Recurring issues of medical fitness of Nigerian leaders

The first time the issue of certifying the mental and medical fitness of leaders was canvassed, it was taken as a ribald joke. Former military head of state, Chief Olusegun Obasanjo, had after his release from prison in 1998, where he was clamped by the late maximum ruler, General Sani Abacha, suggested that persons aspiring to lead the country should be subjected to psychiatric tests.

The matter came to the fore once again in 2010 when the health condition of former President Umaru Musa Yar’Adua, became a subject of national apprehension and speculations.

While members of Yar’Adua’s kitchen cabinet started acting funny and speaking from both sides of the mouth about the actual state of fitness of the president, who had been on pro-longed absence outside the country, it took the boldness of the late Prof. Dora Akunyili, the then Minister of Information and Orientation, to urge her fellow cabinet members to tell Nigerians the truth.

Stung by the critical imputations of the expose, especially against the background that Yar’Adua did not transmit a letter of absence to the National Assembly conveying the imperative of his deputy to act in his absence, the nation was thrown into turmoil.

Recently, following the death of Prince Abubakar Audu, who was the gubernatorial candidate of All Progressives Congress (APC), midway into the collation of election results, the National Assembly decided to amend the constitution and Electoral Act to take care of such eventualities.

However, the cumbersome stipulations in the constitution, which make it near impossible for a seamless resolution of issues of doubtful medical fitness of an incumbent president or governor elicited further attention to the matter.

In the light of the intricate legal requirements for declaring a president or governor incapacitated, was it not high time that prospective leaders like prospective employees, started depositing their medical certificates of fitness with the Independent National Electoral Commission (INEC) as part of the preconditions for eligibility for contesting for election?
The situation is further accentuated by the discovery that most often when public officers, who lack constitutional immunity against criminal prosecution, are faced with the arrows of the law they begin to allude to sundry illnesses and pleas for foreign medical attention.

Constitutional roadblock
Section 144 of Nigeria’s 1999 Constitution stipulates as follows: “144 (1) The President or Vice-President shall cease to hold office, if -(a) By a resolution passed by two-thirds majority of all the members of the executive council of the Federation it is declared that the President or Vice-President is incapable of discharging the functions of his office; and (b) the declaration is verified, after such medical examination as may be necessary, by a medical panel established under subsection.”

Late Abubakar Audu

The medical panel, according to the provision, “shall be appointed by the President of the Senate, and shall comprise five medical practitioners in Nigeria:-(a) one of whom shall be the personal physician of the holder of the office concerned; and (b) four other medical practitioners who have, in the opinion of the President of the Senate, attained a high degree of eminence in the field of medicine relative to the nature of the examination to be conducted in accordance with the foregoing provisions.”

Section 144 (4) states that “in its report to the President of the Senate and the Speaker of the House of Representatives, adding that (2) Where the medical panel certifies in the report that in its opinion the President or Vice-President is suffering from such infirmity of body or mind as renders him permanently incapable of discharging the functions of his office, a notice thereof signed by the President of the Senate and the Speaker of the House of Representatives shall be published in the Official Gazette of the Government of the Federation.”

It added that the “President or Vice-President shall cease to hold office as from the date of publication of the notice of the medical report pursuant to subsection (2) of this section.”

Being appointed by the president, it sounds incongruous in our clime where subservience is the norm of service that members of the cabinet could be impartial enough to follow through with the investigation with objectivity and candour.

It could be based on the challenges that members of Coalition of United Political Parties (CUPP) decided to seek a court order barring President Muhammadu Buhari from seeking another term in office after manifestations that suggested impaired health.

In a suit filed at the Federal High Court, Abuja, CUPP is seeking an order directing the president to make public the result of his medical examination.

Spokesperson of the coalition, Ikenga Ugochinyere, explained that re-electing Buhari “would only empower members of a purported cabal, who have hijacked the presidency to rule for another four years as earlier alleged by the wife of the President.”

Describing the move as patriotic, Ugochinyere said it was being done “in order to save this great country from the disaster that will follow if President Buhari is in a rare happenstance, re-elected.”

However, a rights activist, Mr. Ifeanyichukwu Okonkwo faulted the steps taken by CUPP, contending that the processes should involve joining all the registered political parties in the suit for it to have effect on the president.

Okonkwo said it is the duty of a political party to institute such legal action and join other registered parties as defendants, stressing that the onus would be placed on those parties to produce the medical reports of their presidential candidates.

Expert opinions
Responding to the development, former chairman, Rivers State chapter of Nigeria Medical Association (NMA), Dr. Ibitrokoemi Kurubo, said it has become imperative for persons aspiring for public offices, be it a local government counselor, as well as the president to undergo a thorough medical assessment.

While outlining that the assessment would entail comprehensive physical, mental and social medical evaluation, Kurubo stressed that this “is standard practice in most parts of the world.”

He warned that if emphasis is placed on mental health over social and physical, then the entire essence of the proposition will be defeated, adding: “Imagine a situation where somebody can be mentally fit but has a condition that could make him die while in office. A candidate or anybody wishing to hold political office should go through physical, mental and social examination this is comprehensive health check.

“A person taking hard drugs cannot take sound decision, therefore in the WHO (World Health Organisation’s) definition of health, that person is not healthy. Social health does influence our everyday life. Complete health is physical, mental and social.”

He said NMA, in a bid to ensure that medical reports produced by doctors can be relied on, has put in place a system whereby every medical report is sealed with a doctor’s stamp which will help the Medical and Dental Council trace the doctor that wrote the report.

Also, a researcher and senior lecturer in Department of Sociology, University of Port Harcourt, Dr. Sofiri Peterside, said while there is merit to subject those in political office to medical scrutiny, but given the level of institutional corruption in the country a person who is not sane could be declared fit.

Peterside added: “There is merit in carrying out such medical test because of the kind of things we see in this country. In fact, sometimes you begin to wonder if some of these political elite who have been in leadership and the kind of looting that is associated with their leadership, whether these persons are insane. Even certain decisions that have been taken often times tends to create the impression that these persons might not be in a sound mental state. So I think that under that kind of circumstance this kind of test will be necessary.”

He observed that the difficulty Nigeria has continued to have in leadership stems of the nature of society that the citizens themselves have created.

His stated: “I think that it is reflection of society, because for most part of our own society, majority of those who go into political positions have just gone there for the purpose of accumulation. For them power is perceived as veritable means of accumulation not only by those who are holding it but their ethnic nationality. If you come from any ethnic nationality once you occupy any position, the expectation of your ethnic group is that that power must be deployed in assisting them.

“So that is the problem in our country.  People who had nothing, who were nobody, suddenly occupy positions, and their life style will change because of the opacity of office. So I think that is the problem in our country. People don’t go there with the intention to serve the people. Rather than serve the people, they become a problem to the people who have elected them to provide service. They are very much interested in their own stomach.”

He argued that until Nigerians begin to dissociate power from that kind of accumulative tendencies that has characterised the polity, and that those who actually genuinely want to lead the people with a clearly defined agenda or programme of action on the basis of which the people are to elect them, the country will continue to have difficulty dealing with the problem of leadership.

On his part, the Executive Director of Enough is Enough, Ken Henshaw, said instead of reliance on medical report to determine a person’s medical fitness, the people in a particular constituency should be allowed to determine whether a person is fit to represent or lead them.

According to him, “If you want to use a medical report as a criteria to determine whether a person should stand for elective position or not, would you be infringing on the person’s fundamental human rights? It should be left to the people to decide that this person is too impulsive in his behaviour or in decision making to lead us. On the other hand, the fact that you make a person undergo medical evaluation before occupying office does not preclude the fact that he can develop psychological problem while in office due to office pressure.”

Rallying around Section 144
In Lagos last week, some groups of right activists under the umbrella of Good Governance Campaign (GGC), demanded that President Buhari and APC should declare the true health status of the president before the next general elections.

The group, consisting of 12 different civil society groups, also urged the National Assembly to invoke Section 144 of the 1999 Constitution to demand for the health status of Buhari before he could seek another four years in office.

The activists, during the protest tagged: “Why we want Section 144 of the 1999 Constitution activated on President Buhari” said the failing health of the President is a big concern to Nigerians and also members of the international community as a result of his poor outings in the last couple of weeks where he was practically supported during APC’s presidential rallies in Kano, Delta and Kogi where he slumped.

A senior member of Campaign for Democracy, Usman Bako from the North, said the need to know Buhari’s state of health is important because the progress of a country is bent on the physical, psychological and spiritual fitness of its leader.

According to him: “Our request for the president’s health status was against the backdrop of how he struggled with his health in the past, especially during campaigns.”

Also, President, Equity and Justice Movement, Obatungashe Adebayo, said their concern about the President’ health status is imperative because of the election which is imminent.

“What we want is that let the president himself or his physicians come out to tell us his state of health for us to know that the president is capable, and that he can rule this country for the next four year when people give him the free mandate.

“We love him, we are not against him. But what we are saying is that we love him the same way we love this country. We stakeholders in the developmental agenda of this country, we cannot afford to see a leader that is sick that will not be able or have the capacity to run this country.”

In the same vein, President, Guild of Public Affairs Analysts of Nigeria (GPAAN), Ayo Baje, said the foundation of democracy is rule of law and so Nigerians have the right to request for the state of health of their president.

“Democracy is like building a house which must have a solid foundation and the foundation of democracy is rule of law,” he said.

In another reaction, Secretary-General of Yoruba Council of Elders (YCE), Dr. Kunle Olajide, said it was true that section 144 of the Constitution states clearly on what the state of health of whoever aspires to be president, vice president, governor and deputy governor should be, but the document is silent on who should initiate the bill to demand for the health status of the president.

According to him, “A lawmaker, probably a Senator or any member of the public could sponsor such bill. But my take on the issue is that if Buhari’s health is not solid and sound, as we knew few months ago when he travelled abroad for treatment, ongoing camping could also have triggered his sickness due to stress. If any Nigerian then felt unsatisfied as to whether he should seek reelection or not based on his state of health, such can forward a bill to the National Assembly for debate.

“However, as a septuagenarian just like Buhari, I know that the campaign stress could have triggered his health crisis, which could have made him to slump in Kogi and other places that were reported recently. Another issue is that the volume of job associated with managing the affairs of a heterogeneous country like Nigeria requires a man or woman with a sound health and mental alertness to rule. On this note, I think someone should sponsor a bill to the National Assembly to start discussion on the matter.”

However, purveying a contrary opinion, factional chairman of Lagos APC, Mr. Fouad Oki dismissed the discussion as baseless and inconsequential because none of those raising the issue has any proof to show that the president is ill.

He asked, “Has Buhari came out to say that he is ill? Has he broken down since the rigorous campaign started or why are the people chasing shadows? If they are bereft of issue to campaign about, they should leave the stage honourably before the contest; else the defeat will be humiliating.”

Buhari’s numerous medical trips abroad since 2015
The president left Nigeria on Tuesday, May 8, 2018 for medical treatment in the U.K and was initially due to return to the country on May 12, 2018. He stayed beyond the expected time of return.

New York Times writes that: “The president is scheduled to return to Nigeria on Saturday, at which point he will have spent more than 170 days in London on official medical leave since becoming president in 2015”.

On February 5, 2016, Buhari also travelled on a six-day medical vacation to London. Likewise on June 6, 2016 he went on another 10-day medical vacation. Presidency said he travelled to deal with a “persistent ear infection”.

On January 19, 2017 Buhari also left Nigeria to London and also on February 5, 2017 when he wrote the National Assembly, asking the lawmakers to extend his London medical leave.

He returned to Nigeria on March 10, 2017 but couldn’t resume work immediately, with the presidency saying, “He’s working from home”.

He embarked on another medical trip on May 7, 2017 to London and didn’t return after 104 days, until August 19, 2017

Then Buhari returned to Nigeria and it took him a while to resume work because rats had reportedly damaged furniture in his office. Presidency announced he’d be working from home.

On May 8, 2018 Buhari left Nigeria to London for test cycles and “medical review,” another name for medical vacation.