Issues in medical tourism ban

SAMSON BENJAMIN, in this report, examines the possibility of the call by President Muhammadu Buhari on compatriots to stop seeking medical treatment abroad, against the backdrop of poor medical facilities occasioned by the lack of adequate funding.

President Muhammadu Buhari on January 3, 2020, said Nigerians should not continue going abroad for medical treatment.

According to him, “Nigerians have suffered so much going abroad for medical treatment. This is not good for us and it must stop because we cannot afford it again.”

The president, who was represented  by the Minister of Science and Technology, Dr. Ogbonnaya Onu, and who himself had travelled to the United Kingdom for treatment on several occasions, stated this at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, during the inauguration and hand-over of completed projects to the hospital management.

 He said, “We have paid very serious attention to the health of our people and will continue to do so. The projects you celebrate their completion today were seriously affecting the workings of this teaching hospital. But today, we can say their completion have started helping to improve on the performance and welfare of both the staff and patients of this hospital.”

Financial implications

In a chat with Blueprint Weekend, the national secretary, Academic Staff Union of Research Institutions (ASURI), Dr. Theophilus Ndubuaku, said the amount of money “Nigeria losses to medical tourism annually is more than the amount allocated to the health sector in our national budget.”

“Nigeria losses N431.2 billion to medical tourism annually, which is more than the 427.30 billion, allocated the health sector in the 2018 budget. Through an average of 9,000 medical tours occurring monthly from Nigeria to other countries, the nation losses 1.35 billion dollars annually to medical tourism, with India being the major beneficiary of 500 visits monthly.

“Many Nigerians who travel out of the country for their medical needs often have to go back-monthly for check-ups and sometimes for corrective surgery,” he said.

Inadequate funding

Similarly, Dr. Aliyu Adamu, a private medical practitioner in Abuja, attributed the situation to poor funding of the health sector.

He said: “Despite Nigeria being a major signatory to Abuja declaration of heads of government, which resolved to adopt a minimum of 15 per cent as national health budgets for all members, Nigeria has never exceeded six per cent since that laudable step was taken in 2001.

“Also, the one per cent consolidated fund, which the National Health Act 2014 stipulates should be for health, especially for universal health coverage with health insurance and primary health care, has never been implemented since the Act became a valid Act of Parliament about five years ago.”

Continuing, he said, “Several studies have shown that if the 20 teaching hospitals spread across the six geo-political zones of the country are refurbished and made to function optimally, Nigerians will not need to travel abroad again for medical treatment and it will prevent brain drain in the health sector. The country would have been spared the embarrassment she got from flying its political office holders, including Mr. President to the UK for medical attention.

“Teaching hospitals in Nigeria have not been able to meet that mandate due to poor funding, dilapidated infrastructure and equipment, and incessant strikes by doctors and other healthcare providers. Until now, teaching hospitals have been described as ‘mere consulting clinics,’ ‘theatre of deaths,’ and ‘final bus stop.”

PDP knocks president

The Peoples Democratic Party (PDP in its response stated that President Buhari leads on the medal table of Nigerians who travel overseas for medical treatment.

The party’s national publicity secretary, Mr. Kola Ologbondiyan, in a statement said Buhari’s comment was self-indicting and raised public apprehensions on alleged high-level deceits in governance.

He said it was  ridiculous, a situation where a president, who patronised foreign hospitals for treatment and even check-ups; whose administration had allegedly  failed to provide adequate health care in Nigeria, could turn around to pontificate to other citizens against seeking medical attention overseas.

He stated further that the PDP did not approve of proliferated foreign medical tourism, especially by leaders and public office holders.

Ologbondiyan urged the president to show example by patronising a Nigerian public hospital on his next medical appointment so that he could experience the health care reality that Nigerians have been subjected to.

“Mr. President can then discover that our health system has suffered untold neglect under his watch, leading to dilapidated infrastructure, empty drug shelves, decrepit and worn-out equipment, brain drain and a demoralised workforce worse than his 1983 recollections.

“It is even more disheartening that all the investments and robust programmes of successive PDP administrations, including the comprehensive National Strategic Health Development Plan, Saving One Million Lives Initiatives, National Health Insurance Scheme, among others, have been degraded and impaired by the dysfunctional APC administration.

“Nigerians recall that under the PDP administration, new technologies and modern medical equipment were available in most federal medical institutions where cases such as cancer, kidney, heart and brain ailments for which Nigerians are now mostly seeking overseas treatment were effectively handled in our country.”

Senate intervenes

Meanwhile, the chairman of the Senate Committee on Health, Ibrahim Oloriegbe, has said the federal government has planned to establish six Medical Centres of Excellence to cater for the health needs of Nigerians who seek medical treatment overseas.

He disclosed this on January 4, 2019, at a town hall meeting in Ilorin, Kwara state.

Oloriegbe said the ninth National Assembly has already mapped out strategies to discourage medical tourism abroad with the resuscitation of specialised centres in federal hospitals.

He said further that a minimum of one centre would also be identified and designated centre of excellence in each of the nation’s geopolitical zones to enable Nigerians undergo treatment, thus reducing quest for treatment in foreign countries.

The legislator, who said some Nigerians travel abroad for treatment due to lack of information, disclosed that cancer fund has been created with the 2020 budget, adding that one of the issues responsible for treatment abroad was the availability of certain specialised equipment.

According to him, the Senate has agreed with stakeholders to establish a database to link all hospitals with media broadcast to keep Nigerians abreast of what is available.

 He said, “Medical tourism is a major issue we considered in the 2020 budget. As the Chairman Health Committee, we discussed extensively on how we can reduce it to the barest minimum; we engaged stakeholders including the Federal Ministry of Health and heads of federal tertiary hospitals.

“Of course, there are many reasons why people go abroad for treatment. There are those we cannot prevent, those who have the resources. They are not going because of lack of manpower or services here; they are going because they just believe they want the best hotels and Nigerians are those treating them.

“What we want to do is to identify minimum of at least one centre per geopolitical zones that will be designated centre of excellence to treat what makes Nigerians to go out. Part of the main issue is the availability of certain specialised equipment, and we have used 2020 budget to create cancer fund.”

He said further, “We have also looked at the budget of various teaching hospitals and we identified some hospitals where we have allocated resources to make them to do better. If you looked at the 2020 budget, it didn’t come from the executive; it was our initiative, to put certain resources in the national hospital for certain area of cancer treatment.

“We looked at the University of Benin Teaching Hospital; it has a Centre for Bone marrow Transplantation, which has been abandoned for many years. We put resources for this. There is an Accident and Emergency at the University of Abuja Teaching Hospital, Gwagwalada, which the previous government had done concession. We said they should recover it and we put resources for this to be able to address that.

“We identified that we do have some resources that are not even known. Some people go out of this country due to the ignorance of the availability of manpower and equipment to manage that. So, we agreed to establish a database that will be linked to all hospitals and then there will be also a media broadcast to enable Nigerians to be aware of what is available. We are really working hard to do that.”

Furthermore, Oloriegbe stated that brain-drain in the medical profession was also being tackled with the provision of fund for Residency Training Programme, adding that talks are ongoing with the Federal Ministry of Health to make available incentives for medical practitioners in the country.

Way out

Blueprint Weekend spoke with experts in the health sector on what it will take to have Nigeria’s health facilities updated to discourage top political office holders from sourcing health solutions in foreign countries.

In that wise, the president, Pharmaceutical Society of Nigeria (PSN), Ahmed Yakasai, said, “It will take commitment, determination and huge investment to update and upgrade Nigeria’s current health facilities to world-class standard so that all Nigerians, whether top political office holders or an infant born in a remote village in any part of the country that need optimum health care will be properly taken care of.

 “In addition, we also need to invest in health care personnel training and re-training, technology and put competent administrators to run our tertiary and secondary hospitals across the country.

“ It is also pertinent to boost the morale and motivation of the healthcare providers in order for the country to stop losing some of our best brains to other countries of the world and for those currently practicing abroad to be able to come home and join the team. I believe with the above multifaceted approach, if applied, within a decade we can revamp our healthcare system and become the healthcare destination for sub-Saharan Africa.”

Again, Adamu told this reporter that: “Not too much if you ask me. This is just an attitude problem, which our leaders need to work on. Let me submit that Nigeria has an array of experts who will rub shoulders with the very best across the borders in the various professions, including pharmacy, laboratory sciences, medicine, physiotherapy and others.”

Sign for things to come

Meanwhile, the Minister of Health, Dr. Osagie Ehanire, has hailed the National Hospital, Abuja, for successfully separating a set of co-joined twins.

He said the careful planning and execution of the surgery by a team of local medical professionals was an indication that Nigeria had all it takes to make significant impact in world medical system.

“We only require good leadership, friendly working environment and commitment from the medical professionals, irrespective of the field; to do what others thought was not possible. Ordinarily, this was what many thought could not be done in Nigeria, but here we are, the surgery was successfully done by a team of Nigerian medical professionals.

“The two lovely children, who were born in Keffi, the Nasarawa state capital, conjoined face-to-face at the chest and abdomen. They were referred to the National Hospital, Abuja 16 months ago. The children had to first be nurtured to stable health by a team of neonatologists, as medical imaging experts conducted tests and studies to determine what and how internal organs were shared or connected between them,” he said.

“In a remarkable operation that followed very detailed planning and preparation, a mixed team of paediatric, plastic and cardiothoracic surgeons, led by Prof. Emmanuel Ameh, performed the operation to separate the twins. It was the first successful operation of this type at this hospital and it marks a bold venture into the realm of advanced surgery.

“The successful outcome of this surgery is thanks to the availability of top experts at National Hospital, Abuja, their dedication to the profession, the careful planning, the excellent teamwork and administrative support they received.”

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