10 April 2017

Aspen New Voices Fellowship (Washington, DC)

Nigeria: Ground Nigeria's Medical Tourism so Healthcare Can Take Flight

Photo: Daily News
(File photo).

I, like many young Nigerians, voted President Muhammadu Buhari into office in 2015 with hope for the future of our beloved country, Nigeria. We supported his promises to fight corruption; create jobs for the youth, and end the practice of Nigerian government officials using state funds to travel to foreign institutions for their personal medical care. Medical tourism, as it's known, expels huge capital flight of about $1billion dollars, particularly from expenses incurred by political and public office holders (and their accompanying aides), whose foreign medical trips (most of which are unnecessary) were financed with tax payers' resources.

Corruption and job creation are complex issues and progress has been slow. But Nigerians had pinned their hopes on immediate progress on medical tourism. We lose billions of Naira every year to medical trips abroad. And at home, many people die because we don't have hospitals that are run at international standards. While our politicians go overseas, the average Nigerian suffers substandard and debilitating healthcare, medical negligence, and even deaths from preventable diseases.

With the dwindling economy and the continuous terror of Boko Haram, I was shocked to hear that the President had travelled to London once again for medical reasons at the beginning of the year - returning only this month. Last year, he travelled to London for a 'persistent ear infection'.

During his seven weeks' absence members of his Cabinet - including his Vice President - had no clue if he was alive or dead. On this return he reported that he could not recall being "so sick" and that he would have to return for more tests.

Like many Millennials, I feel that Nigerian government officials are not transparent, cannot be held accountable and, frankly, do get away with being corrupt. Nigeria has been here before, though, with former president Yaradua. President Yaradua fell ill and died while in office with much mystery shrouding his reason for travelling to Saudi Arabia for medical treatment.

Take, for example, the former governor of Enugu State Sullivan Chime who spent 4 months in a UK hospital receiving treatment for an undisclosed illness, abandoning his duties as governor. Or the former governor of Akwa-ibom, Godswill Akpabio, who unveiled a N30 billion Specialist Hospital he built in May 2015 and told Nigerians the hospital was of world-class standard. Yet four months later he sought treatment in the United Kingdom after sustaining minor injuries in a car crash in Abuja, the federal capital territory.

This has been the modus operandi of our leaders for decades.  In 1989, the military president at the time, Ibrahim Babangida travelled to Germany for an operation. His wife Maryam also sought treatment abroad and died in an American hospital. Other examples include former First Lady Stella Obasanjo who died in Malaga, Spain, Former President Goodluck Jonathan's wife, Patience Jonathan, who made several trips to Germany for medical treatment and former Senate President David Mark who travelled to Israel to treat his eye and teeth. The list goes on and on. Other prominent leaders including politicians, business executives and traditional leaders die abroad while receiving medical treatment and are then flown back to Nigeria at great expense for burial.

Why do Nigerian government officials think this is acceptable? They were elected into office to make the country better and that includes fixing the healthcare system. Citizens who can afford to travel do so and Nigerians - including government officials - spent $1bn on foreign medical trips in 2013. However the poor - who make up the majority of Nigeria's 170 million people - are left to bear the consequences of an inept government.

The average Nigerian visits a hospital where he or she is met with a doctor who is most likely frustrated with not getting paid monthly by the government, has to work in dilapidating hospital conditions without electricity or basic life saving measures, such as oxygen and blood transfusion services. These services are fast becoming a luxury, and because of the poor state of affairs in the health sector, we've seen incessant strikes. As a result, a patient experiences hostility, unsatisfactory services, and pays the price for medical negligence.

In countries like South Africa, politicians use the same medical facilities as ordinary citizens. Nelson Mandela for example, was treated at a South African military hospital until his death. So far, there is no record that a South African president was flown abroad for medical treatment and the current health minister uses state hospitals. South African leaders and elite attend to their health care services in South Africa because the current and previous administrations laid a solid foundation for functional, workable and standard public health care services.

Unfortunately, the same cannot be said for Nigeria, the 'giant of Africa'. Nigeria spends less on healthcare as a share of GDP than Angola, South Sudan and Ethiopia . It is ranked nearly the lowest of the 53 African states in the World Bank's database, surpassing only the Democratic Republic of the Congo (DRC) in healthcare spending. The country also falls short of the declaration by the African Union that member countries spend 15% of their budgets on health. Nigeria spent only 8.2% of its budget on health in 2014 and reduced this percentage some more to 4% in 2016.

It is absolutely clear that the leadership in Nigeria do not take healthcare seriously and are not committed to building an efficient healthcare system. The only way to curb this problem is to first, stop electing old men who are past retirement age. Apart from the fact that they are far removed from the daily realities Nigerians face, their old age increases the chance of ill health. A sick president who travels abroad for treatments is not the kind of exemplary leader Nigeria needs. We need someone who will prevent medical tourism, find innovative ways to improve the health system through direct investments, and attend local hospitals for treatment themselves. Second, we need to protest the current medical tourism practice by officials; we must enact laws that would criminalise anyone in office from seeking medical care abroad. Maybe this will get them thinking about using funds appropriately since they too may get affected by the dilapidated health system.

If Buhari banned medical tourism, the money saved could be invested directly into the health system. This could improve the services citizens receive, avoid medical personnel going on strike, train better doctors who understand what it means to have taken the Hippocrates oath,  improve the overall infrastructure problems the health system faces and most of all, avoid unwanted and avoidable deaths caused by the lack of medical supplies and negligence.

As a young Nigerian, it is scary that I cannot trust the healthcare system our leaders have left for us.  If things carry on this way, it will only get worse. This means that while young people in the UK or Japan have the chance of living well into their 80s, young Nigerians could have their lives cut short to about 48 years old. Largely, this is due to disease that could most likely have been prevented or treated.

This is a call to young Nigerians to demand their basic human right for access to quality and affordable health. The leaders currently accessing quality care overseas will not be here for long to bear the burden of the disaster they are creating: we and our unborn children will bear the burden.

We simply cannot mortgage the health of Nigeria's youth to fund the excesses of its leadership.

Ify Aniebo is a PhD candidate at Oxford University in Clinical Medicine and Infectious Tropical Diseases and a 2016 Aspen New Voices Fellow. Follow her on Twitter at @ifyaniebo.


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