Wikileaks: Update On President Yar'Adua's Illness

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SAN FRANCISCO, Jan 23, (THEWILL) – Controversial whistle-blowing website, Wikileaks weekend released more classified United States Government cables on the state of health of late President Umaru Musa Yar’Adua and the power play by influential persons around him.

The cable from then US Ambassador to Nigeria, Ms. Robin Sanders to the Pentagon states as follows:


“Ref A requested updated information about the health of Nigerian President Umaru Musa Yar'Adua. We note that our GON and private contacts continue to state that President Yar'Adua is managing his known health issues -- chronic kidney problems -- and is not suffering from something more serious. The Villa also continues to keep a tight hold on any information concerning his health and has been cautious about any indications on travel outside of Nigeria, to avoid additional concerns. As a result, attempts to gain specific and/or verifiable information on his condition, prognoses, medication, treatment options are limited.

“The Ambassador's last personal dialogue with him (Ref. C), in which she observed him up close, noted that he was extremely frail, more soft spoken than usual, his skin was extremely drawn, teeth were extremely tarred and his involuntary cough had increased. He was, however alert and could carry on a sophisticated conversation. We have also reported, ref. B, recent extensive critical comments by a Villa staff member on the impact of the President's health on the country's governance. What is clear is that the President's health is a matter of growing concern, particularly on the minds of the northern Nigerian elite. We have noted a considerable up-tick in what appears to be behind-the-scenes machinations and backroom dealing, most notably the recent reconciliation meeting between former President Obasanjo and former VP Atiku and Atiku's pending official return in March to the ruling PDP, former President Babangida's sudden return to the political scene with a string of public pronouncements, and Kwara Governor Saraki's machinations to possibly be a PDP candidate in 2011.

“If Yar'Adua were closer to "death's door," we would expect more of a political power struggle publicly to break out drawing in these traditional "Godfathers" of Nigerian politics, as well as newer groupings including Kwara State Governor Saraki (and Governors' Forum chairman), some of the other Governors (e.g. Niger and Kaduna), and some members of the "Katsina clique" who have gathered around Yar'Adua. All these groups have a shared interest either in maneuvering VP Goodluck Jonathan out of assuming the presidency, or in assuring that his power as President was strictly circumscribed and that he appointed a strong Northerner as his VP. (We note there has been a speculation of a Yar'Adua demise in February 2009. Thus, this has not happened and he may either not be suffering from a terminal disease or could -- as other leaders have done in the past -- hang on longer than we anticipate.)

“Yar'Adua began a two-week vacation on January 26 (to date he still remains in Abuja and his vacation is scheduled to end on Monday, February 9). However, official statements from the Presidential Spokesman indicated that he would pass the two weeks in Lagos, Cross River State (at the Obudu Cattle Ranch) and at his home state of Katsina. There is widespread speculation, however, that the Villa may be using the guise of a "vacation" to hide medical treatment. On January 27, Kwara State Governor Saraki insisted to Ambassador that Yar'Adua will not/not leave Nigeria during his vacation; however, we believe that he is most likely receiving clandestine medical treatment in Nigeria during this period.

“Ambassador was told by two key contacts, Shell Abuja 00000203 002 of 006 VP for Africa on January 27 and Information Minister Akunyili on February 2, that experts from Germany have been brought in to oversee the President's treatment. END

“Information below on the health of President Yar'Adua is keyed to Ref. A questions: overall health DIAGNOSES: Despite continued statements by the Villa spokesperson that the President is not in poor health, several individuals xxxxxxxxxxxx and First Lady Turai Yar'Adua) have admitted privately to the Ambassador that he suffers from acute kidney disease (Refs. C, G, H and others). We continue to hear press and blog reports that Yar'Adua suffers from lung cancer, although this is generally from sources further removed from the Presidency. xxxxxxxxxxxx is the only credible source who confirmed that he heard reports of lung cancer. xxxxxxxxxxxx is not close to the President and has access to tertiary information at best.) On October 27, First Lady Turai Yar'Adua told Ambassador that Yar'Adua did not have lung cancer, but admitted that he suffered from long-term kidney disease and from asthma (Ref. G).

On January 27, Kwara State Governor Saraki, a medical doctor by training, told Ambassador that Yar'Adua is "not at death's door" and that he is learning to cope and manage his energy levels better, leading to an improvement in his energy and breathing since the September 2008 timeframe. xxxxxxxxxxxx a contact xxxxxxxxxxxx at the German Julius Berger company said that Yar'Adua is steadily weakening and going downhill, noting that although he is "not in danger of dying soon," his ailments were serious and chronic. Other media outlets, such as the online news site "Sahara Reporters" have reported several conditions: Churg Strauss Syndrome and/or lung cancer along with kidney disease. In a follow-up meeting with Information Minister Akunyili on February 2, xxxxxxxxxxxx told the Ambassador that Yar'Adua remained extremely weak. xxxxxxxxxxxxx noted that when xxxxxxxxxxxx last met with him it was at the residence and not the office as he has substantially reduced his office hours to conserve his energy. xxxxxxxxxxxx said Yar'Adua told xxxxxxxxxxxx that he really wanted to go out of Nigeria for "a rest" but given the uproar over his September 2008 trip to Saudi, he was compelled to stay in Nigeria to avoid more speculation on his health. xxxxxxxxxxxx added that Yar'Adua's current strategy is to have meetings planned well in advance so he can rest up in order to be able to have enough energy to complete the session. xxxxxxxxxxxx

“PAIN: Most of Post's information concerns his lack of energy and fatigue; however, information exists in other channels regarding pain management. A 3. (s/nf) health improved/worsened, changes in appearance: We believe that Yar'Adua still remains weak and as physically fragile as he was in November-December 2008. Ref. C contains Ambassador's observations during her meeting with Yar'Adua on the margins of the December 19, 2008 ECOWAS meetings. Ambassador noted: he coughed more extensively as he delivered his speech on becoming ECOWAS Chair, he appeared to weigh no more than 130-140 pounds, his skin was very taunt, his handshake was weak, voice was fainter than on previous Abuja 00000203 003 of 006 meetings, his eyes were deep set with dark circles underneath, and his teeth were also very badly tarred. Over the past several weeks, Yar'Adua has made few public appearances. Despite this, he was able to carry on a sophisticated conversation.

“His most recent appearance was at his daughter's marriage on January 25, 2008, to Bauchi State Governor Yuguda. Although we believe these appearances were meant to calm public anxiety, they actually tended to renew suspicions about his health. Based on pictures and TV coverage of these events he appears pale and weak. He continues to lose weight and he coughs and appears at times to have difficulty breathing when he talks. U.K. diplomats told us January 28 that they have seen reports that Yar'Adua wears make-up for public appearances and padding to hide his weight loss.

RESTRICTIONS TO ACTIVITY/SCHEDULE: Yar'Adua's schedule, since assuming office in May 2007, has never included long days or late night appointments (Ref. M); however, it has clearly been severely restricted since late Summer and appears to be more so since late December 2008. President Yar'Adua has made few international trips since assuming office, including missing the September 2008 UN General Assembly meetings. xxxxxxxxxxxx contact of the Mission shared his risk-analysis paper with us in late 2008 (Ref. B, q.v.), in which he complained that Yar'Adua's restricted office hours are "taking a heavy toll on governance." He also noted then that the President "works for limited hours, often can't keep scheduled appointments, and cannot undertake rigorous national tours." On xxxxxxxxxxxx told PolCouns that Yar'Adua's health has improved "a bit" since last fall; however, there has been no positive impact on his ability to meet the demands of the presidency. (This comment dove tails with Saraki's, who also indicated that Yar'Adua has had a slight improvement.)

“Yar'adua aware of his diagnoses/prognoses: Although the spokesman for the Villa continues to maintain that Yar'Adua has no serious health problems that hinder his ability to carry out his executive functions, the President's wife admitted his serious kidney ailment to the Ambassador. We do believe that those around him may be jeopardizing his well-being for their own political gain. We note that, in conversations with other foreign diplomats, the First Lady has indicated she is looking forward to Yar'Adua running for a second term in 2011.

“NAMES AND SPECIALTIES OF PHYSICIANS: Adamu Banye Barau serves as Chief Physician to the President. Barau applied for a U.S. visa in April 2008. xxxxxxxxxxxx Barau planned to travel to the U.S. to purchase medical equipment. In addition, we know Hussaini Yakasai Munir serves as a Villa medical officer. (NOTE: Munir applied for a visa in mid-January to attend medical training in North Carolina from February 2-14. Specifically, he will attend Advanced Cardiac Life Support, Cardiac Stress Testing, Overview of Cardiac Catheterization, Non-Invasive Management of Myocardial Infarction, and Advances of Echocardiography at Ladan Medical Center, North Carolina under Dr. Mohammad Lawal Garba.) We also know from several sources that German specialists do come in and out of Nigeria as they are, xxxxxxxxxxxx, transported by the German Julius Berger company. A 7-8. (c) who provides yar'adua with reports on health and IS HE FOLLOWING DOCTOR'S ADVICE: We have no specific information, but we believe that his wife and other members of the "Katsina clique," such as Agriculture Minister Ruma, and possibly Kwara Governor Saraki (who is a medical doctor), are managing Yar'Adua's health strictly for political reasons, which seems to overshadow any advice he may be receiving from medical experts.

“Procedures and treatments B 1. (C) MEDICATIONS AND CHANGES IN MEDICATION: Information Abuja 00000203 004 of 006 exists in other channels that provides suggestions on what Yar'Adua may be taking. B 2. (s/nf) medical procedures/surgeries in the past year: Yar'Adua had a range of medical tests in Saudi Arabia in late August 2008, about which there is reporting in other channels. According to Leadership newspaper, between August 20 and August 31, 2008 he was at the King Abdulaziz Hospital in Jeddah. We understand that, in 2001 or 2002, while he was Governor of Katsina State, Yar'Adua had a kidney transplant. The Ambassador was told on November 1, 2008 that Minister of Agriculture Ruma was the donor for Yar'Adua's transplant, but that the kidney now appeared to be failing. The individuals (lunch attendees at a Central Bank luncheon) maintained that Ruma's brother had traveled to Germany to determine if he was a potential match for a second transplant.

“ADVISED TO SEEK TREATMENT IN LAST MONTH: We understand that travel to Germany was being heavily considered by the Villa in December 2008, but given that it sparked renewed public concern about Yar'Adua's ability to govern, the President remained in Nigeria. This has been confirmed by xxxxxxxxxxxx .

“CANCELED OR POSTPONED ANY PLANNED TREATMENT:xxxxxxxxxxxx told Ambassador on December 22 that First Lady Turai Yar'Adua confided xxxxxxxxxxxx that Yar'Adua would travel to Germany for a second renal transplant between December 16 and January 1.

“Yar'Adua did not take this planned trip given public reaction to rumors about travel and concerns about his ability to govern. We have no information on whether this trip may be rescheduled.

“Medical equipment: EQUIPMENT ACCESSIBLE IN ABUJA: We understand that the Villa maintains a dialysis machine for the President's use in Abuja and from a credible source at Shell Oil Company that some additional medical equipment for the President arrived in December-January 2009. xxxxxxxxxxxx was more specific in a xxxxxxxxxxxx meeting with Ambassador, saying that Yar'Adua is on dialysis three times a week in the afternoons.

“Access to equipment to treat lung cancer: U.S. medical personnel operating in Nigeria believe it may be possible to bring chemotherapy drugs into Nigeria to receive chemotherapy; however, the only hospital which may/may have radiation equipment is Lagos Teaching Hospital. In all, however, the American physician with whom we spoke on January 29 noted that both chemo and radiation therapy require a large cadre of trained specialists (from oncologists, to nurses and equipment technicians). However, Nigeria has little to no specialists in these areas. Due to the lack of local specialists, our medical source believed it would not be possible to receive reasonably adequate treatment in Nigeria.

“Access to equipment for surgery related to renal FAILURE OR LUNG CANCER: St. Nicholas Hospital in Lagos recently began performing minimally invasive transplants (including both removal -- important as all donors in Nigeria are "living donors" -- and transplantation) using equipment from South Africa.

NEW MEDICAL EQUIPMENT BROUGHT TO ABUJA: Press reports have circulated periodically that new equipment was being purchased (dialysis machines mainly) and online news site Sahara Reporters reported on January 22 that a contract had been awarded previously to one of Yar'Adua's brothers to build a 10 billion Naira ($64 million) "State House Clinic" at the Villa (advertised in the SUN newspaper on July 5, 2008). Sahara Reporters maintained that the clinic was never completed, but that dialysis equipment and equipment for a complete Intensive Care Unit (ICU) was purchased. As noted in A6 above, Chief Physician to the President Amadu Barau is Abuja 00000203 005 of 006 believed to have traveled to the U.S. in May 2008 to purchase medical equipment. The specific type of equipment is unknown. Surgical equipment and specialists in Nigeria to PERFORM KIDNEY TRANSPLANTS: The St. Nicholas Hospital in Lagos has a full transplant team. St. Nicholas has been performing renal transplants for approximately ten years, performing more than 80 of the 100 or so transplants that have been done in Nigeria. To date, there remains no capacity in Nigeria to do HLA (human leukocyte antigen) tissue matching, although samples can be taken in Nigeria and sent abroad for testing.

Mental health D 1. (s/nf) does Yar'adua seem sad, detached, distracted, IRRITABLE OR CONFUSED: xxxxxxxxxxxx both reported to Ambassador in December that the President was exhausted, but still very intellectually competent, and that the political haggling and pressure of putting together a new cabinet drove him to push for a vacation outside of Nigeria. The political pressures of the cabinet reshuffle reportedly took a further toll on his physical wellness. At Ambassador's last meeting with him, he did not seem sad, detached, irritable or confused. D 2. (s/nf) does yar'adua conduct meetings/ is he alert and FOCUSED: Yar'Adua has delivered remarks recently at the January 12 Armed Forces Remembrance Day and the January 16 presentation of the 2006 Census to the National Assembly, as well as attended the highly visible wedding of his daughter to Bauchi Governor Yuguda on January 24. In these public appearances, he appeared physically fragile. Ambassador noted in her December 19 discussions with Yar'Adua and observations of him at ECOWAS that he "remained focused and still showed intelligence, understanding and awareness in his dialogue." Others, from the Foreign, Petroleum and Information Ministers to the Central Bank Governor, have confirmed the same.

“Does yar'adua use prepared notes/ do aides prompt HIM OR ANSWER FOR HIM: Yar'Adua spoke at the January 12 Remembrance Day events in Abuja without notes. In his December 19 interactions with Ambassador, he spoke without notes and without prompting from aides. We believe that he is still intellectually fit, even if we don't agree with his style of governance. However, his physical weakness adds to the inability of his administration to do more on top of his slow leadership style. We judge that even if his health were not an issue, his governance and leadership style would likely remain slow and largely ineffective as a result of his personality, his lack of a political network of his own, and the fact that he chooses not to dictate decisions to his Ministers, even when necessary and/or expected. Although he may not be up for days beforehand, he still chairs his weekly Cabinet meetings, which we still understand can run 3-4 hours.

“Spread of health information. Why are yar'adua/family/advisors reluctant to DISCLOSE HEALTH INFORMATION: While we have heard the argument that Yar'Adua's quiet personality and his northern Nigerian culture are the reasons for his unwillingness to discuss health information, we believe that those close to him are motivated more by a desire to retain power. His wife and several special advisors, such as Economic Advisor Tanimu Yakubu, we would put high on this list as they only have influence so long as he is President. E 2.xxxxxxxxxxxx Abuja 00000203 006 of 006 stage is missed. (This is a point the Mission raises regularly with GON interlocutors.) E 3. (c) reasons or motivations for those close to yar'adua TO LIE ABOUT HIS HEALTH: We would characterize the behavior of those close to Yar'Adua more as avoidance, secrecy and disregard for what is ultimately medically best for the Nigerian President. We would add that the closed-mouth nature of both Yar'Adua and his wife, plus the influence of their religion are also factors. In Yar'Adua's May 15, 2008 interview with the Financial Times, he admitted he is "a normal human being, who can fall sick," hinting at his medical condition. His wife admitted his kidney and asthma ailments to the Ambassador on October 27, 2008 without hesitation. So, his handlers do not directly lie, but just go to great lengths to avoid talking about it.

(U) This cable was coordinated with Consulate Lagos. SANDERS.”