The death of a former president abroad is a thunderous indictment of a broken system and a shattering call to action. Nigeria’s leaders must finally confront the bitter truth: their reliance on foreign hospitals is a blatant betrayal of the very citizens they govern. We have the talent, the intellect, and the resources, but we lack the courageous leadership and moral fortitude to build a healthcare system worthy of our nation.
By Shu’aibu Usman Leman
The recent passing of former President Muhammadu Buhari in a London hospital is far more than a personal tragedy; it serves as a stark and painful reminder of the profound structural deficiencies plaguing Nigeria’s healthcare system. It’s also a deeply symbolic moment, imbued with a bitter irony. Buhari, who first captured the nation’s attention in 1983 by famously lambasting Nigeria’s hospitals as “mere consulting clinics,” lived long enough to depart this world in precisely the same scenario he once vociferously decried: unable to place his trust in the very health system he once governed and helped shape.
Over four decades have elapsed since Buhari’s stinging critique of Nigerian healthcare. In that considerable span, successive governments – including his own civilian administration from 2015 to 2023 – have regrettably done precious little to alter this disheartening narrative. If anything, the system’s inadequacies have become even more glaring and entrenched. Today, what ought to be a fundamental public good, universally accessible to all Nigerians, has devolved into a grim arena of stark inequality. The political elite routinely jet off to Europe or the Middle East for even routine medical check-ups, while the vast majority of ordinary citizens are left to grapple with overcrowded clinics, underpaid doctors, and hospitals bereft of even the most basic supplies.
The irony could not be more profound: Nigeria, a nation teeming with intellectual capital and consistently producing some of the most sought-after medical professionals globally, remains inexplicably incapable of establishing and maintaining world-class hospitals within its own borders. Nigerian doctors and nurses are rightly celebrated in the hallowed halls of London, Toronto, New York, and Riyadh for their exceptional expertise and remarkable resilience.
Yet, back home, they are routinely underappreciated, pitifully underpaid, and chronically overworked – often compelled to emigrate in vast numbers in a desperate search for better opportunities and more humane working conditions. This devastating phenomenon, colloquially known as brain drain, continues to hollow out the nation’s vital healthcare workforce, leaving behind a fundamentally broken system that lamentably fails both the patients it is meant to serve and the dedicated practitioners within it.
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The statistics paint a truly grim and distressing picture. According to the Nigerian Medical Association, over 2,000 doctors abandon the country every single year. In some impoverished rural communities, a solitary doctor may find himself serving thousands of people – a colossal workload that would be utterly unimaginable in any truly modern and functional health system. Meanwhile, countless public hospitals lack reliable electricity, struggle with intermittent or non-existent running water, and are frequently depleted of essential medications. Critical medical equipment is often outdated or, in many cases, entirely absent. Furthermore, the woeful absence of specialist care in a multitude of states means that even readily treatable conditions can, tragically, swiftly become fatal.
Yet, while these pervasive issues are undoubtedly systemic and fundamentally affect the general populace, the country’s political class has largely managed to shield itself from the dire consequences. Since the dawn of the Fourth Republic in 1999, Nigerian leaders have routinely and unashamedly sought medical care abroad. Some have effectively transformed London into their de facto clinic, visiting for everything from seemingly simple medical tests to complex, advanced procedures. This trend extends beyond just presidents and ministers; governors, legislators, and even local government chairpersons frequently perceive foreign medical treatment as an inherent right – one funded, more often than not, by the unsuspecting and long-suffering Nigerian taxpayer.
It is truly galling and, frankly, quite bewildering that Nigerian leaders continue to feel compelled to seek medical services abroad, despite the substantial investment and apparent improvements made to the State House Clinic in Abuja. One might have reasonably expected that the lavish expenditure on domestic medical facilities would have, by now, curbed the persistent inclination towards overseas treatment.
In 2023, as articulated by the then Nigeria’s esteemed First Lady, Aisha Buhari, the staggering N21 billion Presidential Wing of the State House Medical Centre was explicitly designed and intended to serve a singular, crucial purpose: to halt the urge for medical tourism among the president and their immediate family. This clinic, a flagship project, was purportedly conceived to provide world-class medical care for the president, their family, and other senior government officials, thereby ostensibly alleviating the chronic reliance on foreign healthcare systems.
The State House Clinic, it is widely proclaimed, boasts an impressive array of state-of-the-art equipment. This includes, but not limited to, a cutting-edge digital X-ray machine, advanced MRI and CT scanners for comprehensive diagnostics, an endoscopy facility for intricate internal examinations, and even a sophisticated Cath Lab for cardiac interventions. Aisha Buhari herself stated unequivocally that, with this magnificent facility, Nigerian leaders would no longer be necessitated to travel abroad for treatment. Instead, she suggested, if absolutely necessary, they could readily fly in international experts to provide assistance right here on home soil.
Indeed, the investment in the Aso Rock clinic appears, on paper at least, to be a solid and tangible reality. The Chief of Staff, Femi Gbajabiamila, went as far as describing the facility as “world-class,” asserting that it possesses “equipment you wouldn’t even find in too many places all over the world.” Such pronouncements painted a picture of a truly exceptional medical institution, capable of meeting the highest standards of care.
Given these seemingly impressive advancements and the public declarations of self-sufficiency, one is left to ponder: why then should our leaders persist in their quest for medical services abroad? The narrative of a fully equipped, top-tier domestic facility stands in stark contrast to the continued patronage of foreign hospitals, raising pertinent questions about the true efficacy of these investments and the underlying reasons for this enduring practice. Is it a question of trust, a perceived lack of specialised expertise, or perhaps a deeper systemic issue that a mere edifice, however grand, cannot resolve?
Even more egregious is the judiciary’s lamentable complicity in enabling this deeply entrenched dysfunction. Time and again, high-profile defendants accused of monumental corruption have conveniently cited mysterious, debilitating health conditions to secure medical leave abroad, brazenly claiming the purported incapacity of Nigerian hospitals to adequately handle their treatment. Many of these very individuals spent years in positions of power, wielding full control over significant healthcare budgets, yet demonstrably failed to construct a single world-class medical facility in their respective states or ministries. The sheer hypocrisy is staggering and profoundly insulting to the millions of citizens who possess no such privileged option but to meekly rely on failing local institutions.
This persistent and disheartening pattern reveals an even more troubling reality: Nigeria’s ruling elite no longer trusts the very institutions they are ostensibly responsible for governing – institutions they themselves are meant to be building and upholding. This fundamental lack of faith in their own public services is, perhaps, the most damning indictment of governance in contemporary Nigeria. For if those at the very apex of power do not believe in the system, why on earth should the rest of the population?
There have, admittedly, been occasional flickers of progress in some isolated areas. Private hospitals, such as the Zenith Medical and Kidney Centre in Abuja, have garnered international commendation for their quality services, including successful organ transplants, offering a glimpse of what is possible. Vice President Kashim Shettima recently highlighted the emergence of “reverse medical tourism,” where, in rare instances, foreigners actually seek treatment in Nigerian hospitals. These are undoubtedly promising developments, but they remain isolated exceptions, frustratingly far from the grim reality experienced by the overwhelming majority of Nigerians, who must navigate a fundamentally broken healthcare system on a daily, arduous basis.
We simply must not allow these scattered, albeit welcome, examples of excellence to obscure the broader, pervasive picture of systemic dysfunction. True and lasting reform will not materialise through piecemeal efforts, superficial public relations campaigns, or token gestures. What is unequivocally required is a complete and radical reimagining of healthcare in Nigeria – one that absolutely must begin with genuine, unwavering political commitment, and be robustly backed by sustained, transparent investment in critical infrastructure, highly skilled personnel, and cutting-edge technology.
The World Health Organisation (WHO) and a multitude of esteemed healthcare policy experts have consistently outlined precisely what such comprehensive reform entails: significantly increased and ring-fenced funding, drastically improved medical education and continuous professional development, vastly better working conditions and remuneration for all healthcare professionals, genuinely equitable access to quality care across all regions of the country, the establishment of functional and truly accessible health insurance schemes, and robust regulatory oversight to ensure unwavering accountability and uncompromised quality control.
Crucially, there must also be a profound and demonstrable cultural shift at the very top. Leaders must, unequivocally lead by example – not by shamefully fleeing to foreign hospitals at the slightest hint of illness, but by genuinely investing in, actively using, and wholeheartedly trusting the very institutions they expect their citizens to rely upon. There is simply no more potent way to build public confidence than for those in positions of power to publicly utilise the same public services they offer the populace. A president who genuinely seeks treatment for malaria at the National Hospital Abuja, or a senator who courageously undergoes surgery in a Lagos hospital, sends a far more powerful and inspiring message than any government press release or carefully crafted speech ever could.
Nigeria possesses the immense potential. We are blessed with abundant talent. What we demonstrably lack, however, is the resolute political will and the profound moral resolve. The unfortunate death of a former president overseas should transcend a mere headline; it must serve as an urgent, resounding wake-up call. It should provoke honest, uncomfortable, and deeply introspective questions: Why, in 2025, can Nigeria still not consistently provide world-class healthcare within its own sovereign borders? How many more esteemed leaders must perish overseas before the undeniable urgency of fundamental reform becomes utterly self-evident?
The death of a former president abroad is a thunderous indictment of a broken system and a shattering call to action. Nigeria’s leaders must finally confront the bitter truth: their reliance on foreign hospitals is a blatant betrayal of the very citizens they govern. We have the talent, the intellect, and the resources, but we lack the courageous leadership and moral fortitude to build a healthcare system worthy of our nation. No more excuses, no more rhetoric, no more medical pilgrimages abroad. The time for genuine, transformative change is now, or we risk condemning generations to a cycle of preventable suffering and a future where healthcare remains a privilege, not a right. The lives of millions of Nigerian people are at stake – people who unequivocally deserve not just the empty rhetoric of reform, but its tangible, life-changing reality.
