Last week, stakeholders in the health sector, at the instance of the Nigeria Medical Association, held a national summit in Asaba, the Delta State capital, to discuss the sector. The national summit, first of its kind (though long overdue), is a welcome development. It comes at a time when the use of public funds by government officials for medical treatment abroad had become rampant.
India, Britain, the United States, Germany are among the preferred destinations of most Nigerians, even for ailments that could be handled by hospitals locally. According to a report credited to the NMA, over 5,000 Nigerians travel to India and other countries monthly for medical treatment, while India alone is said to be realising between $1bn and $2bn from the medical tourism market that is worth over $20bn. The Nigerian High Commissioner to India, Oyebola Kuku, underscored this fact when he stated that, out of 25,000 Nigerians given visas in 2011, 20,000 went there for medical care. This drain must stop!
Apart from other health professionals, state governors and the President of the Senate David Mark’s involvement in the summit is critical. The National Health Bill, which approximates to the Obama health care legislation in the US, is yet to gain the attention it deserves at the National Assembly, just as the country’s 2013 health expenditure of 6.4 per cent of the national budget remains a far cry from the World Health Organisation’s template of 15 per cent. The Minister of Health, Onyebuchi Chukwu, whose role is vital in breathing new life into the system, echoed what has become a policy refrain. “The Federal Ministry of Health has directed that on no account should cases, which could be handled by some of our private health facilities, be referred from government teaching hospitals to private hospital overseas.” Government should go beyond rhetoric if it wants to be taken seriously on this. No mechanism is in place yet to arrest the trend one year after the preachment started.
Lamentably, most of our health institutions are far from being life-saving centres, which they ought to be. Way back in December, 1983, the late Gen. Sani Abacha, while announcing the military coup that ousted President Shehu Shagari’s government, dismissed Nigerian hospitals as “mere consulting clinics.” They have remained so 30 years after; among them are the 50 federal medical centres, which include 14 teaching hospitals and the National Hospital, Abuja. A survey by SERVICOM (Service Compact with all Nigerians) affirmed that none of these hospitals could be relied upon in service delivery. This accounts for why many Nigerians with kidney, cancer and heart-related diseases are seen regularly begging public-spirited citizens for financial lifelines from their hospital beds to enable them to undergo urgent surgery in India.
It rankles that Sudan, a country that was ravaged by civil war for nearly 20 years, has a world class medical facility, Salam Centre for Cardiac Surgery, where some Nigerians are taken to. The Kanu Nwankwo Heart Foundation is known to have sponsored kids with heart ailment for treatment in Sudan. Besides availability, Nigerians need affordable health care, but the collapse of our primary health care programme has made this a mirage.
However, what then has become of the country’s university teaching hospitals at Ibadan, Enugu, Zaria, Lagos and Maiduguri, which the Federal Government classified as "centres of excellence"? The University College Hospital, Ibadan; University of Nigeria Teaching Hospital, Enugu; and Ahmadu Bello University Teaching Hospital in Zaria, are designated neuroscience, cardiothoracic disorders and oncology and radiotherapy specialist centres, respectively. Though these institutions have the will to deliver as successful kidney transplants in Maiduguri in 2010 and LUTH in 2011 have shown, the way – government funding and provision of facilities – is lacking, thereby making them "centres of excellence" only in name. Little wonder that some of our medical schools are losing the National Universities Commission’s accreditation of their programmes.
Only an efficient health sector can beget a productive workforce for an economy in dire straits such as ours. The Asaba NMA health summit therefore challenges the governors to focus on providing world class health facilities in their states, with the huge financial allocations they get from the centre monthly, which are being frittered away by some of them. Also, there are many Nigerian medical experts in the Diaspora that could be attracted home with necessary infrastructure or incentives to set up world class facilities. Again, there are foreign investors eager to explore this terrain, which is evident in the proposal of a Turkish hospital – with the global brand, Florence Nightingale Group – to invest $100 million in the Nigerian health sector. This kind of foreign inflow should be given every government support. Nigeria, with its 160 million population, is a huge market for health investors, a fact the success story of the telecommunications sector liberalisation underscores.
However, Nigerian physicians need to heal themselves. Many of the doctors seem not to have the passion anymore for their profession. The spate of NMA’s trade disputes with governments over remuneration calls for introspection. The usual victims are patients, some of whom die in the process. This was the case in Lagos State last year during a strike that lasted for over seven weeks. Some doctors indulge in unethical practices that violate the Hippocratic oath, while those in government’s employ pay more attention to their private practices. A change in the status quo, therefore, is what the country badly needs. Doctors must act as agents of that change.