Nigeria’s healthcare system is reeling after the death of Dr. Oluwafemi Rotifa, a young resident doctor at the Rivers State University Teaching Hospital (RSUTH), who collapsed and died after a reported 72-hour shift.
Fondly known as “Femoski” by colleagues, Rotifa was the only doctor on call in the hospital’s emergency unit for three consecutive days. He reportedly slumped in the call room shortly after reviewing a patient and was later pronounced dead despite resuscitation attempts in the Intensive Care Unit. His sudden death has sparked outrage, grief, and renewed debate over the worsening conditions faced by Nigerian doctors.
Confirming the incident, Dr. Tope Osundara, President of the Nigerian Association of Resident Doctors (NARD), described it as “preventable” and “a death on duty,” blaming excessive workload, staff shortages, and systemic neglect.
“This was a death caused by exhaustion. He was the only doctor on duty in the emergency room for 72 hours. No doctor should ever be subjected to such working conditions. His health was strained beyond its limits, and this tragedy was the result,” Osundara said.
The Nigerian Medical Association (NMA) also condemned the incident. Its Vice President, Dr. Benjamin Olowojebutu, described it as “heartbreaking and unacceptable,” stressing that doctors should not be losing their lives due to unsafe working conditions.
A Reflection of a Broken Health System
Rotifa’s death is not an isolated incident but a symptom of a failing healthcare system. Nigeria has one of the worst doctor-to-patient ratios in the world, with the NMA estimating one doctor for every 5,000 to 10,000 patients. This is a staggering contrast to the World Health Organization’s recommended ratio of 1:600.
For doctors who remain in the country, the workload is crushing. Rotifa’s case exposes a dangerous practice where resident doctors often spend days on continuous call duty, with little rest, inadequate support, and overwhelming patient numbers.
Adding to the crisis is the ongoing “brain drain.” Thousands of Nigerian doctors have migrated abroad in recent years, seeking better pay, improved working conditions, and professional opportunities. Rotifa himself had recently secured registration with the UK’s General Medical Council and was preparing to relocate before his untimely death.
The Human Cost of Burnout
Burnout in the medical profession is a global issue, but in Nigeria, it has reached epidemic levels. Studies show that nearly 45% of Nigerian healthcare workers experience severe burnout, with devastating consequences on their health and wellbeing.
Doctors routinely endure 24-hour shifts, overcrowded wards, inadequate sanitation, and constant exposure to high-stress emergencies. A 2023 study revealed that 30% of Nigerian doctors suffer from severe depression tied directly to workplace stress.
Burnout is not just about fatigue; it leads to hypertension, insomnia, impaired decision-making, and in some cases, sudden death as tragically seen in Rotifa’s case. Personal relationships also suffer, with doctors unable to spend quality time with family and friends due to their exhausting schedules.
The ripple effect extends to patients. Exhausted doctors are more likely to make errors, miss critical diagnoses, and emotionally disengage from patients. Trust in the healthcare system erodes when patients witness overburdened doctors struggling to provide safe care.
What Went Wrong: HSE Perspective
From a Health, Safety, and Environment (HSE) perspective, Rotifa’s death was entirely preventable. It points to multiple failings:
- Unsafe Work Practices
Globally, no doctor is expected to work continuously for 72 hours. Medical institutions in advanced countries strictly regulate working hours, limiting shifts to protect both doctors and patients. By contrast, Nigerian doctors are often forced into double or triple shifts, a clear violation of workplace safety standards. - Chronic Manpower Shortage
Nigeria’s doctor-to-patient ratio means that hospitals operate with skeletal staff, pushing available doctors into unsafe workloads. Policies mandating immediate replacement of doctors who resign or emigrate are either weak or poorly enforced. - Lack of Infrastructure and Support
Hospitals often operate with unreliable power, inadequate medical supplies, and outdated equipment, which compound stress levels for doctors who must work under constant resource constraints. - Systemic Neglect
Despite repeated warnings by NARD and NMA, governments at all levels have failed to prioritise reforms in healthcare staffing, welfare, and safety. This inaction has created an unsafe occupational environment for doctors, putting lives at risk.
Who Should Be Held Responsible
The death of Dr. Oluwafemi Rotifa is not merely an accident of circumstance; it is the direct result of systemic negligence. At the heart of the problem is government failure, both at the federal and state levels. For years, Nigeria’s health sector has suffered from chronic underfunding, leaving hospitals understaffed and under-resourced. The absence of effective policies to recruit, retain, and immediately replace doctors who resign or leave for opportunities abroad has created a dangerous vacuum. That gap was the very burden Rotifa carried on his final shift.
Equally troubling is the role of hospital management. Allowing one doctor to bear the weight of an entire emergency unit for three consecutive days reflects a disturbing disregard for occupational safety. Hospitals are not only responsible for treating patients; they also have a duty of care to their staff. By failing to enforce humane duty rosters and rest schedules, RSUTH exposed one of its brightest young doctors to fatal exhaustion.
The broader medical establishment is not blameless either. While associations such as the Nigerian Association of Resident Doctors and the Nigerian Medical Association have consistently raised alarms, their advocacy has not yet translated into enforceable reforms. The repeated cries of overworked doctors have often been ignored by those in authority until tragedies like this force attention.
Ultimately, this is not about a single institution or a single shift. It is about decades of systemic neglect that have normalised unsafe work conditions for those who are meant to preserve life. Unless accountability is demanded from policymakers, hospital administrators, and professional regulators, the cycle of overwork and preventable deaths will continue.
Beyond Doctors: Patients Are Also at Risk
While doctors bear the brunt of burnout, patients also suffer. With fewer doctors attending to thousands of patients, waiting times increase, medical errors become more common, and the quality of care drops drastically. As NARD stressed, unsafe working conditions for doctors ultimately create unsafe treatment conditions for patients.
This is a dual crisis: protecting doctors’ lives is also about protecting patients.
