Hundreds of Nigerian nurses are stranded following the Nursing and Midwifery Council of Nigeria, NMCN, continuous closure of its portal for verification of nurses' certificates.
It was gathered that while many nurses are currently stranded in different countries abroad, others are on the verge of being deported.
Nursing boards in the US, Canada, New Zealand, Australia, and the UK are said to have stopped accepting nursing certificates from Nigerian nurses because they can't verify their authenticity.
The National Assembly had twice urged the NMCN to open its site and commence verification of Nurses and Midwives based on its former guidelines pending the conclusion of an investigation by the House Committee on Health Institutions.
However, the council has yet to heed the resolution of the House.
The latest directive is a letter dated 13th August 2024, titled "Negative Portrayal of the House's Resolution" and signed by the Clerk of the National Assembly, Mr. Sani Magaji Tambuwal, to the Nursing and Midwifery Council of Nigeria.
The letter came after Hon. Patrick Umoh had raised a motion of urgent national importance on the need to safeguard institutional integrity and address any misinterpretation of the previous House's Resolution by the Nursing and Midwifery Council of Nigeria.
The House also had previously urged the NMCN through a resolution on Tuesday, 26th, February 2024, not to implement the revised Guidelines for Verification dated February 7, 2023, pending investigation by the House.
This came after some stakeholders in the health sector had raised their concerns over the new circular by the NMCN, revising the guidelines for requesting verification of certificates for nurses and midwives to foreign nursing boards or councils.
Many also called for a review of the circular's contents to avoid a situation where nurses' progress and development are subject to other professionals' determination.
How it all started
In February 2024, the NMCN expressed worry that over 42,000 nurses left the country in the last three years to seek greener pastures in foreign countries.
According to the council, over 15,000 nurses left Nigeria in 2023 alone.
It is reported that the development is coming on the heels of poor healthcare infrastructure, inadequate funding, poor welfare, and working conditions in the health sector.
Seemingly worried by the imminent threat of brain drain in the nation's health sector, the Council introduced revised guidelines for verifying nursing certificates to address the crisis.
It is also reported that the NMCN, in the memo dated February 7, 2024, outlined the revised guidelines and requirements to be met by all applicants seeking the verification of certificate(s) to foreign nursing boards/councils.
It stated that applicants seeking verification of certificates to foreign nursing boards and councils must have two years of qualification experience and pay a non-refundable application fee.
The memo signed by the Registrar/Secretary General of NMCN, Dr. Faruk Umar Abubakar, was sent to the Commissioners/Secretary of Health Services; Chief Medical Directors/ Medical Directors; National President; Directors of Nursing Services; Heads of Department; Provosts & Principals; Coordinators; Zonal Officers; All States Ministry of Health & Federal Capital Territory, Abuja; University Teaching Hospitals/Specialist & Federal Medical Centre and National Association of Nigerian Nurses and Midwives, National Headquarters, Abuja.
The circular was also sent to the Ministries of Health, Hospitals Management Boards, All States & Federal Capital Territory; All Universities Offering Nursing Programmes; Colleges of Nursing Sciences, Schools of Nursing & Midwifery, All Post-Basic Nursing Programmes; All Nursing and Midwifery Council of Nigeria Zonal Offices.
It provided that, "Eligible applicants must have a minimum of two (2) years post qualification experience from the date of issuance of the permanent practising licence. Any application with a provisional licence shall be rejected outrightly.
"The Council shall request a letter of Good Standing from the Chief Executive Officer of the applicant's place(s) of work and the last nursing training institution attended, and responses on these shall be addressed directly to the Registrar/CEO, Nursing and Midwifery Council of Nigeria. Please note that the Council shall not accept such letter(s) through the applicant.
"Applicants must have an active practising licence with a minimum of six months to the expiration date. Applicants must upload Certificate(s) of Registration only. Notification of Registration is not acceptable.
"The applicant shall receive prompt notice via his/her email and dashboard on the status of the verification application.
"Please note: Processing of verification application takes a minimum of six (6) months. All applicants shall ensure that complete requirements are met before initiating verification application as incomplete documentation shall not be processed."
Nurses kick against policy
However, nurses and other health workers kicked against the policy, insisting the guidelines and requirements were typical of a denial of human rights.
The health workers stressed that there had never been any occasion where regulatory bodies asked for work experience or mandated years of service as a condition for verification.
They are particularly uncomfortable with the provision in the guidelines which stated that a nurse seeking NMCN certification must have a minimum of two years post-qualification experience.
They are also opposed to the requirement that a nurse applying for NMCN's certification must obtain a letter of good standing from the Chief Executive Officer of their place of work and the last training institution attended while the processing of application shall take a minimum of six months.
As a protest against the policy, the nurses, under the aegis of the National Association of Nigeria Nurses and Midwives, NANNM, Abuja, and Lagos chapters, took to the streets to express their disapproval of the new circular.
The nurses converged on the NMCN's offices in Abuja and Lagos to express their dissatisfaction.
They also threatened a nationwide strike, describing the new guidelines as an effort to hamper their freedom.
Meanwhile, some others took to social networks to protest against the policy.
A group of nurses also took legal action against the Nursing and Midwifery Council of Nigeria and the Minister of Health, among others, challenging the recent revisions to certificate verification guidelines.
However, the litigation has since been withdrawn.
Reactions
A nurse in one of the nation's foremost university teaching hospitals, who spoke anonymously, for fear of victimisation, expressed worry that the controversy is taking so long to end despite the resolution of the House of Representatives on the matter.
"The portal is not yet open despite the order from the National Assembly that it should be opened.
"The excuse that the secretary of the NMCN is giving to us is that they are working with the IT people so that they can reset the portal to its previous setting.
"You know there's a previous setting where you just did your verification with a few requirements until they brought this new policy that caused all those problems.
"We are also worried why it's taking so long. The information I have just given you is what I saw on our platform. The secretary admitted he has received the letter from the clerk of the National Assembly, and that they are working with the IT people to reset the portal, that's what he said.
"You know NMCN claimed that it was the National Assembly that told them to shut the portal, which was the controversy, but the lawmakers wrote back to the council saying that wasn't their resolution.
"The lawmakers wrote clarifying that they asked NMCN to revert to the old verification guidelines, pending when all the parties involved will sit to look at the issue.
"Now it is just for them ( NMCN) to go back to the old verification guidelines but the secretary is claiming that they are working with the IT people," she stated.
She said it was sad that health workers are leaving the country in droves, which according to her, was being caused by poor working conditions in Nigeria's health sector.
The health worker urged the government to make a deliberate effort to fix the country's health care system.
"We are not happy that people are leaving the country but the working conditions in Nigeria are crazy. I work in an institution where we are not sure of a 10-hour energy supply.
"In a teaching hospital, there's no light, there's no water, nothing to work with.
"Emergency comes and people just die like that. Not that you haven't done your part but there's nothing to work with. We are just stranded. Patients go out to buy everything that we use to work for them. And the hospital pharmacy doesn't have everything that they need. So most of the time, the patients' relatives go outside to buy what they need.
"I work in the maternity section. A mother may come to the hospital by 2am and she's bleeding profusely. The laboratory people will be telling you there's no light; of course there's no light; they cannot work without light. They can't do grouping and cross matching, they can't give you blood.
"You go to the pharmacy, they will tell you they can't work because there's no light to power their system. You see patients' relatives going outside the hospital at 2am, you just lose patients. It's painful.
"It's not that we are enjoying all these. Nigerian nurses are still overworking themselves outside the country but it's still better.
"The working condition and the pay too is far higher than what we are receiving in Nigeria. In Nigeria, they only pay attention to one particular profession. Until they do something, people will keep traveling.
"Just like I have explained, the government should make a deliberate effort to fix our health care system. If you go to the rural areas you will see what people are passing through.
"The experience I have just shared with you is where I work. Nigeria is tough for everybody. If I tell you my salary, you will just smile. I can't buy a bag of rice. Let them see how they can reduce inflation. Even if they increase our salary, things are so expensive, we can no longer meet up with our basic needs," she lamented.
She also lamented the inability of the National Association of Nigerian Nurses and Midwives, NANNM, to fight for the interest of its members.
"Personally, I am so disappointed with the National Association of Nigerian Nurses and Midwives because they didn't handle this matter the way they ought to.
"If this kind of thing happens in our sister organization, they won't take it likely. NMCN infringed on our fundamental human rights and we were so pissed.
"That's even what led to the young nurses taking the matter to the court. NANNM didn't come up as an organization to fight for us. And by the time we went to court, just like the 'Nigerian system', they kept adjourning the case.
"Another group also went to the NANNM to find out why they weren't doing anything about the matter, and they said they will meet the registrar and all that. At the end of the day, they said they can only intervene if we withdraw the case from the court. That's what led to the withdrawal of the case from the court.
"You know a lot of Nigerian nurses are stuck because you can't travel without verification, you can't do anything. A lot of people were already on their way out before the portal was shut down," the concerned nurse further stated.
Graduate Nurses Association of Nigeria - GNAN
Also speaking about the matter, the President of Graduate Nurses Association of Nigeria, GNAN, Mr Ojo Opeyemi said his association has been working underground to ensure the issue is resolved amicably.
Opeyemi said the stalemate in verification of nurses' certificates is having a serious effect on their members as some people are stranded abroad.
According to him, GNAN formed a coalition with other groups under the Director of nursing services in Abuja following the total shutdown of the portal to negotiate with the registrar of the nursing council.
He said he's extremely positive they will have good feedback because the coalition had honoured its own part of the agreement earlier reached with the registrar.
Opeyemi said the deal saw the withdrawal of their case against NMCN and the registrar from the court.
He said: "When it was initially suspended, our association went to court to sue the NMCN, including the registrar. Then after the total shutdown of the portal, a coalition was formed when it was really having negative effects on our people.
"We decided to form a coalition under the Director of nursing services in Abuja. We formed a coalition that negotiated with the registrar.
"Well, last month, we had a meeting in his office in Abuja. And part of the agreement we reached from the meeting is to withdraw the case from the court. Then we will come back for another meeting, where those issues causing controversy will be sorted out in-house.
"We have played our own part. Fortunately during the time of withdrawing the case from the court, another group went to the National Assembly. The National Assembly deliberated upon it and said the NMCN should revert to the old guidelines for verification of nurses and open the portal.
"The letter has been sent to the nursing council as I read online and some people have also informed me that the letter has been delivered to the NMCN.
"Those at the nursing group administration, we are working together. We believe that we have honoured our own part in all honesty. As I speak to you, one of our representatives in Abuja is going to meet the registrar today to chart the way forward on our agreement.
"Actually the agreement wasn't signed but we believe that they are the government and we are an association, so based on mutual understanding, we will resolve the issue in-house. We believe that the registrar will also honour his own part of the deal.
"So by the close of the day, (Tuesday) we are actually anxious to get feedback if we are going to go for a meeting or there will be automatic reopening of the portals, since the National Assembly has passed a resolution for them to reopen the portal.
"That's why we ensured the complete withdrawal of the case from the court so that the House resolution would not be stepped down. We have done our own part.
"At the end of today, when our representative meets the registrar, we are going to know if our initial understanding and agreement is honoured or otherwise.
"I am extremely positive we will have good feedback being that we have been the one championing the coalition under the director of nursing services at the federal Ministry of health because she is the one mediating between the group, the registrar and the nursing council.
"I don't want to say anything negative or be pessimistic. We are believing that today we shall have feedback. And I also believe that the registrar is making contact with necessary people at the Ministry of health for the portal to be reopened.
"Many of the people don't know about these negotiations because they are extremely anxious. We are working underground to make sure that this thing gets resolved amicably so everybody could move forward. That is the position of things at the present.
"We are extremely worried. In fact, we had wanted to pursue the case to a logical conclusion, because of the excruciating pains on our people and the effects the total lockdown of the portal was having on our people.
"Let me correct one wrong impression, verification does not mean that everyone wants to 'japa' or seek greener pastures. We have people who want their certificates verified because they want to further their education.
"We also have people who are outside who want to move to other countries, they will still ask them to get verification from where they studied, where they originally practised or got their license to practice as a nurse. So they will also refer them back again to Nigeria.
"There are many that are stranded and I also have a report that next month, some people will be deported massively from Saudi Arabia, UK, Canada, etc.
"So because of this, it is having a serious effect on our members and we have decided after our SWOT analysis of the whole scenario to remove the case from the court and have a negotiation to solve the issue in-house.
"As I speak to you some people are already stranded in the US, UK and others."
Efforts to hear from the NMCN, as well the President of the NANNM didn't yield any result as they didn't respond to calls put to them.
However, DAILY POST did contact the Rivers State chairman of the National Association of Nigerian Nurses and Midwives, Mr Madonna Wichendu.
Wichendu on getting to know the subject of the interview said he was in a meeting and not disposed to comment on the matter.
Meanwhile, the National Association of Nigeria Nurses and Midwives (NANNM) has issued a 15-day ultimatum to the Nigerian government to address the long-standing demands of the nurses.
This decision was made during NANNM's National Executive Council meeting in Abuja on August 28, 2024.
The association is seeking the immediate reopening of Nurses' Verification Portal, enhanced Nurses' Salary Structure, and the creation of a Department of Nursing.
The association is also demanding for the gazetting of the Unified Scheme of Service and the inclusion of Nurses in policy making.
NANNM said the government should address those demands within the 15-day ultimatum to avoid industrial actions.
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