Medical tourism: Healing Nigeria’s health sector

PUBLIC office holders’ use of public funds to defray their medical expenses abroad is an abuse of the treasury that must stop. It accounts for the seemingly criminal neglect of our health institutions. At many fora, the Minister of Health, Onyebuchi Chukwu, had affirmed the Federal Government’s plan to end public officers’ medical tourism for ailments that our local hospitals could adequately handle.

The minister, who represented President Goodluck Jonathan at a conference of General and Private Medical Practitioners in Port Harcourt, Rivers State, recently, scoffed at the practice. The abusers of public funds for private health care include Presidents and their spouses, state governors, lawmakers and top civil servants. India, Britain, the United States and Germany are among their preferred destinations.

According to the Nigerian Medical Association President, Osahon Enabulele, “We lose at least $500 million every year to patients travelling abroad for treatment. India makes $260 million from Nigerian patients annually.” It is estimated that 5,000 Nigerians travel to India and other countries monthly for medical treatment. The Nigerian High Commissioner to India, Oyebola Kuku, while decrying this development, stated that 20,000 out of 25,000 Nigerians given visas in 2011 went there for medical care.

However, a ban on foreign medical trips infringes on individual liberty or freedom guaranteed by the constitution. What should concern the government is why Nigerians do not have confidence in our health care system or why our medical experts move in droves to Europe, US and Saudi Arabia. The truth is that most of our hospitals have lost their value as life-saving centres, as they remain “mere consulting clinics,” which the soldiers tagged them 30 years ago when they toppled a civilian government.

Health challenges that take Nigerians abroad include kidney, cancer and cardio-vascular or heart diseases. The late rights activist, Gani Fawehinmi, who died of cancer a few years ago, bemoaned how his ailment was wrongly diagnosed as pneumonia in Lagos hospitals, only to be belatedly, but properly investigated in the United Kingdom. Cases such as Fawehinmi’s prompted the General Medical Council in the UK, in 2012 to ban doctors trained in Nigeria from practising there. About 3,564 Nigerian doctors practise in the UK.  A total of 33 of them, together with their counterparts from India, Egypt, Pakistan, Uganda, Cameroun and Iraq, were labelled “danger doctors,” and their licences were suspended because of poor knowledge of medical practice.

This is the crux of the matter; and Chukwu should face it squarely instead of engaging in rhetoric. With frequent strikes by our universities and resident doctors over poor remuneration, poor funding and lack of equipment, the quality of doctors produced by our medical schools is, without question, becoming suspect.

It was deplorable service delivery by hospitals, including 50 federal medical centres, among them 14 teaching hospitals and National Hospital, Abuja, that prompted  a national survey by SERVICOM (Service Compact with all Nigerians) a few years ago, which affirmed that none of them could be relied upon.

Funding is therefore critical in making our hospitals ideal. The University Teaching Hospitals at Ibadan, Enugu, Zaria, Lagos and Maiduguri, which the Federal Government classified as “centres of excellence,” are far from what they ought to be. A revelation by a former NMA chairman, Cross River State branch, Ofem Enang, last year that some states lacked consultants or specialists in their general hospitals, shows how deep-seated Nigeria’s health care crisis is. This means that primary health centres in the affected states would have no hospital to refer complicated cases to. The consequence is the avoidable death of patients. This is most shameful.

Changing this ugly tide requires a radical touch. This involves proper training and retraining of our medical personnel and equipping hospitals. Our primary health care system has broken down and should be revived without delay.  Cuba, whose health care delivery is legendary, and serves as a model for over 100 countries, could serve as an inspiration. There, a doctor-nurse team is part of every community. This has reduced its infant mortality rate to a level lower than that of the US, just as it has eradicated polio, malaria, measles, TB and meningitis – diseases that compound Nigeria’s health burden. Yet, Cuba is not as blessed as Nigeria in resource endowment.

While we appreciate the fact that the government cannot do it alone, it can, however, create the enabling environment in providing land and tax incentives for foreign investors. A Turkish hospital, Florence Nightingale Group, a global brand proposed last year to invest $100 million in Nigeria. Such a project deserves government’s support.

The telecoms liberalisation leveraged so much from Nigeria’s huge population of over 160 million people; foreign investors in the health care sector too, stand to exploit this strength.


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