Despite the growing criticism against medical tourism by top government personnel to foreign countries, thereseems nottobeawayout of whathasbecome acostlyofficial 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, asthePresidentisexpectedtospendabouttwo weeksforthe‘shortrest’.
Thismedicaltripcanbesaid to be ill-timed on the premise that doctors, under the aegisof theNationalAssociationof ResidentDoctors (NARD) are on a nationwide strike to press home demandsforbetterwelfareandtheimperativeof fixing the nation’s deteriorating health system.
What makes the President’s case disturbing is thathehasallegedlyspentover200non-consecutive days on medical tourism in the United Kingdom alonesinceheassumedofficein2015andwithhuge 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 vacationafter whichhewrotetheNationalAssembly by seekingan extensionandwhenhefinallyreturned to Nigeria, he did not resume work immediately, saying that he was ‘working from home’. Thereafter, heembarkedonanothertriptoLondon 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 outof thecountryontheslightestmedicalissuedid not start under the present administration.
This waswhythe State HousePermanentSecretary wasseriouslyquestionedwhileappearingbeforeaSenatepanel, todefendthe2021budgetestimates, wherehe gave a budget of N19.7bnfor2021, outof whichN1.3bn wasproposedfortheStateHouseClinic.
ThePermanentSecretaryhadpromised toput necessaryarrangementsinplacetomeetthemedical needs of the President and other top public officers once the budget was approved. Not much has been heard in the public domainin this regard.
Asaresultof thehugefinanciallosstotheeconomy, theintentiontoinvoketheFreedomof InformationAct, 2011onhowmuchthePresidenthasspentonmedical travels has not yielded much fruits by concerned Nigerians, but it is estimated that medical tourism could drainover $1billionayearby leadingtodeficiency inthe FederalGovernment’shealthbudget.
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 thirdhighestnumberof foreigndoctorsintheUKatthe expense of Africa’s most populous country.
Thisbraindrainhasautomaticallycreatedavacuum and dearth of doctors at variance with the World HealthOrganisation(WHO) recommendationsthatfor anycountrytoclaimtohaveenoughdoctorsforitspopulation, itshouldhaveonedoctorforevery600persons.
This means that at an estimated population of about 200 million, Nigeria needs over 330,000 medicaldoctors, butpresentlyhasabout35,000and leaving a deficit of about 295,000 qualified doctors!
What this signifies is that the country has consistently failedto invest in its healthsector becauseof poor incentive to do so andlargelydue topublic officials’ crave forpatronisingforeignhospitalsattaxpayers’expense.
Theresulthasbeenthealmosttotalneglectand thepoorcapacityof thiscriticalsectortoeffectively tackle preventable diseases and provide quality health services.
TheWHOalludestothefactthatthecountryhasvery high infant and maternal mortality rates such that the riskof awomandyinginpregnancyorchildbirthishigh whencomparedtowhatisobtainableindevelopednations where democratic institutions are strong andthe provision of basicamenitiescanbetakenforgranted.
Without personalising issues and blaming the incumbentadministration, our system should not bedesignedinsuchawaythatpublicofficialsarenotmadeto 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 beattendedtointhecountry.
Themindsetthateverything foreign is superior should be addressed. Once thisis done, other publicofficerswould 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 abroadformedicaltreatmentunlessthecasecannot behandledinNigeria, saying“Whilethisadministration 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 equallymade a move in this regard through the sponsorship of “A Bill for an Act to Amend the National Health Act, 2014 toRegulateInternationalTripsforMedicalTreatment by PublicOfficers, toStrengthentheHealthInstitutions forEfficientServiceDelivery; andforRelatedMatters”, whichpassedthroughthesecondreadingintheHouse, 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, andinadequatesupervisionbyregulatorybodies.
A timely move would involve the health stakeholdershelping tooperationalisetheNationalHealth Act2014, todealprofessionally withissuesof clinical governance, medicaleducation, diagnosis, research, and generally improving health care delivery.
Furthermore, thereisthe justificationforimproved funding in meeting WHO standards, timely and judicious use of funds, better planning of the healthcare systemthroughprivatesectorinvestment, thebuilding of critical infrastructure, and the creation of the right andenablingenvironmentforhealthservicestothrive.
Traditional and indigenous medicine practices should be encouraged in view of the perceived inability of orthodoxmedicinetoaddressallthehealth 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