Despite the growing criticism against medical tourism by top government personnel to foreign countries, there seems not to be a way out of what has become a costly official indulgence. Just a few days ago, Nigerians staged a protest at the Nigeria House in London against President Muhammadu Buhari’s current medical trip to the country, as the President is expected to spend about two weeks for the ‘short rest’. This medical trip can be said to be ill-timed on the premise that doctors, under the aegis of the National Association of Resident Doctors (NARD) are on a nationwide strike to press home demands for better welfare and the imperative of fixing the nation’s deteriorating health system.
What makes the President’s case disturbing is that he has allegedly spent over 200 non-consecutive days on medical tourism in the United Kingdom alone since he assumed office in 2015 and with huge expenses paid for with public funds. For instance, he once took a six-day vacation on the excuse that his doctors lived in England, after which he went back on a 10-day trip for an ear infection surgery that was later extended by three days. Again, he returned to the UK on a medical vacation after which he wrote the National Assembly by seeking an extension and when he finally returned to Nigeria, he did not resume work immediately, saying that he was ‘working from home’.
Thereafter, he embarked on another trip to London and returned after more than 100 days. The President returned to Nigeria and it took him a while to get back to work because rats had reportedly damaged furniture in his office and restated that he would be ‘working from home’ before returning on a four-day “medical review”. These cases of top government officials jetting out of the country on the slightest medical issue did not start under the present administration. This was why the State House Permanent Secretary was seriously questioned while appearing before a Senate panel, to defend the 2021 budget estimates, where he gave a budget of N19.7bn for 2021, out of which N1.3bn was proposed for the State House Clinic. The Permanent Secretary had promised to put necessary arrangements in place to meet the medical needs of the President and other top public officers once the budget was approved. Not much has been heard in the public domain in this regard.
As a result of the huge financial loss to the economy, the intention to invoke the Freedom of Information Act, 2011 on how much the President has spent on medical travels has not yielded much fruits by concerned Nigerians, but it is estimated that medical tourism could drain over $1 billion a year by leading to deficiency in the Federal Government’s health budget. The drastic drift in medical personnel from the country drew the attention of the UK General Medical Council, a government body that maintains the official register of medical practitioners, which raised the alarm that Nigeria has the third-highest number of foreign doctors in the UK at the expense of Africa’s most populous country. This brain drain has automatically created a vacuum and dearth of doctors at variance with the World Health Organisation (WHO) recommendations that for any country to claim to have enough doctors for its population, it should have one doctor for every 600 persons. This means that at an estimated population of about 200 million, Nigeria needs over 330,000 medical doctors, but presently has about 35,000 and leaving a deficit of about 295,000 qualified doctors!
What this signifies is that the country has consistently failed to invest in its health sector because of poor incentive to do so and largely due to public officials’ crave for patronising foreign hospitals at taxpayers’ expense. The result has been the almost total neglect and the poor capacity of this critical sector to effectively tackle preventable diseases and provide quality health services. The WHO alludes to the fact that the country has very high infant and maternal mortality rates such that the risk of a woman dying in pregnancy or childbirth is high when compared to what is obtainable in developed nations where democratic institutions are strong and the provision of basic amenities can be taken for granted.
Without personalising issues and blaming the incumbent administration, our system should not be designed in such a way that public officials are not made to become a burden on state resources health-wise. As much as possible, only those that are fit and proper should be made to occupy public offices. The situation we have found ourselves in should be properly managed, hoping that it would serve as a learning curve for the future. The President should look inwards, resolve to prioritise health reforms, and set an example by visiting local hospitals as most of the ailments can be attended to in the country. The mindset that everything foreign is superior should be addressed. Once this is done, other public officers would naturally take a cue from that and things would fall in line provided that the political will is there to curb the practice.
Recall that in 2016, President Buhari gave an assurance that he would shun medical tourism when he said that the Federal Government would not provide funds to any government official travelling abroad for medical treatment unless the case cannot be handled in Nigeria, saying “While this administration will not deny anyone of his or her fundamental human rights, we will certainly not encourage expending Nigerian hard-earned resources on any government official seeking medical care abroad, when such can be handled in Nigeria”. Similarly, the Senate also issued a warning to State House officials that henceforth, Mr. President should stop embarking on foreign trips for medical attention. The Upper Legislative House had reasoned that rather than allow the President to seek medical attention overseas, the government should explore local alternatives. The House of Representatives equally made a move in this regard through the sponsorship of “A Bill for an Act to Amend the National Health Act, 2014 to Regulate International Trips for Medical Treatment by Public Officers, to Strengthen the Health Institutions for Efficient Service Delivery; and for Related Matters”, which passed through the second reading in the House, showing the willingness to salvage the ailing sector.
No doubt, Nigeria’s health sector has been plagued by a disturbing degree of deterioration traceable to past administrations notwithstanding the billions of naira expended on some tertiary hospitals, the challenge in the sector remains daunting. What we see are inadequacy of medical facilities, expensive cost of drugs, sub-standard medicine, weak work ethics, wrong diagnosis, high morbidity and mortality rates, and inadequate supervision by regulatory bodies. A timely move would involve the health stakeholders helping to operationalise the National Health Act 2014, to deal professionally with issues of clinical governance, medical education, diagnosis, research, and generally improving health care delivery.
Furthermore, there is the justification for improved funding in meeting WHO standards, timely and judicious use of funds, better planning of the healthcare system through private sector investment, the building of critical infrastructure, and the creation of the right and enabling environment for health services to thrive. Traditional and indigenous medicine practices should be encouraged in view of the perceived inability of orthodox medicine to address all the health needs of people. When carried, out this would go a long way in tapping into the numerous potentials that African medicine can offer. It is only hoped that relevant stakeholders would ponder over some of the points raised in this discourse and see why the growing quest for foreign medical tourism should be halted.
Kupoluyi writes from Federal University of Agriculture, Abeokuta (FUNAAB), Ogun State, @AdewaleKupoluyi
