Despite allocating huge resources to the health sector, Nigerian leaders and politicians have continued their mistrust for the sector by abandoning it to rot, while flying abroad to treat the commonest of ailments at taxpayers’ expense in what stakeholders have described as medical tourism.
The health sector, like other major sectors in the country, has continued to suffer ups and downs, including industrial actions, low funding and low access to basic healthcare facilities among poor Nigerians.
The Nigeria Association of Resident Doctors, the umbrella body of doctors undergoing residency, announced the commencement of a five-day warning strike on Wednesday, May 17, 2023.
The strike, which has grounded activities in government-owned hospitals and health facilities, has left poor citizens, who cannot afford treatment in private health facilities, stranded.
This is not the first time doctors and other categories of health workers will embark on strike in the life of the regime of the President, Major General Muhammadu Buhari (retd).
In 2016, NARD, under the leadership of the then National President, Dr Muhammad Askira, embarked on an 18-day strike.
In 2017, the association, under the leadership of Dr John Onyebueze, again went on strike. The strike, which commenced on September 4, was suspended on September 17.
In 2020, NARD members, under the leadership of Dr Aliyu Sokomba, again embarked on a one-week nationwide strike on June 15 over the disengagement of 26 resident doctors at the Jos University Teaching Hospital, salary cuts and issues surrounding the Medical Residency Training Fund. The strike was eventually called off on June 22.
A year later, NARD initially embarked on a 10-day strike from April 1 to 10, 2021. Later in July of the same year, the association proceeded on a 60-day strike.
While the strikes persist, Buhari and his wife, Aisha, and their son, as well as the incoming President, Bola Tinubu; and the consensus candidate of the All Progressives Congress to become the Senate President in the 10th National Assembly, Godswill Akpabio, among other prominent politicians, continue to enjoy seamless healthcare in hospitals abroad.
Some of the benefiting countries of medical tourism by Nigerian politicians include the United Kingdom, the United States of America, France and India.
Though the amount spent by the politicians on medical tourism could not be obtained by our correspondent as of the time of filing this report, the Nigerian Sovereign Investment Authority in 2021 said citizens spend an average of $1bn annually on medical tourism for a range of healthcare needs across four key specialities of oncology, orthopaedics, nephrology and cardiology.
In May 2019, Sergius Ose Ogun, a member of the House of Representatives, sponsored a bill seeking to prevent public officials from seeking medical treatment abroad. The bill sought to amend Section 46 of the National Health Act thus: “(1) A public officer of the Federal Government shall not embark on medical trip abroad without approval; or be sponsored for medical check-up, investigation; or treatment abroad at public expenses except in exceptional cases on the recommendation and referral by the medical board and which recommendation or referral shall be duly approved by the minister or commissioner as the case may be; or embark on medical trip abroad unless he satisfactorily proves to the office where the officer is working, that such ailment cannot be treated in Nigeria.”
Buhari’s family trips
Before he was sworn in as President eight years ago, Buhari, whose mantra was ‘Change’, visited the Chatham House in London in 2015, where he said, “What is the difference between me and those who elected us to represent them? Absolutely nothing! Why should a Nigerian President not fly with other Nigerian public? Why do I need to embark on foreign trip as a president with a huge crowd with public funds? Why do I need to go for foreign medical trip if we cannot make our hospitals functional? Why do we need to send our children to school abroad if we cannot develop our universities to compete with foreign ones?”
Eight months after assuming office in February 2016, Buhari embarked on a medical trip to the UK, where he spent a total of six days.
In April 2016, months after his first medical trip to London, Buhari condemned the use of Nigerian resources for international medical expenses.
Amidst criticisms, the retired general embarked on his second medical trip on June 6, 2016. He spent 10 days treating an undisclosed ear infection, after which he rested for three extra days before returning to Abuja on June 19, 2016 despite the availability of the National Ear Centre in the country.
On January 19, 2017, the President embarked on his second longest medical trip. Before leaving, however, he wrote to the Bukola Saraki-led Senate revealing his plan to travel to London for a 10-day vacation.
In the letter, Buhari said he would hand over to his deputy, Prof Yemi Osinbajo. Though the medical holiday was due to commence on January 23, 2017, the President left Abuja the same day.
He returned to Abuja on March 10, 2017, after spending 50 days away.
In May of the same year, barely two months after his last trip, the President departed for London for his longest medical pilgrimage lasting 104 days.
It is still unclear what ailment he was being treated for, but Nigerians were asked to “pray” for the President.
What followed were speculations and misinformation about his health status, with some presuming him dead and replaced with a body double.
The long treatment must have helped as the President would not visit London for another medical check-up until a year later in May 2018 when he spent four days on “medical review.”
In late March 2021, Buhari departed for London again for a “routine medical check-up” that lasted 15 days.
His trip came amid a labour crisis in the health sector, which saw members of NARD embarking on an indefinite strike over unpaid allowances.
On March 6, 2022, the President jetted out to London again for a medical trip, which lasted 12 days.
Earlier, Buhari was scheduled to visit London from Nairobi, Kenya, where he was attending the United Nations Environmental Programme at 50.
He, however, returned to Nigeria on Friday March 4, 2022 but departed for London two days later.
The President’s Special Adviser on Media and Publicity, Mr Femi Adesina, had announced that Buhari would proceed to London from Kenya for “routine medical checks that will last for a maximum of two weeks.”
On October 31, 2022, the President departed Owerri, the Imo State capital, for London for another medical check-up lasting about two weeks and returned to the country on November 13, 2022.
The President’s spokesman had, times without number, defended Buhari’s medical trips abroad, saying he “has used the same medical team for about 40 years.”
Recently, the Presidency noted again that Buhari visited a hospital abroad to take care of his tooth.
The President is not alone in medical tourism as his wife, Aisha, was flown to Dubai in August 2020 over a “persistent neck pain.”
Similarly, their son, Yusuf, was in 2018 flown abroad for treatment after he was involved in a power bike accident.
In August 2020, Buhari’s nephew, Mamman Daura, was also flown to the UK for medical treatment.
The President-elect, Bola Tinubu, is no stranger to medical tourism.
The former Lagos State governor spent a total of 90 days in the UK in 2021 following a knee surgery.
The presidential candidate of the Peoples Democratic Party in the last election, Atiku Abubakar, was flown to Dubai, United Arab Emirates, in December 2015.
Similarly in October 22, 2023, Atiku also jetted out to France for what was simply tagged “medicals.”
Earlier, the former vice-president in December 2022 noted that the limitations in the healthcare system at home would not allow him to patronise hospitals in the country.
In June 2022, former governor of Ekiti State, Ayodele Fayose, was flown to an undisclosed hospital abroad for back surgery.
The outgoing Minister of Education, Adamu Adamu, in 2020 was flown to Berlin, Germany, for treatment. He has undertaken multiple medical trips abroad since then.
Akpabio, in a letter sent to the Economic and Financial Crimes Commission on March 27, 2023, disclosed that he did not honour the anti-graft agency’s invitation because he was undergoing medical treatment abroad.
In September 2015, Akpabio, who was the then Senate Minority Leader, travelled abroad for medical treatment after sustaining injuries in a car crash.
In March 2022, the Governor of Yobe state, Mai Mala Buni, returned from a medical trip to the United Kingdom.
In August 2020, a former military dictator, Abdulsalam Abubakar, returned to the country after spending about three months abroad for medical treatment.
The Nigerian Army in April 2018 announced that seven of its men, who sustained injuries fighting Boko Haram, were flown to India for proper care.
In June 2018, the senator representing Ekiti Central Senatorial District of Ekiti State, Opeyemi Bamidele, was flown to the UK for treatment in a private jet belonging to Tinubu.
Bamidele and five others were shot at a reception rally organised for the All Progressives Congress candidate.
In November 2017, the Presidency announced that Buhari approved an immediate overseas medical treatment for former Vice-President, Alex Ekueme.
In August 2016, the Senior Special Assistant to the President on Economic Matters deployed to the Vice-President’s office, Ayodele Adu, died in an Indian hospital.
A former governor of Ekiti State, Dr Kayode Fayemi, confirmed the death of the presidential aide in a condolence message issued by his Special Assistant on Media, Olayinka Oyebode.
The list of prominent politicians and Nigerians who have embarked on medical tourism over the years is inexhaustible.
NARD condemns medical tourism
A former Vice-President of NARD, Dr Julian Ojebo, in an interview with Saturday PUNCH flayed politicians for travelling abroad for medical conditions that could easily be diagnosed and treated in Nigeria.
Ojebo lamented the poor state of health institutions in the country.
He said, “When it comes to the amount spent on medical tourism, the data available is underreported. We need to understand that the population is divided into low, middle and upper classes. Members of the low and middle classes, who are forced to go abroad for treatment, go to low income Asian countries like India and they spend roughly $800m to $900m.
“However, we have the rich and politicians, and these are the one per cent of the one per cent. These ones go to Europe. Recently, the President-elect went to France. For that category of people, we cannot even get the data.
“Medical tourism has impacts on our economy, how the world views us and on the quality of healthcare service delivery at home. When these politicians go abroad and they get their medical treatment, they tend to forget and not care about the situation back home. Yes, we also have good private institutions now like Duchess Hospital and Nisa Premier, but how many of those at the lower class can afford their services?
“How many of our public hospitals have functional MRI machines? Our politicians cannot continue to go abroad for medical conditions that can be diagnosed and even treated in Nigeria. The money taken abroad, if injected into our health system, will go a long way in reviving the sector.”
Similarly, the National President, Medical and Dental Consultants Association of Nigeria, Dr Victor Makanjuola, said, “Medical tourism is a scourge with a very negative impact on the Nigerian health sector. It has been estimated that this phenomenon costs the country over $1bn annually.
“Other than the direct benefits to the ill individuals, medical tourism impairs the corporate health of the nation.
“It is partly responsible for the poor funding of the health sector with attendant poor healthcare delivery to average Nigerians. This is because most of the people who engage in medical tourism are politicians and senior public servants (usually at the expense of taxpayers) and are also the ones expected to mobilise resources for the local health sector. This results in chronic underfunding of the health sector.
“Indirectly, medical tourism negatively impacts the economy of the country through capital flight, increasing the demand for foreign currencies significantly, and contributing to a negative trade balance for the country.”