria

Their experience highlights a broader crisis in Nigeria’s healthcare system, where only about 55,000 licenced doctors are available to serve a population of over 200 million. According to a recent report  by Premuim Times, a ratio of roughly 1 doctor attends to every 4,000 patients. This falls short of the World Health Organization’s recommended ratio of at least 2.5 medical staff including physicians, nurses and midwives per 1,000 population needed to deliver basic primary care and make progress toward universal health coverage.

Annual migration estimates reveal that Nigeria loses between 1,800 and 2,000 doctors each year according to Nigeria’s Coordinating Minister of Health and Social Welfare,  Muhammad Pate.

In late 2022, over 10,296 Nigerian‑trained physicians were recruited by the United Kingdom.

According to the report, doctors cited poor pay and harsh working conditions, including a lack of medical equipment, dilapidated hospital infrastructure, and overwhelming workloads that lead to burnout and frustration, as key reasons for leaving the country.

NMA FCT reaction 

Despite two appeals and consistent departmental recommendations, the hospital management stood by its decision. The affected doctors then turned to the National Medical Association for intervention.

The association noted that “following receipt of the letter an appeal to the management was written and also a call for intervention was sent to the Medical and Dental Consultants’ Association of Nigeria (MDCAN) NHA chapter and NMA FCT branch. However, it was agreed that the MDCAN NHA should handle the issue” according to a document obtained by The ICIR.

It noted that the MDCAN tried but failed to secure an amicable resolution. The NMA Federal Capital Territory branch waded into the matter but was equally unsuccessful prompting a call for intervention by the NOC NMA.

According to a document obtained by The ICIR, the NMA FCT held an emergency congress meeting on March 27, after receiving a formal complaint from the consultants.

In a letter dated April 2, obtained by The ICIR, the association appealed to Mahmud, the CMD, citing the doctors’ IPPIS salary status and urging reconsideration based on “equity, justice, and fairness.”

“The association is really concerned that no reason has been so far advanced as to why the services of these concerned members who draw their salaries from IPPIS are no longer needed in the hospital other than the fact that it is a “top management” decision.

“Sir, we wish to passionately appeal that you reconsider your stand and let the concerned consultants go back to work while we continue the process of engagement and advocacy to resolve any possible challenges posed based on the principle of equity, justice and fairness” the letter read.

The association noted that the Executive Committee was expected to update the Congress and the National body on April 7, 2025, on his response and progress made.

A second letter, submitted on April 4, referenced discussions led by  Badamasi, who represented Mahmud, on April 3, acknowledged that the decision had been reviewed twice without change but still gave no clear rationale for the selective dismissals.

“Abba Badamasi said the exiting of the affected forum consultants was a top management committee’s decision. He added that even though the initial decision has been further reviewed twice, it still didn’t change. 

“However, there was no reason whatsoever for the selective disengagement of the three (3) affected consultant doctors out of many others,” the letter reads.

In its final communication, the NMA warned that the perceived victimisation of certain members could jeopardise industrial harmony at the hospital. 

“We are hoping for a positive outcome on or before April 7, 2025, when we shall give the NOC an update and consider an emergency congress meeting to look at the issue as directed at our last OGM which was held on 27/03/2025,” it added.

However, the association said it didn’t get a positive response and outcome despite its efforts. 

A disrupted service delivery 

After the hospital dismissed Wachap and his colleagues, the hospital grapples with staffing gaps.

A source at the hospital told The ICIR that the shortage of consultants is worsening patient care. “The absence of specialists in key departments is putting pressure on the remaining staff,” the source said.

A patient who corroborated the growing strain said, “I gave birth on a Friday. After they cleaned my baby, no one checked on me or the child until Sunday when I insisted on being discharged.”

Another hospital staff, who spoke to The ICIR on condition of anonymity, said his shift was rescheduled to cover the entire week, with two additional departments placed under his supervision because of the shortage of staff.

Akinbola, the obstetrician and gynaecologist who was dismmised said the Senate and the Minister of Health summoned the CMD and the affected doctors to a meeting in June, during which the CMD was directed to reinstate them.

“The association gave a strike ultimatum which the senate invited us, CMD and the ministry of health to an investigative panel. 

“In the panel it was concluded it is a case of victimisation, and he was asked to recall us which he is yet to do after three weeks,” he said.

We planned to sack 32 consultants – National Hospital 

The hospital’s Public Relations Officer, Maijamaa Adamu, told The ICIR that the management had initially planned to dismiss all 32 remaining consultants, but he could not explain why only three were eventually affected.

“I don’t know the mindset of the management. I don’t know why the three, but I believe they had issues,” Adamu said, confirming that the remaining consultants are currently awaiting authorisation. “So, that six-month arrangement for them was not renewed.”

In response to the shortage of medical personnel, he said that the hospital is currently in the process of recruiting 400 doctors and nurses.

“As we speak at the moment, from last week to this week, employment letters are being distributed for the recent recruitment exercise that the federal government had given waiver to the hospital to employ over four hundred doctors and nurses. 

“We are expecting a very big relief, in terms of the stressful nature of the work arising from the number of staff that we have” he said.