In all of Derin’s 21 years on earth, she had never heard the word “sepsis”, nor had she imagined that she would wake up in a private hospital’s Intensive Care Unit (ICU), confused and weakened by an infection that sounded less dangerous than it was. But it’s typical of life to defeat our imaginations and throw us into a reality we’d rather escape.
“I was so clueless when the doctor said I had sepsis. All I remember is that I ate roadside moin-moin. But somehow, I found myself in the ICU,” Derin recounts. She would eventually make it out of the ICU and be admitted to the hospital, where she spent the most painful days of her life.
Derin recalls walking out of the ICU on her feet, but by the next day, she was confined to a wheelchair. Her organs had become terribly inflamed, her throat was clogged, and she could barely breathe. She could no longer eat or drink water, because her body rejected everything. Yet, when she called for help, she was told she would have to wait until the only available attending doctor in the hospital visited her floor — a dangerous wait that lasted two days. By then, she had become dehydrated and utterly dependent on caregivers for basic activities like bathing.
The Nigerian Doctors Association says Nigeria now has only 24,000 licensed physicians to attend to the medical needs of over 200 million citizens. That means there’s just one doctor for every 10,000 patients. What they won’t tell you is that the survival of 10,000 people could tragically depend on one bad doctor. Like Derin, thousands of vulnerable Nigerians have been at the mercy of undertrained and overworked doctors. Some of them weren’t lucky enough to walk out of those hospitals alive.
“When the attending doctor eventually came, he placed me on a medication that made it impossible for me to eat for eight hours. I protested because, at that point, I hadn’t eaten or drunk water for two days due to diarrhoea. He gave me the drug anyway and ordered a blood sample,” Derin said.
“They drew my blood, knowing fully well that I was dehydrated, and two days later, they told me the intern doctor who took my sample had lost it,” she continued, remembering the pains she felt.
That was the beginning of another round of dehumanising torture Derin endured at the hospital. They would eventually misplace two more blood samples taken from her weak body, which had started to lack visible veins.
“At that point, I was already tired. I felt sicker than when I came in. But the day I knew I was going to die if I didn’t leave that hospital was when they misplaced my stool sample. I felt like a lab project for doctors in training. My mom had to pay one of the nurses to take me out in my wheelchair and pretend I was going for another round of tests. That’s how I ran away and was transferred to another private hospital.”
The next hospital was the one that saved Derin’s life. She had taken pictures of the drugs she was given at the previous hospital, and now, she’s thankful that she did.
“The second hospital had an attending doctor on call, but the doctors in training told me I was lucky because she doesn’t come around often, because it’s hard to get a hold of doctors like that these days. She asked if she could take one last blood and stool sample and promised to make sure I got better in two days. She ran some tests and found out that the reason I felt worse was that I was allergic to one of the medications from the other hospital. She replaced that medication, and I recovered in two days as she promised.”
To understand what this mass decline in doctor availability really means for Nigerians, I set out to speak with someone who has a firsthand understanding of it. After weeks of reaching out and consistent follow-ups, I finally got Dr Babatunde Iyanu to speak with me. From the moment we started talking, he kept apologising for his delayed responses — a testament to just how tight his schedule has become. And he’s not alone. It’s the same story for the other 24,000 doctors still trying to hold the healthcare system together.
Dr Iyanu says the dangers of the declining doctor-to-patient ratio are endless for patients and doctors. “Patients wouldn’t get optimal treatment as the workload on doctors would prevent them from or affect their output. Due to excessive workload, doctors become tired and even unmotivated in managing the patients they are responsible for.”
When I asked him to describe the life of a Nigerian doctor, he said it depends on the day you catch him — some days are great, others are blatantly pathetic because fatigue is a constant part of daily life for doctors who don’t work in top-notch private hospitals.
About 19,000 doctors have left the country for better pay in the last twenty years. In 2024 alone, nearly 4,000 doctors left the country for good. Dr Iyanu says these medical practitioners are leaving for the most basic things they can’t get here in Nigeria—houses, cars, and other basic amenities.
“The salary of an average doctor can’t cover his basic needs. He’d need to save for years just to be comfortable, which was not so in the past. In the past, after medical school, in some hospitals, they were given cars even during their internship, and they received good money, as opposed to now,” he said.
Unfortunately, 70% of Nigerians who rely completely on public healthcare services are at the losing end of this mass relocation.
“The attention and care you’d give to 20 patients daily isn’t the same as what you’d give to 100. With more patients and fewer doctors, there’s a higher chance of missing important symptoms or complaints, simply because the doctor is rushing to attend to everyone,” he explains.
The state of primary healthcare centres (PHC) in Nigeria also makes it difficult for doctors to do their jobs effectively. Only 20% of the 30,000 PHC facilities in the country are functioning at full capacity, while the other 80% remain significantly incapable of delivering quality care to patients.
Dr Iyanu also acknowledges that more people will likely die from causes that could have been prevented, and the doctors who are being forced to take on heavier workloads may eventually become patients themselves.
Unfortunately, Dr Iyanu’s fear is slowly becoming the reality of many doctors in Nigeria. In September 2023, house officers at Lagos University Teaching Hospital (LUTH) publicly raised awareness about inhumane working conditions after the death of Dr Umoh Michael, who reportedly died after working a nonstop 72-hour shift.
It is equally concerning that Nigerian nurses seem to have similar complaints about the healthcare system. On July 30, 2025, over 25,000 nurses, under the National Association of Nigeria Nurses and Midwives (NANNM), Federal Health Institutions Sector, commenced a seven-day nationwide warning strike primarily over welfare concerns.
The Nigerian Medical Association (NMA) has also issued a 21-day ultimatum to the Federal Government to address its demands or risk a total and indefinite nationwide strike by medical doctors. If these nationwide strikes happen simultaneously, Nigeria’s healthcare system could shut down temporarily, leaving millions of people at risk.
When I asked Dr Iyanu what it would take for Nigerian doctors to stay in the country, he listed several key changes: a significant salary increase, improved and expanded health facilities, better access to healthcare, increased investment in the health sector, scholarships and grants for medical training, and more flexible scheduling for medical school programs.
As basic and necessary as these changes sound, they’ve remained a constant demand from doctors. But with President Bola Ahmed Tinubu’s proposed 2025 budget allocating just 5.18% (₦2.48 trillion) to health, far below the 15% benchmark set by the Abuja Declaration, it’s hard to see how any of these demands will be fully met.
According to the Gombe chapter of the NMA, the ripple effect of these unmet demands will be brutal, as more doctors will keep packing their bags and moving to countries that prioritise healthcare workers.
Like Derin, more Nigerians will become victims of the country’s declining doctor-to-patient ratio.
Names have been changed to protect the identity of victims.
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