NIGERIA'S HEALTH WOES: ANY PANACEA?

Does anyone still remember one of the reasons adduced by the dark goggled, gun-wielding soldiers for truncating Nigeria's attempt at democracy in 1982? The then military General Sani Abacha who announced the ouster of the democratically elected civilian government of Alhaji Shehu Shagari in 1982 among others, adduced the total failure of the health sector as reason why the military intervened.

In his radio/television broadcast heralding the infamous come back of the Khaki boys into politics of administering the territorial entity of Nigeria, General Abacha (late) accused the then widely incompetent civilian administration of President Shehu Shagari of rendering public health institutions prostrate and made them mere consulting clinics.

The bad news however is that in 1999 when the military decided to embrace their rightly constitutional role of defending the territorial integrity of the nation and thus subjecting themselves to the democratic ethos as stipulated in the grund norm, the state of public health sector was further diminished and almost nearly destroyed by the same military who ousted the democratic government over the same reason of running down health institutions.

It was said that the military regime of General Ibrahim Badamasi Babangida (rtd) even proceeded to enact a decree allowing medical workers in public hospitals to go into private practice thus further bastardising the standard of health services rendered to the poor Nigerians since medical doctors and pharmacists paid by tax payers found ways of establishing their private health centers whereby they divert rich clients and are even said to be in the habit of stealing public pharmaceutical products for sale to their rich private hospital clients even as the standard of services rendered in public hospitals further nosedived. To quote Chinua Achebe, the erudite novelist, this was precisely 'when the rain began to beat us in our public healh services in Nigeria'.

In the twilight of his military contraption called government, General Babangida appointed a well respected medical practitioner Dr. Olukoye Ransome-Kuti as health minister and this medical revolutionary was said to have worked round the clock to revive primary health care services that have become moribund but very little success attended these heroic effort no thanks to the diminishing regime of Professional discipline in place in public health sector.

Is it then right to blame the proliferation of private hospitals for the sharp decline witnessed in the public health services? Your guess is as good as mine since I like most people believe that it was morally reprehensible to allow publicly paid medical workers to run their own private clinics because this tendency gave rise to the widespread indiscipline and total lack of commitment on their part to fulfill their obligations to poor and disadvantaged seekers of health services who are the people of Nigeria and the real owners of the sovereignty of Nigeria. Health ministry officials especially those in charge of public procurement have embraced corruption as their stock in trade as against the public good.

The other fundamental cause of collapse of the public health sector is corruption, lack of transparency and accountability in the utilization of scarce public fund voted for the introduction of state of the art health facilities across the country.

Nigeria's public health infrastructure has collapsed so much so that the few available private hospitals are grossly insufficient to cater for the growing number of people in search of better health services. This decline in the standard of health services obtainable locally has created a new kind of problem simply identified as health tourism whereby rich Nigerians travel out to countries like Egypt; Germany; India and the United States of America to seek for solution to their diverse health challenges.

Nigeria is said to be losing billions of foreign currency through these ever expansive lifestyles of seeking for better health care outside of our shores.

I will return to the all important problem of health tourism and its implication on the general economy of Nigeria and the state of health care services for the millions of other less endowed citizens without the resources or means to join the ever growing number of rich Nigerians seeking for foreign health services brought about by their proximity to the corridors of political power.

Professor Chinua Achebe in his latest book “There was a Country: a personal history of Biafra”, also lambasted African dictators for ruining their local health care and exposing their citizens to untimely and avoidable death. Achebe who was fatally wounded in a road accident had to relocate to the United States of America so as to be able to get the kind of standard health care that was able to save his precious life.

In this widely acclaimed book, Professor Achebe was full of praises for Dr. Nelson Mandela for showing good example as a leader who truly embraced selfless service while in office.

Achebe drew a corollary with the late Togolese leader Mr. Gnassimgbe Eyadema who spent nearly four decades in office but could'nt build a single specialist health care institution in his home country which resulted in his death while being flown abroad for medical attention after he suffered heart attack.

Professor Achebe wrote thus; “…Eyadema had died from a heart attack even as he was about to be flown to Europe for treatment. If Eyadema stayed that long because he was good, why was there no hospital in Togo to attend to his condition”.

Corruption is the answer if you ask me.

In South Africa, the 96 year old Nelson Mandela was driven to a South African military hospital where he was reported to have undergone successful surgery. South African political and business elite attend to their health care services inside South Africa because previous administrations laid solid foundation for functional, workable and standard public health care services.

But in Nigeria, a sitting President Umaru Musa Yar'adua was surreptitiously flown abroad for medical attention without the slightest knowledge of his then Vice President who is currently the President of Nigeria Courtesy of the doctrine of necessity invoked by the National Assembly to avoid political vacuum after nearly three months of the absence of the then President who was facing serious health challenge from which he died when he was reportedly brought back in the dead of the night by some members of his Kitchen Cabinet.

While the medical challenge of the then President Yar'adua persisted, reports in the media stated that several medical delegations from Germany visited the Presidential Villa to offer him specialize treatment which is said not to be available in Nigeria because of the run down public health care services by the political elite.

One year after coming into office, President Jonathan's wife Mrs. Patience was said to have been flown to Germany for medical attention.

Conflicting reports followed her nearly three months absence from public media radar because while the disorganized media team in the presidency told the Nigerian public that she went abroad on holiday, the President was later in a national media chat confirmed that his wife indeed had medical reason for her absence.

The Senate President David Mark also joined the growing list of political elite who embark on exotic medical tourism because he travelled to Israel ostensibly on public expenses to take care of his medical condition. The Senate President was absent at the signing of this year's budget because he had to travel to Israel to treat his teeth and eye which were earlier treated may be unsuccessfully at the National hospital in Abuja.

Professor Babatunde Osotimehin the then Health minister but now with the United Nations was once quoted in the media to have estimated the losses Nigeria incured on medical tourism at $200 million USD Per annum.

The Vice President Mr. Namadi Sambo added his voice to growing criticism of how political elite waste scarce foreign currency on medical tourism abroad.

Mr. Sambo who was cited in a report of a national newspaper of December 14th 2012 was credited with affirming that Nigerians spends several billions of hard currencies abroad to address medical challenges.

The Vice President spoke at the commissioning of the newly built Kwara State Advanced medical Diagnostic Center in Ilorin. He claimed that the current Federal government was addressing the issue of lack of functional health care infrastructure in Nigeria.

As a fact, there are few evidence to prove that the current government is committed to addressing the unprecedented health woes faced by millions of Nigerians.

These health woes have only brought international disgrace to Nigerians travelling abroad thereby encouraging some countries to impose stiff conditionalities for Nigerians travelling abroad for lawful business.

Because of the near collapse state of public health care, Nigeria was unable to eradicate wild polio, which health experts say, place Nigeria alongside Pakistan at the very center of countries frustrating global eradication of the disease. The United States of America was quoted recently to have demanded that from June 2013, Nigerians travelling to the United States must be vacinated against wild polio.

Sadly, global health experts believe that health –related millennium Development Goals (MDG's), especially those concerning infant and maternal health, have already been declared unattainable by 2015 in Nigeria.

The disturbing cases of health tourism is also linked to huge capital flight out of Nigeria because political elite use such opportunities to ferry out public fund into their private off shore bank accounts. Few days back, the 2010 Mass Communiation graduate son of the governor of Jigawa State Sule Lamido was arrested at the Kano International Airport over alleged money laundery. His father said his son was on medical tourism to Egypt.

This is a governor that has spent over six years yet he could not erect one functional health care facility to cater for the health challenges of his people. His children and grand children are flown abroad for medical services even as the ordinary citizens without access to public fund are left to their own design. What a country.

Taraba State governor Mr. Danfulai Suntai, a Pharmacist, who had accident while flying his private Jet was flown abroad to Germany for treatment since three or four weeks now probably at public expenses. His wife who was heavily pregnant even delivered twins in the same German hospital. Danfulani Suntai who has been governor of Taraba State for about six years never built any specialist health care center even though he is a professional pharmacists.

He was reported recently to have built and donated standard pharmacy facility to his former university- Ahmadu Bello University, Zaria but yet he culd not build one formidable medical institution in Taraba State. This is a cas of a physician not being able to heal himself.

Such is the irony of political leadership in Contemporary Nigeria.

Judges of Superior Courts regualarly embark on medical tourism abroad during vacation from the legal year. State governors such as the Enugu and Cross River States have all gone abroad to seek for medical services. As I write this piece, the Enugu State governor Sullivan Chime has not been seen in public since September that he was reportedly flown abroad for medical treatment. The Cross River State governor Mr. Liyel Imoke reportedly checked into a United States based health facility for medical services.

These unbridled quests for foreign medical services by political elite are some of the sources of leakages whereby public fund are diverted for private use. Recently, Algeria was in the news for accepting to borrow $2 Billion USD to Egypt to enable Egypt meet the conditionality set by the International Monetary Fund to advance it needed credit lifeline to revive her failing economy that has suffered adversely since the Arab spring over a year ago.

Algeria's trade surplus for 2010 has risen to over $83.14 Billion. The Algeria centre for information and statistics Directorate of Algerian customs attribute this increase from 2009 due to higher fuel revenue due to the high price of a barrel of oil, and the slight decrease in imports of consumer non-food materials.

Regrettably, Nigeria which is the highest exporter of crude oil in Africa has gone to borrow $7.9 billion loan out of which the country will service with $5.4 billion charges.

On August 9th 2012, the Guardian reported that the Nigeria's National Petroleum Corporation is a drain pipe on the economy of Nigeria accounting for disappearance of several billions of United States Dollars that ought to accrue to Nigeria from crude oil sales.

In a climate of unprecedented corruption, it is almost impossible to tackle Nigeria's health woes without building strong anti-corruption agencies to retrieve looted public fund to channel some of them into reviving the collapsed public health care infrastructure.

*Emmanuel Onwubiko, Head, HUMAN RIGHTS WRITERS' ASSOCIATION OF NIGERIA [email protected].*