Nigeria’s Healthcare System is a Prayer Point: And Prayer Alone Cannot Remove a Tumour

My Thoughts Have No Filter By Abdul’Azeez Bello

WhatsApp: 0805 113 0075 | omobolajibello@gmail.com

Welcome to the Nigerian Hospital. Please Come With Faith. And Your Own Gloves.

Let me tell you how healthcare works in Nigeria in 2026.

You feel unwell. You go to the hospital. You wait. You wait some more. You wait so long that you begin to wonder if the sickness will get tired and leave before the doctor arrives. Eventually someone in a coat appears. They examine you. They write a prescription. They send you to the pharmacy. The pharmacy does not have the drug. You go to a private pharmacy outside the gate. You pay a price that requires a moment of silence before handing over the money. You go home. You pray.

The prayer is not optional. In Nigeria’s public health system, prayer is not a supplement to treatment. For many Nigerians, it is the treatment.

Nigeria’s public health system is in a state of systemic breakdown, a slow-burning crisis that now threatens the very survival of millions. What is unfolding in hospitals across the country is not just dysfunction. It is an epidemic of inefficiency, neglect and human suffering of alarming proportions.

That is not a street corner opinion. That is a description from a national newspaper. And every Nigerian who has ever sat in a public hospital waiting room knows exactly what that sentence means in practical, personal, lived terms.

The Primary Health Centre That Exists Mainly on Paper

Here is Nigeria’s plan for healthcare delivery. You get sick. You go to your nearest Primary Health Centre. The PHC treats whatever it can. If it cannot handle it, it refers you to a general hospital. The general hospital handles more complex cases. Teaching hospitals handle the most complex. Clean. Logical. Theoretical.

Now here is what actually happens.

Primary healthcare centres, which should serve as the first line of defence, have all but failed. General hospitals, federal medical centres and teaching hospitals are now overrun by patients suffering from minor conditions.

A national daily recently reported that 85 percent of Nigeria’s Primary Healthcare Centres are in distress and lack doctors, despite N55.44 billion in disbursements between 2022 and early 2025. The money went somewhere. The drugs and doctors and equipment did not follow it to the PHCs.

Many PHCs lack staff, equipment, and essential drugs. Access to care is deeply unequal, often determined by income and location. Low-income patients cannot afford tests, while others access faster care. This gap is costing lives.

Costing lives. Not inconveniencing lives. Not delaying lives. Ending them. Because a person in a rural community whose nearest functional health facility is three hours away, who cannot afford a private clinic, who goes to the PHC and finds it closed or empty or without drugs, that person does not always get another chance to try again.

The Doctors Have Left. And Honestly, Can We Blame Them?

Now let us talk about the people who were supposed to be in those hospitals.

16,000 Nigerian nurses migrated to the UK in 2025 alone, pushing the total number of departures to around 57,000 over the past five years. Nigeria is currently left with about 55,000 practising doctors serving a population of more than 220 million people.

55,000 doctors. For 220 million people. That is one doctor for approximately every 4,000 Nigerians. The World Health Organisation recommends one doctor for every 600 people.

Nigeria has approximately 3.8 doctors per 10,000 people, far below global benchmarks for adequate coverage. And in some parts of northern Nigeria? Doctor density is as low as 0.5 doctors per 10,000 people.

Half a doctor per ten thousand people. If you are in one of those communities and you need medical attention, you are essentially on your own. With your faith. And your generator-powered phone to call a relative who might know someone who knows a nurse somewhere.

Our hospitals are not properly equipped, we have severe manpower shortages, and the health insurance system is dysfunctional. Doctors are overworked, underpaid, and dying daily. That is a physician describing colleagues.

Despite rigorous medical training, Nigerian doctors often receive low and irregular salaries, with delayed or minimal hazard allowances, and face limited opportunities to supplement income. A doctor who trained for six years, then did one year of housemanship, then years of residency, earning irregular salaries in a system that cannot provide basic equipment. The fact that any of them stayed is the real miracle. Not the ones who left.

The Budget Announcement Was Lovely. The Equipment Did Not Get the Memo.

Every year, Nigeria announces health budgets with figures that sound serious. Every year, the gap between what is announced and what actually reaches the hospitals, the clinics, the rural health posts, remains wide enough to park several government SUVs in.

For the 2025 fiscal year, the Federal Government proudly approved N218 billion specifically for health capital projects, meant to build clinics, purchase lifesaving diagnostic machines, and upgrade aging facilities.

This persistent failure to disburse cash explains the physical ruins of our healthcare landscape. It is the direct reason why primary health centres across our rural communities look abandoned, why premier teaching hospitals lack functional CT scanners and basic oncological equipment, and why our most brilliant medical minds are fleeing the country in droves.

Approved on paper. Not released in cash. And so the CT scanner remains a rumour in the teaching hospital. The oncology unit remains a room with good intentions and bad equipment. The PHC remains a building that is technically a health facility in the same way a car without an engine is technically a vehicle.

Because public facilities are starved of operational liquidity, citizens are forced to financially sponsor their own survival in a broken system. Financially sponsor their own survival. That phrase deserves to be read slowly, out loud, by every Nigerian official who has ever described our healthcare system as functioning.

The Poor Nigerian Patient: The One Nobody Designed the System For

Here is the cruelest part of this entire story.

The Nigerian who suffers most from this broken healthcare system is not the one who can afford a private hospital. Not the one who has health insurance through a formal employer. Not the one who can fly to India or the UK or the US when things get serious.

The one who suffers most is the ordinary Nigerian. The market woman. The okada rider. The retired teacher living on a pension that arrives late. The farmer whose nearest health facility is a PHC that has not had drugs in three months.

Nigeria’s health indices remained low, Universal Health Coverage was weak, and health insurance coverage continued to exclude a large segment of the population. The cost of healthcare rose sharply, driven by high prices of drugs, consumables and medical equipment, many of which are imported and subject to heavy tariffs.

Rising costs. Weak insurance. Low coverage. For the ordinary Nigerian who cannot absorb those rising costs, every serious illness is a financial catastrophe on top of a medical crisis. They must choose between treatment and rent. Between drugs and school fees. Between getting better and staying solvent.

That is not a health system. That is a lottery. And the poor Nigerian is always drawing the shortest ticket.

Meanwhile, At Abuja Airport

I want to say something gently but firmly.

It is difficult to have a serious conversation about fixing Nigeria’s public hospitals when the people responsible for fixing them consistently travel abroad for their own medical care.

Not because foreign healthcare is always better. But because the signal it sends to the Nigerian public is very clear. The people who could fix this system have removed themselves and their families from its consequences. They do not wait in those queues. They do not use those PHCs. They do not sit in those waiting rooms that smell of disinfectant and disappointment.

When the personal consequences of a broken system are removed from the people who can fix it, the urgency to fix it changes character. It becomes a policy issue rather than a personal one. A line item rather than a lifeline.

We are not asking government officials to stop seeking quality healthcare. We are asking them to ensure that the quality they seek abroad is eventually available to the 220 million Nigerians who cannot follow them.

The Way Forward

Nigeria does not lack knowledge. What we lack is the system to deliver it. That one sentence from a Nigerian healthcare expert is the most honest summary of the situation available. And it points directly to what needs to happen.

Release the health budget as cash, not just as approval.

Approved budget lines do not heal sick citizens. Only real cash releases, fully stocked clinics, working equipment, and motivated, well-paid medical professionals can do that. Every naira approved for health capital projects must be tracked from approval to actual delivery in an actual facility.

Fix the Primary Healthcare Centres urgently and seriously.

The PHC is supposed to be the first line of defence for the majority of Nigerians, most of whom cannot afford private hospitals. Restocking, restaffing and rehabilitating PHCs across Nigeria is not optional. It is the foundation of everything else in the health system.

Pay health workers what they are worth and mean it.

Unless salaries and working conditions improve, doctors will continue to leave, and the system will collapse. The brain drain is not a mystery. It is a direct response to conditions that no skilled professional should be expected to endure indefinitely. Competitive pay, regular payment, functional equipment and safe working environments are the minimum required.

Make healthcare genuinely affordable for low-income Nigerians.

The National Health Insurance Authority exists. It must be made to work for the people who need it most, not just for formal sector employees in urban centres. A Nigerian market woman in a rural community deserves the same access to basic healthcare as a civil servant in Abuja. Full stop.

Strengthen the referral system so it actually works.

A functional PHC that correctly refers patients to a general hospital that is actually equipped and staffed would save lives daily. The chain is broken at multiple points. Fix every link, not just the visible ones at the top of the system.

The Verdict

As Nigeria looks ahead, doctors warned that without urgent reforms, Nigeria risks deeper workforce losses and worsening health outcomes.

Deeper losses. Worsening outcomes. In a system that is already losing and already producing poor outcomes.

Nigeria’s healthcare crisis is not new. It has been building for decades, fed by underfunding, brain drain, policy gaps, corruption in disbursement and the quiet decision by those in power to exempt themselves from its consequences.

But the people in those queues are not policy abstractions. They are real Nigerians with real bodies, real pain and real families waiting at home for them to return healthy.

The market woman who cannot afford the drugs prescribed to her at the PHC that barely has drugs is not a statistic. She is someone’s mother. Someone’s grandmother. Someone who woke up this morning hoping that today Nigeria would work for her the way it should.

We are not asking for world-class healthcare overnight. We are asking for healthcare that keeps people alive. That does not require them to sell land to pay for a scan. That does not send them home with a prayer because the pharmacy is empty.

We are asking for healthcare that remembers that the patients are human beings, not inconveniences on a broken system’s waiting list.

The hospitals need to be fixed. The equipment needs to arrive. The doctors need reasons to stay. The poor Nigerian patient needs to matter as much as the budget line item that was supposed to help them.

And the government needs to stop treating healthcare as a speech topic and start treating it as what it actually is.

A matter of life and death.

Abdul’Azeez Bello writes from the streets of Nigeria, where the truth is always louder than the headlines.

My Thoughts Have No Filter.