3 March 2017

Nigeria: President Buhari Medical Trips Signal No End to Medical Tourism

Despite his pledge to halt medical tourism in Nigeria, President Muhammadu Buhari has sought medical assistance in the United Kingdom for the second time since he took office in May 2015. Nigerians spend more than USD1 billion a year on medical tourism, and Buhari's recent trip to the UK for vacation and medical screening is grave testimony to the inadequacies of health care and facilities in Nigeria

When President Muhammadu Buhari swaggered onto the podium on 29 May 2015 to deliver his inauguration speech after winning the presidential election, a wave of optimism and hope rippled through the cheering crowd. With admirable messianic fervour, President Buhari promised to tackle insecurity, endemic corruption, waste, and fuel and power shortages head on.

Nigerians who watched the live broadcast of the inauguration ceremony, held at Eagle Square in the heart of Nigeria's capital city Abuja, could not resist the temptation offered by this newfound hope. The 74-year-old leader, who was Nigeria's military head from 1984 to 1985, also promised to address education and health challenges so Nigerians could have access to quality education and health care.

Nearly two years into his four-year tenure, President Buhari is struggling to keep to his promises, especially on improving health services for the people and putting an end to health tourism, which has bedevilled the country for a very long time. Since he took office in 2015, Mr Buhari himself has travelled abroad twice to receive medical treatment, a clear indictment of the health services offered in Nigeria.

It all began in June last year, when the former military ruler cancelled two planned trips to the volatile Niger Delta region and Lagos in order to take a 10-day holiday in the United Kingdom. His spokesman, Femi Adesina, had said the president needed to go abroad on the recommendation of his personal physician and an ear, nose and throat (ENT) specialist in Abuja.

And Buhari left, forgetting that he once warned that the country would not support any government official seeking medical care abroad, particularly when evidence shows that they can be treated in Nigeria.

Most politicians who go to the UK to receive treatment usually receive care from Nigerian doctors, analysts say.

Repeating mistakes from the past

Nigerians complained, the national body of doctors lamented and the vice-president of the Commonwealth Medical Association, Dr Osahon Enabulele, became a statistician to show why the president's medical trip was not healthy for the development of Nigeria's health institutions. Dr Enabulele pointed out that there were more than 250 ENT specialists plus a National Ear Centre, so the president's trip to treat an ear infection was "a national shame".

But silence followed these complaints and public displays of dissatisfaction against a leader who promised to tackle corruption and waste on medical trips to foreign countries to seek care.

This silence lingered until the presidency issued a statement in January, saying the president was leaving for the UK for another vacation and "routine medical check-ups". The interesting facts about President Buhari's medical trips abroad reside in the destination, the number of days and his inability to always return on the due date.

Both trips were to the UK and were meant to be a 10-day vacation, which culminated in an extension on the day when he was due to return. When he travelled in June last year to treat an ear infection, Buhari failed to return on the scheduled date: Thursday, 16 June 2016. With his latest trip in January 2017, he was expected back in Nigeria on 6 February, but at the time of writing he has not yet returned to the country. In addition, the reasons for the medical check-ups are unknown to the public. His continued absence means that the Vice President, Prof Yemi Osinbajo, continues to deputise for him as the acting president.

Analysts say that Mr Buhari's extended leave and the secrecy surrounding his health mean government officials are on track for repeating the same old mistake that characterised the ill health of then President Musa Yar'adua who later died in 2010 at age 58, months after he was airlifted out of Nigeria in November 2009.

About 40 000 Nigerians visited India in 2015 for medical reasons

Losing the public's trust

Public confidence in Buhari's administration is already eroding, especially as Nigeria's weak economy plunged into recession for the first time in 20 years. Inflation also surged to an 11-year high of nearly 19%. Last month, hundreds of Nigerians took to the streets in Abuja and Lagos in protest against unemployment, the rising cost of food and medicines, access to education and the lack of electricity.

Buhari's decision to seek medical attention abroad calls for a review of the health sector in Nigeria. The national budgetary allocation to health is usually between 4% to 6%. This year, the federal government allocated around USD957,5 million (4.17%) of the national budget to the health sector. This is a little above the 2016 budget of 4,13%.

This allocation is inadequate and falls short of the agreement among African countries in 2001 to allocate at least 15% of their budgets to health care. This invariably means health care will be grossly underfunded and many people will continue to struggle to access basic health care.

In 2013 alone, estimates say Nigerians spent more than USD1billion a year on medical tourism. And with a sense of hidden pride, Indian high commissioner to Nigeria, Ajjampur Ghanshyam, once said about 40 000 Nigerians visited India in 2015 for medical reasons, including transplant surgery, joint replacement and dental surgery.

The lamentable brain drain of Nigerian doctors

There are thousands of Nigerian-trained doctors in the UK and US, no thanks to poor working conditions and heavily underfunded health facilities. Most politicians who go to the UK to receive treatment usually receive care from Nigerian doctors, analysts say. A former governor in Nigeria's south-eastern region once shared his experience in a UK hospital where he was treated by a Nigerian doctor. The governor said the doctor told him the country was frustrating hard-working doctors.

This brain drain is predicated on the failure to improve working conditions and health centres. Strikes by Nigerian doctors and physicians are commonplace, with patients left stranded because medical facilities are shuttered to the public.

As Nigerians continue to look forward to the president's return, it behoves Buhari to remember his pledge to halt medical tourism and engineer serious reforms that would lead to significant transformation in health facilities in Nigeria. This will increase the likelihood of Nigerians shunning medical trips abroad and encourage native doctors to return to the country.

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