Nigerians who cannot afford medical tourism
In the news recently (Sunday Trust, 19th August),
Ibrahim Mohammed, a patient, was refused carriage by airlines in his
quest to travel abroad for treatment. Ostensibly, because he was spinal
cord injured from a road traffic accident. He had been lying, paralysed,
in a hospital bed in Kano for about a month. He was eventually treated
at Primus Hospital in Abuja…. by an Indian doctor. Both the patient and
the doctor are apparently happy.
Who cares?
We should care about the real story behind this story
but as always, we do not have the full facts. The story says that the
patient works for the Kano State Government and money was not a problem.
The National Orthopaedic Hospital, Dala, is one of those labelled
“centres of excellence” and one place he should have found succour. Why
could he not have been offered treatment by the neurosurgeons and
numerous orthopaedic surgeons in the North? Did he refuse treatment
locally? Why was he desperate to fly out of the country for treatment?
Let us digress
It is an inalienable right of Nigerians to choose
where they go for medical treatment. Patients have a choice and the
right to seek the best medical treatment for themselves. This happen in
all communities and the need to preserve life and limb means patients
and their relatives will gravitate to the best medical care available.
We (health care practitioners) could and should be involved in directing
them to the appropriate places where they will get good care. One of
the key components of care is confidence in your health care
practitioner. If you are happy and feel you will get better, most times,
you will. After all, we care and God heals. Should they decide to go
outside the country, for whatever reason, we should be able to provide
post medical tourism care for them. After all, they cannot afford to
stay abroad forever.
Home support
In truth, the poor health care delivery in Nigeria
and poor medical advice have contributed to the mass movement of our
patients to ‘safer’ shores. It is not enough to say patients should not
go to India, Egypt or elsewhere, we must give them a good reason not to
go. The best reason is good medical practice and effective
communication. More importantly, doctors must appreciate their
professional and personal skill level and limitations in practice. If
you cannot treat the patient, know who can, learn to refer early to
preserve the life and limb of your patient. Working together and better
communication between professionals are the prerequisites for good
quality of care.
Minimum standards
Dr Azodoh, Consultant Urologist with Chivar Clinics,
Abuja once said that we need to provide a better standard of care for
Nigerians. At the minimum, hospitals must be equipped with the basics to
ensure life and prevent death. For example, the presence of simple
oxygen and monitoring equipment for use by the patient can actually make
the difference between life and death in some situations. We must be
able to provide a satisfactory level of care for patients in this
country. It therefore means that everyone must be hands on deck to
improve standard of care. Medical practice in Nigeria must return to the
good old days when excellence of practice was the by word. Running away
at the time of need does not help.
Health Care Practitioners
Health care practitioners are educated people who
have left health policy decisions to be made by uneducated and
unqualified people. A lot of our medical infrastructure and respect has
been eroded because of this oversight. We have a responsibility of
guiding and influencing policy change at all levels – making top
government functionaries see the bigger picture of these issues. We have
the potential and the capacity to do this and that is what we should
strive to do. We dare say that the responsibility to bring back the
faith and trust by the Nigerian populace in our healthcare systems in
the long term rest with all of us collectively. This faith is being
restored by the formation of the Health Care Practitioners Association
of Nigeria (HC-PAN). The association is a collective umbrella body of
all health care practitioners and is in prime position to provide a
solid basis for improved health care delivery systems in Nigeria.
Medical tourism is big business
India’s National Health Policy declares that
treatment of foreign patients is legally an “export” and deemed
“eligible for all fiscal incentives extended to export earnings.”
Government and private sector studies in India estimate that medical
tourism could bring between $1 billion and $2 billion USD into the
country by 2012. Specifically, it has been reported that India earns
about $260 million USD from medical tourism from Nigeria alone. So, this
is big business for India and they are actively pushing this activity
and generating huge revenue from Nigeria. This is truly appalling and we
are losing significant revenue to India and other countries. Instead,
we should encourage inward medical tourism- into Nigeria. There is no
reason why we should not be earning this money for Nigeria instead. This
is money that could be used, potentially, to develop our crumbling
health infrastructure.
Support your local
The colossal sum of money spent abroad could be used
to equip many local hospitals in Nigeria to provide equitable standard
of facilities and care for all Nigerians. Sadly, Nigerians, and many
politicians and government officials do not support their local
hospitals both morally and financially. They forget that some illnesses
are so acute requiring immediate medical attention that cannot wait for
the flight to other countries. Supporting the local hospital and
ensuring that it has both personnel and equipment may be the difference
between life and death. Anyone proudly strutting off to India and other
countries is truly a big fool. Develop your local hospital and help
prepare them to be able to help you when it really matters. That you can
afford to travel to other countries is simply not the issue. Many have
gone to other countries and return dead despite colossal sums of money
spent.
Demoralising local doctors
One other fact is that medical tourism is further
demoralising local doctors and sapping the little energy and interest
remaining. This is very important and should be of concern to every sane
Nigerian. We recognise the fact that over time, Nigerian doctors and
hospitals have lost the trust and respect of patients. Rather than
seeing this as a reason to seek medical attention elsewhere, this should
be a call and pressure applied to the government to optimise and
improve our facilities and expertise. Patients are best served by
medical treatment provided close to where they live; particularly in
emergencies.
The key issues are that such medical tourism is
eroding the fabric of our own health services and further depleting the
nation of medical facilities and expertise. It demoralises local medical
practitioners and increases the brain drain. It reduces training of
medical students, further creating substandard and poorly trained
doctors to look after us all in the future.
It simply creates a vicious circle we must break free of.
