How government can help stop medical tourism

Medical tourism, a term used to describe trips abroad for medical treatment is a phenomenon that has plagued Nigeria for years.

This phenomenon has been exacerbated over the years by the neglect of the nation’s health sector by successive governments. 

Due to decades of neglect, the nation’s health system became so poor to the extent that hospitals at primary, secondary and tertiary levels could not provide the care that patients need.

The problems of the health sector have been multidimensional. Aside from decay in infrastructure, lack of needed equipment and absence of basic health commodities in the hospitals, years of incessant brain-drain also led to the loss of many experienced health experts to hospitals in Europe, America and even Asia.

Consequently, many Nigerians who could afford it embrace medical tourism whenever they need to access healthcare.

Aside affluent private individuals, many top government officials, in successive administrations, also embraced travelling abroad for treatment of all kinds of health conditions.

These are conditions that the government they are part of ought to ensure the nation’s health facilities can treat. 

Unfortunately, this trend has continued even in this present government of Nigeria.

A few days back, news filtered in that Aisha, wife of the President, Major General Muhammadu Buhari (retd.), was flown to Dubai in the United Arab Emirates, for urgent medical treatment due to persistent neck pain.

That this was happening at a time Nigerians feel lessons would have been learnt from the nations experience so far from the COVID-19 pandemic and plans made to revamp the health sector is a sad commentary for the nation.

For many pundits, constant medical trips abroad by the President, his family members and top government officials is an indictment on the government for failing to turn around the fortune of the health sector even after six years in charge.

It must be stated that the nation’s health sector is still in doldrums and the proof of how bad things are could be seen from the poor health indices and the ranking of Nigeria by international bodies. 

For instance, the World Health Organisation ranked Nigeria 187 out of 191 countries in the world’s health systems.

Sadly, even neighbouring countries such as Ghana, Togo, Niger, Mali, and Chad ranked better than Nigeria in health care delivery.

That was and still is the reason the number of Nigerians, (both government officials and private individuals), travelling abroad for treatment continued to increase until the outbreak of COVID-19.

However, the novel coronavirus has shown that Nigeria, like all nations, must stop depending on other countries for the healthcare needs of its citizens.

The viral pandemic forced many Nigerians, including top government functionaries and public figures to patronise local hospitals as they have no option due to flight restriction.

While Nigeria has lost a few public personalities to COVID-19 related complications and other conditions, the fact is that the beleaguered health sector has managed to provide care for millions of Nigerians in this trying period. 

The implication of this is that with the right investment in health infrastructure and appropriate welfare package for health workers, the Nigerian health system can be strengthened to provide the top-notch care Nigerians travel abroad for.

Since the inception of his administration, President Buhari has been accused of not delivering on one of the promises he made during his 2015 campaign, which is, prohibiting government officials from embarking on medical tourism.

Between 2015 and 2019, Buhari spent at least 217 days in the United Kingdom, mostly on health grounds, and for meetings of the Commonwealth Heads of State and Government.

Yet, the President, who continues to access medical treatment in the UK, urged Nigerians to stop travelling abroad for medical treatment.

It could be recalled that the president reiterated his opposition to medical tourism while inaugurating the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State capital, in 2011.   

“Nigerians have suffered so much going abroad for medical treatment. This is not good for us and it must stop because we can’t afford it again,” he said.

 Buhari, who was represented at the event by the Minister of Science and Technology, Dr. Ogbonnaya Onu, said, “We have paid very serious attention to the health of our people and will continue to do so.

In an academic paper entitled, ‘Medical Tourism in Nigeria: Challenges and Remedies to Health Care System Development,’ sociologists at the Department of Sociology, University of Ilorin, Kwara State, noted that medical tourism was fast becoming a culture among many Nigerians due to the deplorable state of the nation’s health care system.

“Every month, almost 5,000 people leave the country for various forms of treatment abroad when such treatment should have been carried out in Nigeria,” the researchers stated.

The sociologists, Mohammed Abubakar, Salawu Basiru, Joseph Oluyemi, Raji Abdulateef and Emmanuel Atolagbe, noted, “About $1.2bn is lost to medical tourism yearly in Nigeria, which could have been invested in the development of the country’s health care system and the country as a whole.”

According to Researchgate, when Nigeria’s population was estimated at 180 million, the country lost $1.35bn to medical tourism annually.

It notes that an average of 9,000 medical tours occurs monthly from Nigeria to other countries. 

“India is a major destination with an average of 500 visits monthly and affordable treatment in modern medicine and specialities. 

“The average growth rate of medical tourism in Nigeria is 20 per cent annually. 

“In 2013, a total of 34,522 Nigerian tourists visited India, out of which 15,328

(42.4 per cent) were medical tourists.

“An estimated 700 Nigerian doctors move to Europe annually,” it stated.

According to a Price Waterhouse Coopers 2016 report, Nigerians spend $1bn annually on medical tourism, with 60 per cent of it on four key specialities namely: oncology, orthopaedics, nephrology and cardiology.

“This is nearly 20 per cent of the total government spending on the public health sector for the year, including salaries of all public sector doctors, nurses and other healthcare workers as well as other health programmes like malaria, tuberculosis, polio and HIV/AIDS prevention as total government expenditure on the health sector for the year 2015, which stood at $5.85bn,” it stated.

As emphasised, one factor encouraging medical tourism from Nigeria is the poor state of the healthcare system. This coupled with poor government expenditure on healthcare must be addressed to bring the health sector out of the doldrums.

Infrastructural decay which is replicated in practically all health facilities across the country must equally be addressed. 

This is perhaps the time to declare a state of emergency to transform the nation’s health facilities to bring them up to speed with the 21st century.

A couple of weeks back, about 58 doctors were stopped from travelling to the United Kingdom for mouthwatering job offers. 

Faced with no tools to work with, lack of job satisfaction, poor welfare package, unfriendly and unhealthy work environment, they opted for a place where they believed that their services would be better appreciated.

This is, therefore, time for the government to champion the complete overhaul of the health sector by instituting and implementing the necessary reforms to transform the sector. 

It must be emphasised that the task at hand is not insurmountable. What has been lacking over the years is the political will to do what is needed.

President Buhari must provide the political will needed to transform the health sector. If the Federal Government lead the way in this onerous task to make the health sector better, governments at state and local government will surely follow that lead.  

It is also fundamental for president Buhari to start leading by example by ‘walking the talk’. He needs to start shunning medical tourism with members of his family. 

If the President can do this and if he also succeeded in implementing the necessary reforms that make quality and affordable healthcare services in the country possible for Nigerians, his administration would have taken a giant step towards ending the unacceptable phenomenon of medical tourism. 

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