By Bimbola Oyesola
President Muhammadu Buhari came to power on May 29, 2015 on a magnetic change mantra.
His emergency at a time many had lost confidence in the way public resources were being wasted on foreign goods and services easily gave him away as the messiah who would rescue the country from its pathological profligacy.
The public sentiment from then, however, was that at least most of the nation’s prostrate infrastructures, including healthcare, power, transportation, among others, would be fixed as government stepped up campaigns like “Change Begins with Me”.
But as the saying goes, “old habits hardly die”; not much seem to have changed with respect to the tastes of Nigerian government functionaries, raising fears that the regime of capital flight through medical tourism may not end soon, despite its grave consequence for economic growth.
Unlike India under its iconic leader, Mahatma Ghandi, Nigerians appear largely unconvinced about the integrity of the nation’s medicare system, prompting continuous patronage of foreign medical facilities to the detriment of indigenous institutions and leaving huge foreign currency leakages within the economy. This was even as government voted a whopping N3.8 billion for Aso Rock clinic alone in 2017.
For instance, notwithstanding the limited application of capital controls by the Central Bank of Nigeria (CBN) to manage the nation’s lean foreign reserves after the crash of crude oil prices, the Nigeria Medical Association (NMA) observed recently that the country spent over $1 billion about (N490 billion) on overseas medical treatment and consultancies in 2014 alone. This figure is bound to increase in the days ahead as no concrete steps have been taken to improve health facilities in the country, while the appetite for foreign medicare is on the rise.
However, expectations that this figure would be reduced drastically with the cost-cutting policies of the President Buhari administration, quickly vanished when it was revealed in 2016 that high profile government functionaries have continued to consult Ear, Nose and Throat (ENT) specialists in the United Kingdom despite claims the country has enough ENT specialists looking for equipment to practice their trade locally to help government conserve resources.
Only recently, the Presidency rose in defence of Abba Kyari, the Chief of Staff (CoS) to President Buhari, stating that the Nigeria High Commission in London never paid his medical bills during a medical check-up in UK.
The clarification came after an online newspaper revealed that Nigerian Mission in London was made to pay Kyari’s medical bills.
According to the President of NMA, Prof. Michael Ogrima, at a recent presentation, the $1 billion on medicals overseas was in 2014 by less than one per cent of the nation’s population.
He had attributed this to the fact that Nigeria’s healthcare system remains poorly funded with about 3.5 per cent of the national budget as against 15 per cent recommended by the World Health Organisation (WHO) in 2016.
It was therefore not surprising that Buhari’s recent 10-day medical tour of the UK had generated so much debate over the last one week, despite the N3.8billion voted for so Rock Villa clinic in 2017 Budget, with some commentators querying the rationale behind the “change begins with me” slogan.
That an economy in recession can spend over $1 billion on medical tourism overseas annually calls for concern, some stakeholders argue.
More curious was the stunning revelation that 30 per cent of those who travel abroad for treatment died, with their family having to fly their corpses back with over N5 million.
But as part of efforts to address what they considered a national drain pipe, stakeholders from within and outside the country recently gathered at the Covenant University in Ota, Ogun State, to deliberate and proffer solution to the malaise.
At the one-day programme organised by Ace Medicare, Sango Ota, Ogun State, themed, “Reversing Medical Tourism: Strengthening Local Capabilities, and Encouraging Foreign Collaborations”, stakeholders identified outbound medical tourism as one of the greatest challenges and threats facing Nigeria’s economy and its healthcare industry.
According to the Medical Director of Medicare, an health institution in Sango Ota, Dr. Oluwole Kukoyi, the Federal Government’s decision to halt medical treatment abroad for government officials was a welcome development.
He stated that government’s various efforts at improving healthcare to mitigate foreign tourism through the Universal Health Care (NHIS), National Health Agenda (NHA), National Health Gazette (NHG) and the National Health Act, may be a job in futility without joint commitments from all the stakeholders.
He said, “these are part of a new focus in the ministry to stop medical tourism. Together, they are bound to fail without real commitment and desire to ensure that we can treat anyone and everyone, anywhere and everywhere, at the point of need, right here in Nigeria.
“Colleagues from Diaspora and organisations outside the country will also have to collaborate to achieve this important national task,” he said.
He called on the government to create the enabling environment for the Nigerian medical practitioners in the Diaspora to return home and also make Nigeria a medical destination.
“Other problems include lack of awareness on the facility on ground; some of those treatments our people are looking for outside Nigeria can be handled here, but for lack of awareness, where these facilities are. But in some cases, it is not because we don’t have the facility or personnel, but our people want to show class. So they rather go abroad for treatment, even for a simple ailment.”
Dr. Biodun Ogungbo, a neurosurgeon and advocate against medical tourism in Nigeria, corroborates the NMA President’s view on the fact that some Nigerians go abroad due to lack of awareness and probably for ego trip.
Ogungbo, a private medical practitioner in Abuja, said spine surgery, which cost over N7 million abroad could actually be handled in Abuja for barely N1.5 million.
“The NHA and all policies are quickly forgotten. For as long as each person feels his own life is more important than that of the collective, we cannot make progress. Secondly, the Ministers of Health and governors buy equipment for Nigerian hospitals and then keep them to rot in underground garages. Directors of health parastatals use money earmarked for health projects to travel to Dubai for shopping sprees and medical check-ups,” he lamented.
The Medical Director of Spine Fixed in Abuja (SFIA), added that Nigeria’s political leaders lack confidence in healthcare facilities established by them and prefer to go overseas for treatment. “Aside the lack of confidence in the health sector, former President of NMA, Dr. Osahon Enabulele, argued that the major reason for the medical pilgrimage includes persistent negligence and under-development of the health sector.
“Dr. Rilwanu Mohammed of the FCT Primary Health Care Board says that more than 210 primary healthcare centres exist in Abuja but only 30 per cent are actually operating. Let us fix the system. If we do that, things will work in this country, then nobody will travel overseas for treatment.”
But NMA Chairman in Ogun State, Dr. Anthony Dike, said there is need to impress it upon the body that the issue of advert should be modified, otherwise reversing medical tourism would be a mirage.
“If we are going to reverse medical tourism, then we should not shackle ourselves. We should provide information for those who need it, where to get good doctors and facilities,” he said.
But commenting on the nation’s huge foreign medical bills, Organised Private Sector (OPS) is concerned, medical tourism is a big waste and a drain pipe on the nation’s economy, more so when the scarce foreign exchange being wasted channeled into could have infrastructure development.
Though the Manufacturers Association of Nigeria (MAN)’s President, Dr. Frank Jacobs, could not hide the fact that it was a sheer waste of resources, as it is not adding any value to the economy.
“We have the manpower in the country, as far as I’m concerned. Whenever I’m sick, I try to seek solution at home. So I consider it a waste of economic resources. The big people are the ones benefiting from it, not the poor. There is no doubt that the money could have been invested to improve infrastructure in the economy to create jobs for citizens.
Similarly, the Director General of Lagos Chamber of Commerce and Industry (LCCI), Muda Yusuf, shared the thought of MAN’s President as he noted that the billion dollar being frittered away annually away could have gone a long way to rebuild the economy.
But according to the LCCI DG, there are other inconceivable areas that Nigeria is wasting dollars on, including importation of petroleum products, which he said gulps $10 billion annually.
“We should look at all areas we should have developed as a country. We have no business importing fuel, the same for medical tourism as we have the expertise here,” he said.
He, however, noted that the problem that could be responsible for Nigerians seeking treatment abroad is the poor state of health facilities, which he blames on government lethargy.
Yusuf lamented that even the private investors that would have bridged the facility gap are often discouraged by several government bottlenecks in form of policies and implementations.
He said, “the system does not inspire confidence, it is not only happening in health but also in education as you see those who can afford it take their children overseas to study. We have the expertise, but not the facility, no support from the government to the private sector, rather what you see is harassment and overbearing taxes.
“Government should support those investors that want to replicate what we have abroad. Like in India, government gave them land, tax rebates among other incentives, but here, it is harassment on taxation, registration and all sorts of problems. Government should give them incentives on land, tax waivers on equipment, drugs and tax holidays. We have lots of our practitioners abroad who want to return home but they are not being encouraged.”
The Director General of the Nigeria Employers Consultative Association (NECA), Olusegun Oshinowo, also noted the poor state of the nation’s social infrastructure as the major reason rich Nigerians prefer to go abroad for medical treatments.
Oshinowo believes that it is the failure on the part of government to provide universal healthcare coverage through effective National Health Insurance Scheme (NHIS).
“NHIS has to go back to the drawing board to give effects to the provision of health because people have to care for their lives and would go to any extent, it’s a pointer to the decadent state of our social infrastructure,” he said.
The NECA DG also agreed that the money could have contributed a lot to the economic development of the country if it had not gone out through medical tourism.
“But can we get government to provide social infrastructure that will guarantee good state of health for the citizens? The key thing is for government to do its part, after that, if anyone still wants to go abroad, then such should not be allowed access to government forex facility,” he said.