The unending quest for medical tourism

President Muhammadu Buhari waves

Despite the growing criticism against foreign medical tourism by top government personnel, there seems not to be a way out of what has become a costly official indulgence. A few days ago, Nigerians staged a protest at the Nigeria House in London, the United Kingdom against President Muhammadu Buhari’s current medical trip to the country. The medical trip is 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 UK 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 another three days. Again, he returned to the UK on a medical vacation after which he wrote the National Assembly by seeking an extension of his medical leave and when he finally returned to Nigeria, he did not resume work immediately, saying that “he’s working from home”.

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. Brain-drain automatically creates a vacuum and dearth of doctors that are 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 working in the country today leaving a deficit of about 295,000 qualified doctors!

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. Without personalising issues, our system should not be designed in such a way that public officials are made not to become a burden on state resources health-wise and in terms of emoluments. 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 can still be remedied and should be properly managed to hope 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 patronising 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. In 2016, President Buhari gave a similar assurance when he said that the Federal Government would not provide funds to any government official to travel abroad for medical treatment unless the case cannot be handled in Nigeria. Similarly, the Senate once issued a warning to State House officials that henceforth, Mr. President should stop embarking on foreign trips for medical attention.The House of Representatives also made a move in this regard through the sponsorship of a bill to amend the National Health Act, 2014 to discourage medical tourism among public officers. No doubt, Nigeria’s health sector has been plagued by a disturbing degree of deterioration traceable to previous 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 drugs, 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, and research in line with global best practices.

Furthermore, there is the need 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 the people. This would go a long way in tapping into the numerous potentials that African medicine can offer. It is only hoped that all the relevant stakeholders would ponder over some of the points raised in this discourse to address the current challenge.

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