Medical treatment overseas continues despite Buhari’s promise to end it
By Jeph Ajobaju, Chief Copy Editor
Nigerians spent $11.01 billion on medical treatment overseas in 10 years, according to Central Bank of Nigeria (CBN) data on balance of payments, a capital flight that depletes foreign reserves and weakens the naira.
Nigerians spent $11.01 billion on health expenses abroad between 2011 and the first quarter of 2021 (Q1 2021). The highest amount was in 2019 ($2.56 billion) and the least in 2016 ($17 million).
It highlights how the health sector bleeds from multiple problems, one of which is underfunding, which averaged 4.72 per cent of budget allocation in the 10 years to 2011.
Inadequate funding leads to poor pay for healthcare personnel, a point driven home yearly by the exodus of medical doctors to foreign countries.
Nigerian doctors number 9,189 in the United Kingdom, with 805 of them licensed by the British General Medical Council (BGMC) between July and 25 December 2021.
Since 2018, others have migrated East to Saudi Arabia where Nigerian doctors are highly priced.
After years of agitation, the monthly hazard allowance of doctors working in public hospitals in Nigeria was in December 2021 raised from N5,000 to between N32,000 and N40,000. Other health workers get between N15,000 and N34,000.
To put that in perspective, however, Senators receive N1.24 million monthly just to buy newspapers.
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Nigerian doctors excel abroad
Nigeria’s healthcare system grapples with massive drawbacks but countless of its citizens excel in the medical profession abroad.
Nigerian-born medical doctor, Professor Iyalla Elvis Peterside, was named as one of the best physicians in the United States in 2020 by the US National Consumer Advisory Board.
Onyema Ogbuagu, another Nigerian-born doctor based in the US, was one of the scientists who discovered the Pfizer vaccine for the coronavirus pandemic.
Buhari’s hypocrisy and failure
Muhammadu Buhari promised on the campaign trail in 2015 to upgrade medical facilities and end foreign medical tourism of public officials, including himself. But he fails to deliver on it and characteristically refuses to give account.
He fails to solve problems listed by doctors, and given his famous record of incompetence, callousness, bullying, and law breaking, he cannot (and will not) solve the problems – which include a lack of medical facilities and low pay.
Buhari himself knows about these problems in healthcare delivery.
But rather than fix them he travels abroad for medical treatment, at huge cost to the treasury. He does not even feel shame for failing to deliver on his promise. Nor does he bother to explain why.
In August 2021, Socio-Economic Rights and Accountability Project (SERAP) urged Buhari to redirect the N4.87 voted to spy on citizens through social media, phone calls, and text messages to pay the salaries of striking doctors.
SERAP also asked that the sleuth money be used to improve the benefits of resident doctors as well as healthcare facilities for poor Nigerians who rely on those facilities and have no means for medical tourism abroad, like Buhari.
Premium Times logs that since Buhari assumed office on May 29, 2015, he has spent 200 days in the UK for medical treatment in seven trips, the last of which he returned from on 13 August 2021.
His ailment has never been made public, even though his treatment has chalked up millions of pounds sterling – counting in his official entourage, family members, presidential jet maintenance and fuel cost, hotel bills – footed by tax payers.
Nairametrics notes that Nigeria suffers significant capital flight for medical services abroad with low inflow for reciprocal services locally where healthcare delivery lacks adequate infrastructure and skilled personnel.
Healthcare allocation
Figures from the Nigerian Sovereign Investment Authority (NSIA) show that Nigerians spend an average $1 billion yearly on foreign medical treatment, 60 per cent across four areas – oncology, orthopaedics, nephrology, and cardiology.
A PwC survey found that more than 90 per cent of respondents described advanced healthcare in Nigeria as “low quality”.
Each new report of poor clinical care reinforces the belief among the populace that healthcare is substandard and should be avoided whenever an alternative is found.
Nigeria’s health sector, valued at N484.76 billion in 2020, accounts for 0.69 per cent of the economy.
Only 4.05 per cent of budget was allocated to the Ministry of Health in 2021, out of which 76 per cent was for recurrent expenditure and 24 per cent capital.
The data shows a decline in fund allocation to health over the past 10 years – 5.58 per cent (2011), 6.03 per cent (2012), (4.05 per cent (2021).
Why Nigerians go on medical tourism abroad
Health Minister Osagie Ehanire while representing Buhari at the second National Health Summit of the Nigerian Medical Association (NMA) in 2019 said the attitude of health workers was a major reason for seeking medical treatment abroad.
“If we must be honest to ourselves, we must admit that even more than lack of equipment and medical technical expertise, poor housekeeping and sanitation and often poor and disrespectful attitude of health workers and also a perceived lack of confidentiality are damaging the image and reputation of the health system and also the public confidence in it,” Ehanire said.
But in 2021, Senator Aishatu Ahmed (Adamawa Central) cited under-funding, weak facilities and infrastructure, poor motivation of health workers, low budget, weak accountability, conflicts with the political structure of the states, and industrial actions as major problems in healthcare delivery.
She disclosed that an average of 20,000 Nigerians travel each year to India for medical treatment due to the absence of a solid healthcare system at home.
A healthcare worker, Emilola Eniodunmo, also listed a lack of adequate facilities and low morale as major reasons for poor medical delivery across the country.
But, she stressed, “in some notable private hospitals in Nigeria and even state-owned hospitals, we have executive rooms for patients, and VIP treatment rooms, where special treatment is being given to patients for the right amount.”
Eniodunmo said a lack medical equipment and technical expertise to manage certain severe diseases are the major patients seek medical treatment abroad.
The Global Health Workforce Alliance of the World Health Organisation (WHO) says factors affecting Nigeria’s healthcare service include:
- A lack of public and private sector coordination.
- Commercial pressures in the private sector that lead to poor quality work.
- Work environments that contribute to low motivation, less-than-optimal productivity, high attrition – especially in rural areas.
- A lack of planning based on staffing projection needs, resulting in an overproduction of some categories of health workers at the expense of others.
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