By Obinna Emelike
In 2023, a Nigerian journalist fell sick while covering an assignment in Gaborone, capital city of Botswana.
He was admitted in a hospital and was given quality treatment without health insurance or probing his visa status and other likely impediments to treatment.
But the exciting story is that it was one doctor Dike Ogbueshi, from Ogwashi-Uku in Delta State, that offered the quick and quality treatment.
The Gaborone-based doctor is among the many health professionals who are flying high the country’s flag abroad.
In the United Kingdom, Nigerian-trained doctors are everywhere, with many patients referring to them as the best in UK hospitals after Indian doctors.
“I schooled at University of Benin and had great lecturers, even now. Our medical colleges are good; the hospitals and welfare are the issues. They are ill-equipped, less maintained and renumeration is a great disincentive for ambitious medical professionals. Apart from passion to save lives, they have families and bills to pay,” Dike decried.
Sadly, the ill-equipped hospitals and not expertise, is the reason Nigeria spends over $USD2 billion annually on medical tourism.
Also, a report from the Central Bank of Nigeria indicated that Nigerians spent approximately $USD2.39 million on foreign healthcare services from January to September 2024, although the amount for the first nine months of 2023 was higher at $3.45 million, according to newspapers’ reports.
The Nigerian Medical Association (NMA), which is sadly battling with brain drain, is even more worried about the ugly trend that embarrasses its professionals.
In his submission at the association’s Healthcare & Medical Expo, titled: ‘Enhancing sustainability and efficiency in Nigeria’s private health sector in the quest to reverse medical tourism,’ Bala Audu, a professor and president of NMA, regretted that globally, the healthcare industry is worth over $12 trillion, expanding to $18 trillion by 2028, with Nigeria having a measly $6 billion of the share.
The measly share is due to the growing medical tourism trend, brain drain and importation of virtually every medical material, especially drugs that can be manufactured in the country.
Sadly, the staggering amount of money paid as a result of medical tourism, which translates to huge capital flight, amid mounting foreign exchange challenges, is despite having over 48 universities offering medical education in medicine, surgery, nursing, and other allied disciplines. Moreover, there are over 400 schools and colleges of nursing, and institutions offering specialised training in various aspects of medical technology.
According to Samuel Maduka Onyishi, founder/chancellor, Maduka University, Enugu, Nigeria spent over diff $USD2.39 billion on medical tourism in 2024.
For those who argue that the huge amount quoted is not correct, apart from consultancy fees and cost of treatment, a single night at a hospital in London costs from £600 to £800, while up to £2000 is paid for same in a high-end private hospital.
In France, Germany, United States of America, India and even Saudi Arabia, the average single night is from $USD1000.
Bearing the high cost in mind, how much Nigerians, especially the elite spend for medical treatment in foreign hospitals, and the negative impact on foreign exchange, and the economy generally, many are worried that little or nothing has been done to reverse the negative trend.
A case in hand is the recent death of Muhammadu Buhari, the immediate past president of Nigeria, in a London hospital, and the admission of Abdulsalami Abubakar, another former leader, in the same hospital.
Sule Adoga, an economist and public commentator, decried that it is a shame that Nigerian elite keep visiting foreign hospitals, especially in the UK, and sadly, dying there despite the so-called high-end medical facilities and doctors trained in the moon.
“Where is national pride? Can a UK prime minister, French or US president go outside their countries for medical treatment? No, they cannot because it means debranding their countries’ image. This is an image thing and that is why they don’t take us seriously,” he said.
Speaking further, he noted that Nigerian elite are still caged in the colonial mentality of everything black is inferior and all whites are superior, including all UK hospitals, no matter how small or ill-equipped.
“I don’t see independence and sovereignty here because we take our presidential campaigns to Chartham House in London. Can we for once take charge of our affairs, develop country pride like Americans, patronise our own and improve on facilities that are lacking? The entire country is a laughing stock in the international community because we cannot provide for ourselves, even the least things like toothpicks,” Adoga lamented.
On her part, Suzzy Elekwute, a trained surgeon, argued that the facilities visited overseas on medical tourism can be acquired and installed here for the exclusive use of the elite, if the poor cannot afford them.
The Ikwerre-born doctor, who consults for many hospitals, queried the essence of the several upgrades of equipment at Aso Rock clinic, National Hospital Abuja and others, yet government officials, cannot use the facilities, even when it is free of charge.
“Every year, Ministry of Health gets huge budget, on regular basis, government agencies claim to refurbish and equip many health facilities across the country, even private and public organisations like NLNG, NNPCL, Chevron, NDDC, and others, keep commissioning health facilities built and donated to communities or to the government, what happens afterwards, are they toy facilities or scam?
We doctors are saying show us quality facilities that will keep us here and pay us well,” she said.
But Adewale Olatunbosun, a university don, blame the ugly trend on the lifestyle of an average Nigerian.
“Those who are criticising the elite for patronising foreign hospitals will do same the moment small money enters their hand,” Olatunbosun said.
According to him, Nigerians have a bad lifestyle and visiting foreign hospitals for treatment has always been a status symbol thing in the country, despite the huge cost and stress.
“My secondary school mate proudly announced on our old boys’ platform on WhatsApp that his father died in a London hospital. See, many Nigerians want to die while on pilgrimage in Jerusalem or Mecca as if that will take them to their heaven. Someone in my Master’s class at Unilag used to recall (as if it was an achievement) how the parents died in a British Airways crash. I used to rebuke her, insisting that plane crash is not something to wish, even to an enemy.
“Some people put it in their will to be buried in Mecca. Why do we prefer everything foreign to our own, which is far better. More are going to die in foreign hospitals because it is status symbol now,” the academic said.
Apart from status symbol, Chijioke Umelahi, a lawyer and one-time Abia lawmaker, noted that most members of the elite group prefer foreign hospital because nobody knows them there, especially the corrupt, while others who do not want to disclose their ailments seek succour in such hospitals.
“When I was in the House of Assembly, most of my colleagues fly out for medical checks even for common ailment that paracetamol can cure. I did not follow them, not because my wife is a doctor, but for the fact that it is just for status symbol and when they lose their seats in the house, they cannot afford such expensive medical trips,” Umelahi said.
But Elekwute, whose over 15 mates from the University of Ibadan 1992 medical school set are practising in the UK, Australia and US, noted that the same doctors who the elite would not want to treat them in Nigeria are still the ones that give them so-called quality treatment in foreign hospitals.
“This is the height of hypocrisy. You distaste government and private hospitals nearby for the reason that the ‘small doctors’ are products of ASUU strike, hence, they are not professional enough. Yet, you depend on them to live in a London hospital. What has really changed, because they are the same doctors trained in Nigerian schools. We need to rethink our values and change our lifestyle,” she admonished.
Offering solutions, Elekwute noted that the country has enough money to build two world class hospitals in every geopolitical zone that will rival the best in the UK and America.
“Let Mr. President get serious with the emergency situation in the health sector. Instead of sharing the subsidy money to the governors, who will divert them, President Tinubu should build 12 world class hospitals, two for each geopolitical zone, and pay medical personal well enough to deliver and not to run away to a London or Paris hospital.
He should do that with the passion he is using in building the Lagos-Calabar Coastal Road. Yes,” Elekwute said.
The NMA suggested that the adoption of public-private partnership in the health sector will enhance sustainability, efficiency and help to reverse the trend, especially as Nigeria is the leading exporter of health professionals globally.
“Part of our recommendations is the need for the government to review the remuneration of health workers, put in place workplace security, as well as equipment that will enable doctors to function most effectively,” the NMA president urged.
For Onyishi, there is urgent need to develop medical entrepreneurship sector in order to boost local manufacturing of drugs and medical equipment to curb the huge amount the country spends annually on importation of medical supplies and consumables.
Adoga suggested that the government should ban its officials from embarking on medical tourism in foreign hospitals, while the Economic and Financial Crime Commission (EFCC), should probe sources of funds leaving the country for medical tourism.
“If the Aso Rock clinic is not good enough, close it; if the National Hospital Abuja does not have enough bed space, build more on the expansive hospital land. Point people to upgraded facilities across the country, where they can get quality treatment and save the huge financial toll of visiting foreign hospitals on patients and the consequent erosion of foreign reserves,” Adoga said.
For Benjamin Olowojebutu, first vice president, NMA, it is not all about bad news, as he pointed out some feats to lure potential medical tourism patients back home.
“We have a hospital that does 16 kidney transplants every month. We have a hospital that can do cardiovascular surgery in a few hours. We have a hospital coming from Niger, from Mali, to see what we do,” he noted.
For many concerned people, the country needs more quality facilities like the ones pointed out by Olowojebutu. But they must not be government facilities, hence PPP arrangement is suggested to close the huge gap in quality health facility offerings and to also curb the huge medical tourism trend that is impacting negatively on Nigeria’s image and economy.
* Business Day