Dr. G.C Okara;Stop public funding of foreign medical trips

Quoting a recent study, the President of the Association of Medical Laboratory Scientists of Nigeria, Godswill Okara, said Nigeria constituted over 20 per cent of foreign patients seeking medical treatment in India. Okara also noted that the 2011 Mo Ibrahim African Governance Index ranked Nigeria’s health care system 51st out of 53 countries in Africa. This, though hardly surprising, is unfortunate.

The current reported hospitalisation of Mrs Patience Jonathan in Germany typifies the state of our health care system. Despite the billions of naira the Presidency budgeted to provide facilities at the State House Medical Centre, Abuja, the president’s wife could still not be treated in Nigeria for whatever ailment she is suffering from. And hers is not the first. The wife of former President Olusegun Obasanjo, Stella, died in a Spanish hospital where she had reportedly gone to undergo plastic surgery.

A few years ago, Vice-President, Atiku Abubakar, travelled abroad to be treated of a knee injury. Senate President, David Mark, went to Israel earlier this year to treat his aching teeth and an eye. Former dictator, Ibrahim Babangida, once sought medical treatment in a French hospital while his wife died in an American hospital a few years ago. And ex-President Umaru Yar’Adua alternated between German and Saudi Arabian hospitals. He later died at home in spite of his frequent foreign medical trips. In and out of government, Nigeria’s elite utilise public funds for medical treatment abroad. Yet, the cost of treating a broken leg in the United States can run up to $20,000. This is absurd.

This rush for overseas medical treatment shows lack of confidence in our health care system. It is also an official confirmation that our best medical centres are not better than consulting clinics elsewhere. The sad truth is that, for our politicians, seeking medical care abroad is about getting the very best treatment that is available anywhere and is inherently a selfish pursuit. Some of our hospitals sometimes give wrong diagnosis. Some prescribe drugs without conducting thorough investigations. Perhaps, the late popular Lagos lawyer, Gani Fawehinmi, might have been alive today if the cancer that killed him was diagnosed early enough. Nigerian hospitals diagnosed something else until he went to a London hospital that rightly diagnosed cancer.

This was why one military regime described our hospitals as “mere consulting clinics”. Patients can wait for days at our teaching and general hospitals without being attended to. Major drugs are hardly available and the environment of some of them is usually not conducive. Aside from this, there are some politicians and government officials who simply see going to foreign hospitals as a status symbol. Ironically, these same government officials are the architects of the downturn in the nation’s health care system. Facilities are either haphazardly provided or not provided at all. Sometimes, when funds are released for projects, they are embezzled.

Indians have capitalised on this craze by wealthy Nigerians for foreign medical tourism to scout for patients from Nigeria. Sometimes, they advertise what they have on offer and even liaise with some doctors in Nigeria to refer patients to Indian hospitals. The doctors reportedly make between 10 and 15 per cent of what the patients pay. But foreign medical treatment is not without its downside. Experts warn that in some countries, there may be a risk of transmission of HIV, hepatitis B and hepatitis C during medical procedures.

The implication is that we help to build those foreign hospitals while stunting the growth of our own. It is immoral to use taxpayers’ money to send political office-holders abroad for medical treatment while the poor continue to die in droves due to lack of good and adequate medical facilities. Infant and maternal mortality rates in the country rank among the highest in the world. Available statistics indicate that the maternal mortality ratio in the country is 545 per 100, 000 live births. A recent United Nations report indicates that half of all under-five deaths in the world occur in Nigeria, India, Democratic Republic of Congo, Pakistan and China.

Public officials need to set an example for the rest of the population by seeking treatment at domestic health facilities. Nelson Mandela’s health issues, for instance, have always been handled mainly in South Africa, not outside the country. The Minister of Health, Onyebuchi Chukwu, had said in April this year that he was preparing a memo for the Federal Executive Council to forbid foreign medical trips by government officials for ailments that could easily be treated in Nigeria. Such an initiative is long overdue.

What is certain though is that we cannot develop our health institutions by travelling abroad for every minor ailment. Nigeria reportedly spends about $200 million annually on overseas medical tourism. This has to stop. Whoever wishes to go on medical treatment abroad should be able to foot the bill without having recourse to public funds. The National Assembly should enact a law to check this type of abuse by those in government.

Most of what takes Nigerians out of the country is cancer, heart or kidney ailments. Why can’t we build and maintain specialist hospitals that could handle these cases and save Nigerians the trouble of going abroad for treatment? Medical facilities in some developing countries, including India, Malaysia, South Korea, Costa Rica and Thailand, have not only caught up with western standards, but have also, in some ways, exceeded them in affordable medical care. Malaysia had almost 600,000 medical tourists last year while South Korea had more than 100,000.

There is the need to increase the budgetary allocation to the health sector; review and implement the National Health Insurance Scheme to ensure that all citizens enjoy good health care; conduct regular audit and accreditation of hospitals; train and retrain medical personnel to ensure optimum performance.