 Thanks for staying with us. According to World Health Organization, Nigeria has a density of 4 doctors per 10,000 people, which is far below the recommended density of 23 doctors per 10,000 people. The shortage of nurses is even more severe with a density of 2 nurses per 10,000 people, compared to the recommended density of 25 nurses per 10,000 people. Our healthcare staffing in Nigeria is a complex issue with several challenges and opportunities. On the one hand, the country has a large and growing population with a corresponding increase and a demand for healthcare services. This has led to a shortage of healthcare workers, particularly in rural areas. On the other hand, Nigeria has a young and growing workforce with many talented individuals who are interested in pursuing careers in healthcare. So tonight we're asking, how do we revolutionize the healthcare staffing in Nigeria? Please let's hear what you have to say. Remember, if you can join the conversation, then there's an SMS over at top to 08-1803-4663. I'll bring in our guests in a minute, but I just wanted to quickly hear your thoughts. I mean, we touched on it just a little bit, right? What do you think would make sense, you know? Like I said to you, Sandy, when you took your story, yes, it's good for you to increase the number of people that are going to be studying medicine or anything around the medical field. The biggest problem we have has never been about studying, it's about retainership, it's about renumeration and all of that. So what do you think? What can we add to that? How can we get the staffing right in our healthcare? I mean, training, retraining, because I mean, it's a different thing for them to have the first, I don't know, the first knowledge about it, but to keep retraining, you know, and then to have even the right infrastructure to be able to work in and operate in. Because again, if you're not at par with international standards, then it also makes no sense because the same service you're going to provide locally, people would rather go outside of the country to get that, you know, service. So number one infrastructure, let's have the right infrastructure. Number two, retraining. Number three, of course, there has to be incentives to even study courses like this. You also want to look at the academic session in Nigeria with NLC strike and ASU strike. So if I'm going into school to study medicine, medicine is, you know, before you do your fellowship, before you do this, your residency and all that. I mean, I'm looking at, okay, by the time I spend 10 years in the university, number one, I'm looking at my age, my earning power reduces. Meanwhile, there are people who are doing three, four year courses, who are out, who are in the labour markets, earning higher, you know, there's a whole lot of... So the government must intentionally actually lure people into that, you know, space with, I don't know, some form of... a lot of incentives really, you know, so we can bridge that gap. And of course, the right in terms of renumeration, it has to... that one is even a no-brainer, it has to be right. You want to agree with that? I definitely agree. It has to be increased reward for labour and, you know, updates the hospitals, the equipments and... because I was reading statistics on Nigerian medical, Nigerian hospitals and it was, I mean, one of them I'm going to read out as we continue during the show. So yeah, everything she said, I completely agree. So let me bring in our guests for tonight's Fei Yi, a DME, is a highly accomplished and multi-licensed pharmacist with over a decade of experience in retail pharmacy and healthcare businesses. He holds degrees from the University of Bath and Warwick Business School, where he earned his undergraduate masters and a postgraduate certificate in business and registration. Fei Yi is known for his ability to bridge gaps between people, clinical practices and businesses, focusing on problem solving and growth. He currently serves as the CEO of Springfield Pharmacy in Dublin, Ireland and is recognized as the only black pharmacy owner in the capital. His career has been marked by numerous awards and scholarships highlighting his academic and business excellence. And he's joined us live in studio. We're honored to have you with us. Good evening. Good evening and thank you for having me. Thank you very much. I mean, so this is an intro. Good evening to our viewers. Yes, good evening. Yeah, he's saying good evening to you guys. I mean, so I like the idea that people understand that, you know, in the midst of trying to save lives, right, healthcare is a business. In my opinion, if the government understood that healthcare is a business, right, by now a lot of things would have changed. India is a big medical tourist country. And most recently, Turkey. And most recently, Turkey because of our BBA. Because India has understood that healthcare is major and people at the brink of a lot of maybe health complications would pay anything just to get well. Right. So and they understood that what they've done in India is making sure that world-class equipments like best equipments in the world, you find it in most of the hospitals there. So what exactly is our problem? Is it possible to actually revolutionize our healthcare especially when it comes to staffing? Because I feel like it's not really so much of a staff. It's the fact that these staff don't have anything to work with. I don't know. You are the experts to help me out. Well, thank you for that. It is possible, and I think you've briefly sort of led the way into that conversation where there is a national strategy and a national consciousness, right, to say we want to do this and we will empower the country, the medical facilities, medical practices and healthcare professionals to achieve it. In fact, with the level of decay we're talking about, we will almost need a national, your country needs you type of strategy to arrest and grab the situation to add to some of the stats you mentioned earlier on. In the last five years, 75,000 nurses and midwives have left Nigeria. Now, if you think with the japa syndrome, everyone on this table and including the production staff will know at least one doctor or one pharmacist or one nurse who has left in the last two years or is preparing to leave or will be leaving soon. Now, it's like a floodgate currently and when you then look at places like Turkey and India as you've touched on, it's almost like the government has provided enabling environment and of course the government cannot do everything and where you see places that have sort of really good facilities in Nigeria, you're talking of the Reddinsons, the Evercares, the Duchess International, you'd find it's sort of heavy investment. So to start with, it'd be heavy investment. We're talking really, really deep investment and perhaps a bit of restructuring as you've mentioned. And the other part, which is a big part, is working conditions and pay. There's no way around it. Also, I've got a friend who will be relocating as a nurse to the UK in about three weeks. And she said, well, look, I love this country. It is the best place in the world if you've got the money. So why are you leaving? And she says, well, I earn 100,000 Naira a month now as a nurse of five years experience in Lagos. Now, she works around Yaba and lives around to earn 100,000 Naira. And I said, how much will make you stay in the country? And she said, at least 300,000 Naira to 500,000 Naira. But if you look at the government pay scales, it'll be chip nursing officers, it'll be chip midwives who'll be around that sort of pay scale. So whilst the government has to do what it needs to do, the capitalist, the free market, has to do what they need to do as well together in tandem. And of course, it is a great century to be in and to live in, i.e., one where we've got our iPhones, we've got our smartphones, we've got technology. And it will then lead on to some of what we aim to do to sort of contribute our quota towards the staffing, almost a solution, a mini solution to some of the things going on. You know, sorry, Sanzee, before I want to just quickly hop on something you said, then I'll come to you, Sanzee. So you see, when you mentioned some of the brands that you mentioned that have done really deep investments, right, the strategy in India was never to make healthcare expensive. It was to make healthcare accessible. In fact, people were afraid to walk into the hospitals because they were not sure they could afford it. So they actually had to do some level of advertisement to say, come, whether you can afford it or you cannot afford it, come to this hospital, we'll treat you. Do you understand? That, I feel, is the kind of structure that we need in Nigeria, because the brands you have called is an Amani leg. I mean, my friend had a baby, she had a son in one of the hospitals you mentioned, I think four days or a week or they noticed something that they needed to do on immediate surgery. They had to cover 400,000 because even our insurance could not cover it. So I'm just wondering, is it possible for us to be able to get this, still get great healthcare that is affordable, that's accessible to everybody, at the same time our healthcare staff are being paid appropriately? Is it possible? I think it is possible. And the way you look at it is, we've done it before as a country. So we think about our parents, 60s, 70s and 80s. They all had, I mean, the ones who were healthcare professionals amongst them, they had good living, they had great working conditions, they had a good lifestyle. And the hospitals were really good. And I know there's been this sort of circulating thing, I don't know how true it is, about some of the Middle East royalties coming to Nigeria for treatment at some point at the University College Hospital in Ibadu. So you're then thinking, if that's possible, if we've done it as a nation before, it means it's doable. We just have to say, look. Right. Now, what's healthcare spending in the national budgets, for example, you know, tiny, health education as a whole, tiny. So it's sort of reprioritized. And of course, the whole economic situation in the country has to grow, GDP has to grow. And when everybody else grows, when everything else goes up, then there's more to spend on healthcare. So it is possible. It's just that thing of one, improving the economy. And then when they improve, increase the spending on healthcare and on education. So if you've got people and you think, right, the UK, for example, the UK comes to Nigeria and other African countries or Caribbean countries and recruits tons of nurses, they don't have enough because the UK nurses themselves are emigrating for greater lifestyles to go to Australia or New Zealand or Canada. Yeah, because they pay them better there. Indeed. So a nurse working at the Unilag Hospital, for example, thinks, well, look, after four years training, I'm on 100,000 or 150,000 a month. A bit of retraining and I could earn 3,000 ounce sterling with overtime. And you multiply that, take taxes out. You're still looking at about 2 million take-home pay. On a monthly basis. On a monthly basis. Now, you don't necessarily need that much to survive in Nigeria because of course the UK is an advanced sort of world leading economy. But, you know, as my friend said, if I could earn 300,000 to 500,000, I'd gladly stay in Nigeria. So it can be done. And I think hopefully with the new administration, I know the country's got lots of issues. But gradually it's like turning a big ship around. You don't just turn it like a Ferrari. It's like slow and steady, slow and steady, an inch at a time and things like technology. And of course that's where the private sector comes in. The government won't develop an app to solve all problems, but where private people can make an impact. And most especially the diaspora community. And I think I've noticed the president talking a lot about people coming back into the country. And if you've got experience and you think you can help your country, you know, no matter how long you've been abroad or whatever. Now is the time to come back. Now is the time to come back. Or if you cannot come back, if you cannot come back because not everybody wants to do that, do your best to equip people back home from a distance remotely. Okay, we'll take a break then. I'll come to you, Sanzee. Stay with us. We'll be right back. All right. Thanks for staying with us. If you're just tuning in, we're discussing the topic revolutionizing healthcare staffing in Nigeria with Fiyi and DME. So please let's hear what you have to say. Remember, you can join the conversation. Send us an SMS or WhatsApp is right 1-803-4663. I see Sanzee is just my name. Yeah, so I saw. She said something, your blue is blue. But anyway, that's like Gen Z slang or something. So yeah, I saw it's a very troubling statistics, which is, I'll really tell. We only make up about 2.5 of the world's population. Yet 30% of the world's population of women dying from childbirth are from Nigeria. And as a woman, that is really troubling because you would imagine that childbirth is an age-long practice that, at least by now, as civilized or as developed as Nigeria is. And even to a certain extent, far more developed than other African countries, you would imagine that you would get a hold of it right now. But 30% of the world's maternal death rate, that's troubling. What do you think that is? It is. And I think it still goes back to some of the stats we've been talking about. So if you lose 75,000 nurses and midwives in five years to relocating abroad, you know, I mean, before the relocation, that number is not enough. Anyway, now you're then scooping out 75,000 over a five-year period, which means that the healthcare staff left behind are under pressure. Like places in the north might have one doctor to 45,000 people. And so there is, and then the other part, of course, is rural community care. And I imagine a big part of where that maternal mortality happens will be in rural areas. So a lot of work still needs to be done in outreach and education and getting involved in care at the community communal spaces. It's still common for people to never to be pregnant, go through pregnancy for the nine months and never have gone through structured healthcare. So it's all sort of local and these sort of grandmothers and the sort of traditional methods. So, you know, so there is a lot of work to do within rural communities. I was going to say to you that whilst you are, you are the one worried that 75,000 of your midwife and nurses left Nigeria, your minister, then minister of labor, you say they can go, that we have plenty of people. I'm just trying to tell you that. You had mentioned earlier about technology. So I want to touch on that and ask you that how can technology be properly integrated to ensure healthcare delivery and staffing. Okay, so with what we are sort of just launching into the Nigerian healthcare space, Prolo comes, what we do is effectively create a bit of a connectivity between healthcare providers and professionals. Now, at the moment, there are lots of platforms and apps out there where if you want to speak to a doctor, telemedicine, it's easy there about 15, 20 apps or platforms like that. But it's difficult to get a locum. So say, for example, your Baghdad hospital, you need a midwife from 4 to 8 tomorrow evening. Unless the human resource manager is in the right sort of WhatsApp group or right telegram group, they might not be able to get one. And that's after asking the other colleagues to see, can anyone do this extra time or overtime? So what we've done is create a platform where anybody who wants to do locum work can go on our app, Prolo comes powered by 8 a.m. Go on the app, look for work. And it just sort of focuses, works around where you live. And I think in terms of sort of contributing back towards the society, we've almost sort of built in with our technical partners a bit of reverse japa into the system. So what it means is that you'd find out a lot of healthcare workers, Nigerian healthcare workers who have relocated abroad, a lot of them still maintain their Nigerian registration surprisingly. Which means that in spite of going out of the country, they still want to be connected. They still want to remain plugged in. So say you've gone abroad and you've done 10 years residency as a surgeon or heart doctor, you can register on a platform and work in Nigeria, provided you still kept your registration. You could come on holiday, be in Nigeria for two weeks, and after seeing your family and friends, you feel, look, I want to do some pro bono work or I want to be connected to a place where I can give back. You can effectively register on that app and we provide that connectivity. As well as the people currently left in the country, it means you could be a doctor in Adoikiti. And I'll give you a bit of a quick paradox. In spite of the shortages, you wouldn't believe it. There are people who are undi-employed as healthcare workers in Nigeria. So it's common to find people in Adoikiti, for example, or people in Jalingo who might not get medical training programs. Or they might be low-bored in terms of salary offer. Or they might just not be a clinic willing to take them on. So it gives those sort of people who've got the knowledge and the skills, opportunity. We'll hit the nail that we haven't done. Because you see, healthcare is not, see, as I am like this, I'm not a journalist. I've been telling this people on TV, they will not listen to me. But you know what? I can talk on TV. I'm not a journalist, but I can talk. Healthcare is not like that. I can come now and I'm done. You're dealing with human life. You're dealing with human life. And the truth is, you cannot make a mistake. So the challenge I have with our healthcare structure, we've said this thing several times. You hear cases of, and let me tell you something, some of the death that we have in this country is needless, completely avoidable. It is just mere negligence. And the fact that we don't sue people. Yes. You know, I want to be able to sue people in your app. That's number one. Let me just drop by one day. But the truth is, right, it is the fact that we have a lot of quackery. Yes. Yes. It admits all of the people that are leaving. Sure. You know, there are so many people. I mean, I told you about the story of the doctor that we located from America. Of course, his license was seized. But nobody checked. Yeah. So how do we verify that these people are competent? Yeah. They must die. Depends on long go. Yes. If you go and inject me wrongly, I'm gone. Right? But yeah, I can't wake up from the dead. Look at what's happened to the young man that died. It's not they said they'll not give him an injection. I'm just saying to you that it's a very tricky thing. I get that. So how do we verify? Because tapping is our biggest problem in Nigeria. Yes, we know that there are infrastructural challenges. But you see, I have seen doctors that pay very serious attention to details. Sure. They see it live just because they pay that extra attention. We don't have those kind of doctors here. Well, so to the first part of your question, there's been a lot of work done in terms of verifying. So if you say on our platform... You know, you see how I call my arrestor. Yeah. I'm just trying to tell you to prepare your mind. Of course. Because we don't know the doctor. Sure. It's you we know. So to get registered as a doctor on our platform, for example. So you've got to put in all of your things that tie it up to you. So your permanent voters card or your international passport, your NIN, and they've got to match your CV. And that shows the last place where you are employed, your professional certificate, i.e. Niger Medical Cancel Licence, and your university certificate. So once those five things are verified, and they are or they've got to match up, then we then proceed to, because we've had conversations with the NMC and the Medical Associations and Pharmacists Cancel, we then proceed to verify to say, this is what we've got on this person. Are they who they say they are. So. So. You want to sleep for a second. Hopefully not. So, you know, and of course, if you're going to engage in, maybe there might be a 10% who've got this criminal behavior or 10% of the criminal bent. What then happens is that it means you would have gone through so much effort to give a fake profile, which will still get found out, regardless. So, I think a message that I could say would be, if you're going to put out a fake out there, just don't bother, because it would just get found out. And the other part as well is that ask now, then go through who you say you've worked with to literally look through the CV and verify. And once that's done, then you are verified and you are allowed on our platform. You can load your head shot in it to say, this is who you are, who ties up with your picture. So, it's very sort of methodical and consistent. Let me help you. I hope we can, we can reach them. Absolutely, you can. I want to even help you before. Let me tell you what I think you should do. Because you see, this is human life. If you are selling chewing gum and chicken, I will not bother you. It's human life. So, I think beyond that, it is not so much of the certification because we can fabricate for certification in this country and it will check out, right? I think we should do what they call them, those ghost shoppers. Oh, mystery shoppers. Do you understand? Where somebody will be sick. I'm just saying because we need to be sure that these doctors know what it is that they're doing. It's not certification as my problem. It's the fact that you know what you're doing. So, imagine if you have... I'm just adding this to you. Please look it into it. Because I don't want you to end up in creativity. And people are embracing now. It's not you. It's not the doctor who does it. The doctor who does it. The doctor who does it. The doctor who does it. The doctor who does it. The doctor who does it. The doctor who does it. To the user. Let's have issues of, say, mystery shoppers. Where people would just seek out some of these doctors already on your platform just to test that they know what it is that they're doing. A young girl in Jaws went for a big hospital. She went in for surgery and came out without one kidney. Do you understand? We've heard so many things. Nigeria is not a place where law is upheld. Right, anybody can do anything and get away with it as long as they know the right thing to do. I mean we sought a doctor, I think he's still inside Kiriki, I'm not sure. Doctor Femi, the gynecologist that was busy doing all sorts of things in the name of cervical cancer. Right, so I mean this person checks out. So I'm just saying that we have to find, because you're dealing with human life. We just have to find a way to bridge that integrity gap, because it is the integrity gap now that I am even worried about. Okay, so thank you for that. A big part of the work we've done is sort of thinking about both sides, i.e. the premises owners, the hospitals, the pharmacies, the diagnostic centres, the veterinary practices, the physiotherapy practices and the professionals that they need. So one feature which we've worked on as well is this ability to rate each other. And I think it forces everybody to up your game and as well as deliver improved patient outcomes. So if you know that you're an irresponsible employer, for example, and you know that low-comes will rate you as not having the right practices and invariably you won't be able to get low-comes to work for you, then you will indirectly have to up your game. Similarly, if you are a low-come who has perhaps a bit of skill shortage or gaps in their knowledge, eventually you get talked about. And once word gets around, which it will do on the app to say, no, please do not send us that low-come again. They were terrible. They were outrocious. Eventually, if you've got enough sort of objectivity and 360 viewing, you do what's necessary to uphold your profession. Mind you, you've gone into that profession. They have vocational professions because you care. And if you know you've got that gaps, then you do what's needed to self-improve. And the beauty of the platform as well is that things, other features can then be added as well as what we have currently. So I'm wondering, do you have plans to work with the federal government? Yes. Most of the work we've done at the initial stage will be to work with private organizations. And once we've gotten off of the critical mass, then it's easy to then sort of approach the government to say, let's help you out here. Yes. Let's help you connect your places. So how do we get investors in the healthcare sector? Because I think the biggest challenge that we have in Nigeria is the fact that, like you rightly said, it's heavy capital that is needed to take us to where we want to get to medically so that even the staff would be happy working because now they have everything. They don't have an excuse. They have the trainings. They have the equipment. They have the infrastructure. So how do we make healthcare attractive enough for investors to want to come into Nigeria? Okay. Well, it's a big question. And the reason it's a big question is that to do that you need other things to work well in Nigeria. So electricity, as rightfully said, because, you know, look, if you're a big private hospital and you're spending 200,000 Naira a day on diesel or a week on diesel, it's not sustainable in the long run because, of course, it's long term. It's not sustainable because, yes, it eats into your bottom line. And of course, businesses exist to make profit. All right. The other thing is that once there's a bit of more critical mass of these type of facilities I mentioned earlier on, you'll find that the medical tourists, and I'll give an example, this BBL, there are some of it being done in Nigeria now, surprisingly, compared to, say, three, four, five years ago where you'd have to go to America or Turkey or... America. Most of America. Most of America. So now, what are you not trying to say? I am not saying BBL is done in Nigeria. I don't even know what BBL means. BBL is Brasilia bought lift in case you're watching and you do not know. Thank you. But hey, thank you so much. I think we ran out of time. But I get the thing, and I would say to people that, you see, there are so many ways to work around these things. I mean, issues around diesel or whatever. Get a partnership, right? Yes. There are solar solutions that are powering everything, powering a full hospital. Indeed. Right? So we can have this kind of partnership. We can have it. So the plea of begging people is that while we're looking in the direction of, you know, other kinds of investment, healthcare is big business. Absolutely. If you understand how to do the business, it is huge. Is that a yes? It might be capital intensive, but if you get it right, trust me, you'll be smiling to the bank, you know, on a daily basis. But thank you so much. Thank you. I hope you had fun with us. I did. Thank you. Thank you very much. I hope. I will make sure that you will. I've got seven angels, you know, singing and paying for this. Thank you. I think we had a fantastic conversation. Thank you so much. Thank you. Thank you. Now before we go and show you follow us across all social media handles, listen to our podcast on Spotify. I wish you Africa. You can interact with us further. Drop a comment. Put it online. Give us some social media like and share and invite your families and friends to watch and follow the conversation. Sandy, why are you laughing? If you missed our course for today, I will do it. If you missed our course for today, here it is again. It says, we must invest in training and retraining healthcare workers and make Nigeria a more attractive destination for healthcare professionals from around the world, right? We'll see you guys tomorrow at 8 p.m. We'll bring another great conversation to your screen. Ciao.