A Boeing 747 flight number 002EA52 Ethiopian airline was just departing the MMIA (Murtala Mohammed International Airport) Lagos, Nigeria for New Delhi, India via Addis Ababa, Ethiopia. On board this flight of 230 passengers, about 23 were on a special trip arranged by System Health International. These 23 passengers unaware of the intents of the others were traveling to India on a health mission, what is now widely called health tourism. Mr. Udo, a 42 year-old married banker with one of Nigeria’s biggest banks was one of these 23 tourists. He had lived an accomplished life with a successful career in the bank, four kids and a loving wife till about 8 weeks prior this trip. Udo had risen rapidly since joining the bank a little over 15 years ago following graduation from the University and completion of his national service. Now an executive director, everything had been smooth sailing till he went for a medical exam. Mr. Udo had gone in for this exam because of consistent right sided dull pain and the finding from that exam was an impression of external growth on the top right corner of his liver. The next two months had been like a terrible nightmare for this young man and with that came significant weight loss, loss of interest in pleasurable activities, and social withdrawal.
As the plane took off, he looked around him and shook his head as he pondered what the outcome of his trip would be. Several rows of seats in front of Mr. Udo, Alhaji Umaru Adamu a retired civil servant sat with a retinue of family members accompanying him to India for a second round of knee replacement surgery after having had his right knee replaced about eight months earlier. He had very bad osteo-degenarative arthritis.
These two cases describe a few of the case scenarios that lead to health tourism to India, Saudi Arabia, Egypt, South-Africa, Dubai, US, Canada, and European nations. Some people may ask, “why India, South-Africa, Egypt and Dubai?” They may actually go on to wonder, “In the 1970s – 1980s Nigeria was at about the same level with Egypt and India in terms of infrastructural development in the health sector.” The response to the question may be “If I will get a better treatment and possible cure, why not”. Others will then legitimately ask “how did Nigeria get to this point?”
Nigeria was birthed over five decades ago, precisely 56 years now and counting. There was a lot of hope after Nigeria went through the tortuous journey of navigating independence from the British. The hope was beaming so much so that this country with its name from Niger River adopted its first national anthem, “Nigeria, we hail thee our own dear native land, though tribe and tongue may differ in brotherhood we stand”. For the years Nigerians pledged “Nigeria we hail thee”, some who may have questioned the need to really hail her, probably found confirmation over the years by the coups and counter coups, the atrocious Civil War and the unending cycle of corruption. So did we mean it when we professed to stand in “brotherhood” despite different tongues?
As the new nation progressed, the passion for hailing her and the commitment to stand in brotherhood with our different tongues gave way for the new anthem, “Arise O’ compatriots, Nigeria’s call obey, to serve our Fatherland…” The new pledge to arise may have been due to some sort of new hope after overcoming the Civil War and the generation of revenue from the newly discovered petroleum. Arise dreamt the dreams of big and bold national plans with promising impacts on education (free education to university level), health and other infrastructural development.
Particularly focusing on health, 1970s and some part of early 1980s gave birth to several tertiary and teaching hospitals with resultant training of health care providers including physicians, dentists, pharmacist, nurses, and laboratory technologists etc. These hospitals and health facilities were equipped with modern facilities of the era. However, the last two decades, specifically from the late 1980s till date have followed with a total collapse, rot and decay of Nigeria’s health institutions. Our health institutions are now so backward that compared to their state in the late 1970s and the progress in the same period made by our counterparts in India and Egypt, we have gone backwards more about 5 to 10 years. There is no clear vision, which is evident by the lack of interest to update medical curricular for training healthcare providers.
Though the story of Mr. Udo and Alhaji Adamu with Systems Health International is only fictional, it however, captures the reality of the situation in Nigeria. It has gotten to the point that our Presidents, Governors, political leaders and traditional rulers are blinded by the implications of their practice of seeking “abroad treatments” and are less concerned about the cost burden on taxpayers. It is not only atrocious because of the expense on taxpayer’s money, but also a national security risk because potential confidential information may get into the wrong hands. When a president or governor is bedridden in a foreign hospital, it is a national security risk. Moreover, is it not a national shame that the political elites and leaders are the sole beneficiaries of health tourism? Is it not disturbing that less than 5% of Nigerians can afford this when needed? What happens to the more than 90% who are unable to pay for treatment here in Nigeria not even after liquidating their assets? Most likely the answer is that they end up dying of potentially treatable conditions. It is also a national security problem when our youths die every day from preventable diseases and are therefore denied the opportunity to contribute to the vigor that the young bring to bear in the future of any country that hopes to remain a nation.
It is easy to understand why most countries in Europe have a national consciousness. This is because most of those nations had origins from the ethnic people that inhabited that land historically. In our own dear Africa only nations like Egypt and Ethiopia can claim some of the historical semblance of European nations. However, the US and Canada both nations of immigrants have been able to grow a national philosophy and psyche that brings to bear their national consciousness. Most African countries including Nigeria have different historical structures compared to the old European nations and the new world immigrant nations like Canada and the US.
Nigeria is perceived by some as an experiment by the colonists that served their interests at the time. Well, should Nigerians then say to themselves “it is finished, we can’t do anything other than blame our colonial masters”? The people of the United States could have said that too, however, they did not. Their position today in the community of nations is an apparent answer to this. If Nigeria will have a future, the people must have a vision that will grow a national philosophy and psyche, thus bringing to bear a national consciousness. Without that, how can Nigerians fight this concept of ‘health tourism’ and prevent the potential national security risks? It is misleading to think that a country should be run by politicians. The fact is that countries that have transcended as a nation are actually run by the masses. This is because the weight of the demands of the citizenry or the masses determines what line the political leaders tow. This may seem farfetched in Nigeria, but we must begin to ask ourselves this question: Are we answerable to our political leaders or are they answerable to us?