Buhari’s curious lamentation about medical tourism

That Nigeria’s leader who has reportedly spent one year, 39 days abroad in three years, 10 months he has been in office has also been the one lamenting the country’s loss of over N400 billion yearly to medical tourism is curious and unfortunate.

Nigeria’s president Muhammadu Buhari who recently lamented the precarious healthcare situation attributed it to government’s inability to address various health challenges.

According to him, “government has shown strong commitment in the revitalisation of the health sector. These efforts notwithstanding, our health sector is still characterised by low response to public health emergencies, inability to combat outbreak of deadly diseases and mass migration of medical personnel out of the country. This has resulted in increasing medical tourism by Nigerians in which Nigeria loses N400 billion on annual basis.”

Doubtless, this is a national embarrassment because if the President who has a responsibility to address the anomaly is lamenting, who will address the challenges? If the President is helpless on the issue of access to health care, who has more powers to help him? Lamentation is not a strategy anywhere.

Anyway, the poor access to health care in Nigeria may not also be unconnected with the disturbing degree of deterioration that has characterised the health sector. The sector cannot be compared to what was obtainable in the 1960s and 1970s when there was some serious governance. The deterioration has been due to neglect by successive administrations. In fact, the nation’s health sector is groaning and now near a total collapse and there is no glimmer of hope.

This dismal situation is in spite of the billions of naira expended on some tertiary hospitals during the twilight of former President Olusegun Obasanjo’s administration to equip some strategic departments in some tertiary and teaching hospitals as ‘centres of medical excellence.’ Curiously, some of the equipment installed had been reportedly tampered with and cannibalised but no one has been prosecuted.

Even the State House Clinic established to take care of the President, Vice-President, their families as well as members of Staff of the Presidential Villa, Abuja joined the league of hospitals that cannot deliver quality healthcare services. This came to the public glare when Mrs. Aisha Buhari took ill in 2017 and was advised to travel abroad because of the poor state of the clinic. However, she opted to go to a private hospital owned by foreigners when she was told that the x-ray machine in the State House Clinic was not working.

So, some of the factors hampering access to quality health care in Nigeria include obsolete equipment and the brain drain that began since 1985; not discounting the not-so-conducive operating environment. Again, inadequacy of medical facilities, high cost of drugs, sub-standard drugs, wrong diagnosis, poor attitude of health workers occasioned by poor remuneration and resulting in the neglect of patients by medical personnel, long waiting time for patients, etc. are all responsible for the unhealthy situation in Africa’s most populous nation.

On brain drain, media reports have been consistent that even as the nation grapples with shortage of medics, more are fleeing the country. Besides, most of those highly educated and talented medical professionals, who are out in foreign countries are excelling, where the conditions and atmosphere are relatively better. This is not debatable because many great doctors all over the world are Nigerians, showing that the country has the brain, but cannot just retain them at home.

A recent example is Dr. Oluyinka Olutoye, who had his medical degree from Obafemi Awolowo University, Ile-Ife in 1988, and in collaboration with a colleague successfully removed tumour from a baby in her mother’s womb. The duo removed the baby from her mother’s womb, operated on it, and returned it to the womb. The baby got healed and continued to grow until she was finally delivered at 36 weeks. This we are all proud of as Nigerians. Olutoye, now a professor of medicine in the U.S, is a Nigerian, who trained in Nigeria. But he is now a brain gain to the United States.

So, it is obvious that Nigerian doctors are competent to manage a healthcare delivery system in Nigeria if the environment can enable them. It is thus curious why governments over the years, have always created the situation, president Buhari just lamented about.Hence, the consequences of medics migrating are grave: the country is facing brain drain and ‘patient drain’ simultaneously because of lack of confidence in the sector, with the attendant capital flight. What of embarrassing child and maternal mortality rates in the country?

Therefore, the continuing exodus of doctors should be a concern to people in authority. And that is why duty bearers should address the rising deficit in medical personnel occasioned by migration. Specifically, there should be conscious policy to attract health technologies and experts in the diaspora back to Nigeria for a more effective and efficient health service delivery. Hence, government ought to recognise that the country is in trouble if there are no adequate healthcare personnel for its teeming population.

So, as a country in need of more medics, Nigeria should develop plans on how to retain trained medics. Against the backdrop that Nigeria’s poor healthcare infrastructure in particular is partly responsible for the mass migration of Nigeria’s best hands in health care, the situation can be reversed by making the National Insurance Scheme (NHIS) compulsory for all citizens, which we hope will provide enough funds to improve the conditions of service and working environment for health professionals.

Also, government should provide adequate remuneration and make conditions of service attractive for medics to live decently. Authorities at all levels should also provide the infrastructure and cutting-edge technologies needed for quality service delivery by medical professionals. Furthermore, we appeal to Nigerian medics in the diaspora to return and set up world-class medical facilities in the country. Their regular medical outreach programmes in Nigeria can’t be enough.

What is more, the President should build on his positive experience in the health systems of other climes while receiving treatment, to impact on the Nigerian healthcare system by replicating what he saw and experienced in London at least to take care of the masses who do not have the resources to fly abroad for medical care. He should encourage health authorities in the country to replicate the medical equipment he saw abroad during his treatment.
Specifically, he should make healthcare his personal agenda, and contribution to the growth of the Nigerian health sector. He should see his health challenge and experience in a London hospital as a wake-up call by revamping to the health sector. This should be pursued so that Nigerians would stop going through this embarrassment for the good of the people and the protection of our national image.

Similarly, the ninth national assembly should demonstrate good leadership, which is a critical variable in dealing with the current crisis in the health sector. The legislators should show good representation in the area of health sector reform. Hopefully, by amending the National Health Act, 2014 and with more investment in the health sector, many citizens will have access to quality and affordable health care, while the capital flight occasioned by medical tourism will be a thing of the past.

Again, medicare should be seen as an investment just like real estate. With commitment and determination, Nigerian health sector can be repositioned too through a private sector intervention. A private sector led world class specialist hospitals, driven by local investors, especially members of Nigerian Medical Association (NMA), Nigerians health professionals and experts in the diaspora, health professional organisations, development agencies and health related not-for-profit organisations in partnership can improve Nigeria’s health sector. This collaboration is important because facilities alone do not run hospitals; the human capacity is an important resource.

Therefore, the private sector led group can partner with government and take over the gigantic hospital buildings that are wasting away and turn them into quality health care facilities. This strategic partnership is needed at this time as it can lead to more people having access to quality health care at an affordable cost. It is definitely more cost-effective to treat Nigerians in their country.