Today marks the beginning of Bola Tinubu’s presidency of Nigeria. The new administration faces a daunting set of challenges, compounded by a persistent lack of confidence and a volatile economy.
One of the problems that Nigerian politicians continue to fear is medical tourism or going abroad to get medical care. Nigerian elites spend huge sums of money on health care abroad, amounting to more than $7 billion between 2016 and 2022, according to the newspaper PUNCH.
This is a big problem for foreign medical centres, some of which have teams committed to foreign marketing and hospitality, arranging transport and language services. Others work with medical tourism agencies to facilitate referrals.
The industry can also be lucrative for medical tourism facilitators in Nigeria. These could possibly be doctors or other agents who refer prosperous clients to overseas healthcare providers and receive a commission. Ethics can be murky.
Olusesan Makinde, managing partner of Viable Knowledge Masters, a fitness and progress consultancy, believes that “there is a high potential for abuse” in the system. It says doctors have a moral and legal responsibility not to promote medical tourism services. This can lead to “doctor-induced demand” for unnecessary services, as well as a mismatch between what is promoted in glossy foreign campaigns and the actual quality of services.
Nigeria’s outgoing President Muhammadu Buhari toasts new President Bola Tinubu in 2018. (PhotoArray. . [] via Stefan Heunis)
Common destinations for Nigerian medical tourists are India and the United Kingdom. According to one estimate, 30,000 Nigerians went for orthopedic, cardiac and other surgeries in 2019.
Some tragic cases of surgeries involving Nigerian medical tourists have become foreign news. In 2005, Nigeria’s former first lady, Stella Obasanjo, died suddenly in Spain from a liposuction procedure in which a tube was mistakenly inserted into her abdominal cavity, perforating her colon. Four years later, the plastic surgeon was convicted of negligent homicide.
Kidney transplant operations are also performed on Nigerians abroad. In an infamous 2023 case, Nigerian Senator Ike Ekweremadu, his wife Beatrice, and doctor Obinna Obeta were found guilty of conspiracy to traffic a 21-year-old street vendor from Lagos to the United Kingdom in order to harvest his kidney and transplant it to the United Kingdom. The couple’s daughter has health problems. The victim was able to flee after learning the main points of the plot.
Dr Obeta, who took in the victim, arranged the transplant through a medical tourism company charging £10,000. He ran a personal hospital in Nigeria and had already won a kidney transplant in London. Obeta said he was concerned that the transplant of Ekweremadus daughter would be performed in Nigeria or India, due to the higher mortality rate of the procedure.
These are excessive cases, but they highlight a link between the families of Nigerian politicians and medical tourism. It’s hard to blame other people with enough resources for opting for more care. As Chidiogo Akunyili-Parr writes in I Am Because We Are: An African Mother’s Fight for the Soul of a Nation: “Performing surgery to remove the tumor in Nigeria, unlike a country with larger medical facilities, was not desirable for anyone who had a choice. The author’s mother, the respected Dora Akunyili, a drug regulator, won a cancer remedy in the United States and India.
In one incident in 2014, family members even woke up India’s ambassador to Nigeria to temporarily unload a visa for emergency travel. The holidays turned out to be disappointing. The hospital in Bangalore was filthy and questionable; She had been promised treatment, but the family learned it was only chemotherapy.
Of course, the vast majority of Nigerians don’t have the resources to travel abroad or pay for personal health care costs in some other country (let alone a contact with the Indian embassy or access to a personal jet). other people and politicians is very big,” says Makinde. The gap in life expectancy between Nigeria and other countries with lower-middle-level income sources is also significant. According to the World Bank, Nigeria has a life expectancy of just 53 years, compared to 60 years for its neighbors, Cameroon and Benin.
Since Akunyili’s tenure, medical tourism has remained commonplace among Nigerian politicians. Some critics have referred to outgoing President Muhammadu Buhari as the leader in medical tourism, due to his unprecedented trips abroad for medical and dental care. These trips continued into the final. de his presidency, particularly for the treatment of toothaches in the United Kingdom after a coronation visit. Their voyages are estimated to have amounted to a whopping 5. 4 billion naira ($9. 95 million). However, it is highly unlikely that the precise expenses of medical tourism will be known. of Nigerian politicians, as they are not made public.
Although the exact amounts are known, the estimates are sufficient to show that significant government resources are enriching overseas personal health care providers. Makinde believes this represents a waste of public funds, in valuable foreign currency, that would be better channeled to support Nigeria’s suffering. system.
“A lot of fitness centers in Nigeria don’t even have electricity,” Makinde says. In Nigeria, amid a still-unstable power source, reports suggest that medical staff are using flashlights or even candles to work.
Politicians who don’t have to be exposed to the weaknesses of local fitness services don’t face as much pressure to reform them. Another challenge is that other treated people may introduce new microorganisms into their countries of origin, thus compromising the fitness of others. Of course, tracking down medical tourists is a challenge once they are thousands of miles away from where they got treatment.
Surgery at a hospital in Maiduguri, northeastern Nigeria. (Photo via Audu Marte)
Some politicians have proposed piecemeal solutions. Investments in technology and high-end medical services are common. Beating first lady Aisha Buhari said her husband’s long stay in a London hospital in 2017 led to the concept for the newly opened presidential wing of the State House Medical Center. She didn’t need it. circle of relatives to go to a public hospital.
Nigeria is also building its first cancer hospital, and other complex facilities are being planned thanks to Nigeria’s oil wealth. These new facilities would disproportionately benefit the wealthy, who are, of course, the ones who can do medical tourism. In general, decrease physical attention. Prices get advantages for many more and are more cost-effective, but basic care isn’t the kind that will lead to an impressive ribbon cutting.
In any case, without enough specialized personnel, this infrastructure, impressive as it is, will not be used. And unfortunately, medical personnel have left Nigeria in gigantic numbers, due to low salaries and poor operating conditions. It is ironic that Nigerian elites leave the country to seek medical care abroad, where they are cared for by Nigerian migrant personnel. The main challenge is not the shortage of Nigerian medical talent.
In fact, a proposal to stop the departure of Nigerian medical students has sparked a furious controversy. A bill introduced by a Lagos lawmaker would require medical and dental professionals, trained in public institutions, to practice in Nigeria for five years before obtaining full licenses that would allow them to move abroad.
The bill has sparked an angry reaction, adding an argument for banning politicians from traveling abroad for medical purposes for five years, rather than penalizing medical staff. The president of the Nigerian Medical Residents Association, Emeka Orji, commented on the conflict: “What medical tourism promotes is because politicians and the rich are not in our healthcare system. So they decide to leave the country and that’s why they haven’t been able to bring the hospitals up to foreign standards. If we all used the same fitness facility, the scenario would have been better.
“I feel like it’s not fair,” said Michael Sotomi, a third-year medical student at the University of Lagos. “Five years is a long time. ” If the law had existed at the time I was considering where to study medicine, I may have attended a private university in Nigeria or studied in Ghana.
“The main explanation for why other people leave is the negative state of the economy,” Sotomi says. If the situation improves, he could choose to re-specialise and practice surgery in Nigeria rather than dream of moving to Scotland.
Makinde, who was a medical student about 25 years ago, remembers a very different situation. So, medical tourists came from other West African countries to seek treatment in Nigeria. The Saudi royal family even gained attention in Nigeria in the 1970s. .
Making Nigeria a destination that is not a source of medical tourists would require innovations in the economy and electrification, as well as increased fitness facilities and more specialized care. But one of the biggest adjustments needed would be a style of greater responsibility to the public, according to Makindé.
This is precisely what other people are asking of Tinubu when he takes office. Some have called on him to end medical tourism. Tinubu’s recent trips to get follow-up medical care in France confirm that it will be difficult to set an example For other Nigerian politicians, such an example would be a useful component of an ambitious overall fitness program in Nigeria.