President Muhammadu Buhari’s announcement and subsequent postponement of his proposed medical trip to the United Kingdom this week again raises questions aplenty about the state of the country’s healthcare system. The harsh reality, however, is a nation that has normalised an irrational act.
When President Buhari swaggered onto the podium on 29 May 2015 to deliver his inauguration speech after winning the presidential election, a wave of optimism and hope rippled through the cheering crowd. With admirable messianic fervour, he promised to tackle insecurity, endemic corruption, fuel and power shortages head-on.
Nigerians who watched the live broadcast could not resist the temptation offered by this newfound hope. The then 74-year-old leader also promised to address education and health challenges so Nigerians could have access to quality education and health care.
In April 2016, Buhari condemned “medical tourism,” the practice of Nigerian elites receiving treatment abroad even as most citizens are forced to rely on underfunded state medical services.
He said, “While this administration will not deny anyone of his or her fundamental human rights, we will certainly not encourage expending Nigerian hard-earned resources on any government official seeking medical care abroad when such can be handled in Nigeria”.
Understandably so. Africans spent over $6 billion on outbound treatment each year. Nigeria is a major contributor. Its citizens provide an estimated $1billion annually with government officials allotting a bulk.
But just two months after, Buhari broke his pledge by travelling to the United Kingdom for an ear treatment. It was a trip that sparked widespread condemnation and ushered what soon became a ‘routine’ as claimed by the Presidency.
In six years in office, President Buhari has embarked on six medical trips, averaging one per year. That figure would soon be altered by his next journey. In total, he has spent over 200 days in a supposed sickbed in London, representing nearly 10 per cent of about 2,160 days in office.
The consequence is continuous neglect of the nation’s health system. Among others, brain drain syndrome, underfunding, dilapidated structures and obsolete equipment, industrial strikes and the negative attitude of health professionals still stares the nation.
Nigerians have for decades suffered from an inadequately funded healthcare system, squalid clinics and hospitals, and poorly paid and overworked healthcare workers who frequently move abroad for employment. There are at least 8,178 medical doctors of Nigerian origin working in the U.K., according to data on the U.K. General Medical Council website. The exodus has worsened healthcare in a country that has one doctor for every 5,000 people, according to the Nigeria Medical Association (NMA).
First, the president must lead by example and stop this anomaly of running abroad for treatment at the expense of taxpayers. The National Health Act in Section 46 lays down the criteria for public sponsorship of medical treatment outside Nigeria. It states that without prejudice to the right of any Nigerian to seek medical check-up, investigation or treatment anywhere within and outside Nigeria, no public officer of the Government of the Federation or any part thereof shall be sponsored for medical check-up, investigation or treatment abroad at public expense except in exceptional circumstances on the recommendation and referral by the medical board and which recommendation and referral shall be duly approved by the Minister or Commissioner as the case may be. The President is a public officer who is supposed to go through this procedure before travelling for medical trips abroad. But it is on record that Nigerians have not been briefed about the existence of a medical board and whether the President goes through this procedure before the various medical trips.
In fact, Nigerians are not even aware of the kind of ailment that takes their leader abroad. Buhari and his minders operate on the mindset that his health is a private and confidential matter that should not be in the public domain.
That aside, adequate funding of the system, improved health care facilities, better remuneration and motivation for health workers, government intervention on the battle for supremacy among health workers, immediate ban of a government-sponsored medical trip abroad, adequate training, enforcement of legal action against medical negligence, improved medical research and encouraging foreign investment are some practical solutions to save the nation’s health care from further decay.
With less than two years to the end of his tenure, it behoves Buhari to remember his pledge to halt medical tourism and engineer serious reforms that would lead to significant transformation in health facilities in Nigeria. This will increase the likelihood of Nigerians shunning medical trips abroad and encourage native doctors to return to the country. He must set the tone for other public servants.