Usha Anenga examines the issues surrounding the massive efflux of Nigerians to America, Europe and Asia in search of medical treatment, most of which are also available in Nigeria.
It’s no news that Nigerians offer the highest patronage of health faculties in India, Turkey, Germany and other parts of the world. Affluent individuals and government officials fly out at the slightest headache for “check up” at enormous cost. The statistics are shocking. According to the former President of the Nigerian Medical Association (NMA), Osahon Enabulele, annual spend on medical tourism by Nigerians is now well above N120 billion, with an estimated 5,000 patients travelling to destinations like India and Turkey on a monthly basis, constituting a huge foreign exchange drain to the nation. It’s ironical that those responsible for fixing and improving healthcare delivery in the country choose instead to spend millions of tax payers’ money on medical tourism in other countries.
Nelson Mandela, the former president of South Africa in all his majesty lay in intensive care for several months, entrusting his life in the hands of home-trained physicians and died with pride in his country. It’s the other way round in Nigeria, “Birth and Death” abroad have become a symbol of social status. Our affluent politicians and celebrities wives rush to give birth in the US in order to ensure dual citizenship for their children and jet off to die in India, Germany, the UK and US. Nigeria is only good as a playground and burial ground.
There is a National Health Bill on the floor of the National Assembly that seeks to curb the incessant travelling abroad of government office holders for medical care, but personally, I don’t think that is the solution to the problem. Patients are free to seek medical care from wherever and whoever they deem fit, and with the globalization of the world, things are continually changing and the options for where to seek care from are expansive. It will not be right to force people to get treatment from where they are not confident about. We have heard testimonies of how patients who battled with undiagnosed diseases from one hospital to the other in the country, travelled abroad and got diagnosed within hours and were treated. Someone went to India and got treated for a condition he almost got his two legs amputated in Nigeria due to unavailability of advanced vascular surgery locally. Another was diagnosed of leukemia and was started on the first dose of chemotherapy in a teaching hospital in Nigeria before he was advised to be taken to India. Within 24 hours, they found out he only had leukemoid reaction secondary to intestinal perforation and was treated appropriately within a week. This means total or outright condemnation of medical tourism is wrong. Instead of sitting down and lamenting over the efflux of sick people abroad, the logical solution is for the government to reform and develop the healthcare industry by investing more in terms of infrastructure and training of doctors to provide specialised care to a competitive level where tourists can also come here for treatment. Secondly there is need to review some of the mundane regulations hindering the growth of medical practice in Nigeria. The former is an ongoing and chronic process but very important is revisiting the code of medical ethic in Nigeria which has not been revised since 1990.
Despite the obvious deficiencies of our health care in Nigeria, we still have very good hospitals (public and private) and qualified doctors who are credible and well trained. Some of these hospitals can competently treat most of the conditions that take over 5,000 Nigerians every year for treatment abroad, hence it is important to expose, publicise or even advertise what we have in our hospitals and what our doctors can do, to Nigerians and the world. The question is, how can we do all of these when the code of medical ethic in Nigeria says it is ethically wrong to advertise, directly or indirectly? How can we compete with the global market of medical tourism?
Going back in time, one will find that physicians were once not allowed to advertise by the American Medical Association (AMA). This status quo changed after the powerful AMA was sued by some doctors and the US Supreme Court declaring that it was unfair to not allow doctors to advertise. The Supreme Court also ruled that it was also unfair to patients, who need access to information on doctors, so they can select the best for themselves. That has led to guidelines by AMA and some other professional bodies for doctors to advertise ethically without provision of deceptive and false information to the public. Several other countries have also followed the same pattern of regulated advertisements and have made information about their services and professionals available to the world, attracting seekers of medical care worldwide including Nigerians.
Nigeria on the other hand is becoming the “North Korea” of health care, we have barricaded and walled off what we have from the rest of the world. Even within the country, many patients are still clueless about where to get some specialist consultations because of faulty policies which will not allow doctors to put their profiles on the pages of newspapers or have websites that provide information on their competences and skill as it will be viewed as advertisement or marketing. By allowing these kind of outdated policies, we limit the growth of medical care in Nigeria and build up those of other countries. For instance, the Indian healthcare industry is growing at a rapid pace and is expected to become a US$145 billion industry by 2017 and US$280 billion by 2020. A sizeable portion of this money will come from the pockets of Nigerians.
I strongly believe patients should be well informed about individual doctors, hospitals and what services they can offer. The policy against advertisement needs to be challenged by medical consultants sooner than later.
Medical advertisement allow patients to make informed choice about the quality of services and where it can be accessible rather that allowing any quacks to worsen his/her medical condition.
It’s high time we moved forward and not be relying on an ethical code that was last reviewed over two decades ago, if not, our healthcare will continue to be undermined and the exodus abroad will continue.