BY BRIGHT JACOB
Medical practitioners have stated that medical tourism would continue to remain a controversial topic in Nigeria because of the way it was perceived in the country, and the disposition of public office holders towards it.
The government, in its quest to end medical tourism, has been dissuading Nigerians from traveling abroad to seek healthcare. They reveal plans that would address the issue, and also leverage on the unveiling of infrastructures and treatment centres previously unavailable in the country.
Responding to the controversies generated by health tourism, a medical practitioner and World Bank consultant, Tunde Ipaiye, said that most statements by government officials about medical tourism were political in nature.
According to him, medical tourism was practiced worldwide, and shouldn’t be used to divert attention from more pressing health issues.
“Wanting to make medical tourism a thing of the past is a political statement. Medical tourism is practiced globally. America has a very strong healthcare system, yet Americans still travel all over the world for medical tourism. So for me, it is just a way (used by the government) to divert attention from very serious issues.
“The serious issues are the fact that we are not investing properly in health services, we are not monitoring the quality of health services, we are not building infrastructures, and of course, the most important is that the system has not been able to create a pool of resources that will make healthcare accessible to ordinary Nigerians,” he said.
Ipaiye explained that Nigeria has not been able to create a system that allowed resources, particularly financial resources to be pooled as an insurance scheme.
The health insurance scheme, he stressed, was the easiest way to ensure access to healthcare anywhere in the world.
“By insurance, we mean that you pool resources and share risk. That is what insurance means. So if the government of Nigeria like governments of other countries where healthcare is more accessible, what they have done is to ensure that everybody is able to make contributions, and when you need healthcare, you don’t pay at the point of service. It is given to you without any financial catastrophic damage to your pocket and income.
“Until we get to that point, we will keep blaming everything on health tourism. What has health tourism got to do with the quality of healthcare in Nigeria? What has it got to do with the unavailability of health workers? What has health tourism got to do with the poor medication and quality of drugs that we import into Nigeria?” he queried.
Ipaiye affirmed that medical tourism was a global phenomenon and there were more Americans who went for medical tourism in India than Nigerians who went there. He also noted that medical tourism was a behavioral issue.
According to him, its only problem in Nigeria was that political elites in Nigeria embarked on it at the expense of the Nigerian system, and that was why it was a topic.
“The moment the Nigerian system is addressed and ordinary Nigerians can access services, nobody would care where the president or governor goes to take health services. So, it is an excuse on the part of those who have failed the system to say the problem is medical tourism. The problem is never medical tourism. And yes, we need to address our health system challenges, but the focus of that address should not be to stop tourism, because tourism will continue forever,” he added.
“The moment the Nigerian system is addressed and ordinary Nigerians can access services, nobody would care where the president or governor goes to take health services. So, it is an excuse on the part of those who have failed the system to say the problem is medical tourism”
Shedding more light on the “behavioral issue” he spoke about earlier, Ipaiye said it was because of it Nigerians still travelled abroad when it was obvious the same treatment could be gotten here.
According to him, “Some Nigerians will not eat cake made in Nigeria, or ice cream made in Nigeria.
They just jump into the next aircraft to go and check their headache.”
He observed that even for medical check-ups, some people don’t stay in Nigeria because our “culture” and “behaviour” was such that “we saw it as a display”.
Ipaiye further said that the conversation about medical tourism should “come from the accountability side of it” rather than whether it was something that should be reversed or not. He pointed to the era of the late Olikoye Ransome-Kuti, a former Minister for Health during the military administration of former Head of State, Ibrahim Babangida, who made healthcare accessible to ordinary Nigerians.
Ipaiye was of the view that Nigerians didn’t discuss medical tourism at that time.
“It never mattered where Nigerians were going for healthcare (in those days). If you were comfortable, and had money, you could go anywhere. The only thing we should, however, discuss today is to stop using public funds to encourage medical tourism.
“That is the only conversation we should have, and the moment we stop using public funds to fund medical tourism, that conversation would cease. If anyone who is in public office wants to go anywhere in the world, let him pay from his pocket and it wouldn’t be our headache,” he concluded.
Another medical doctor who is also a consultant at Famacare Centre Limited, Egbeda, Lagos, Hart Ikechukwu, told The Point that he referred to every discussion about doing away with health tourism in Nigeria as a “fantasy”.
According to Ikechukwu, all the bold steps (by the government) to rid Nigeria of medical tourism would only make sense when they (leaders) told themselves they shouldn’t go to receive any healthcare abroad.
“They just want to say something to lead the headlines. We all know that the bold step they are trying to take is still a fantasy. If they want it (end to tourism) to come to pass, then they should tell themselves that they shouldn’t go and receive healthcare abroad,” he said.
Ikechukwu also told our correspondent that public office holders used taxpayers’ money which was meant to be used to develop the country, to pay for such services abroad, and were enriching those countries. He also said our healthcare system was not one that worked.
This failed system, according to Ikechukwu, was the cause of the brain drain in the health sector, and was also responsible for people visiting foreign countries to treat certain ailments that could be taken care of in Nigeria.
“Who are the doctors Nigerians are travelling abroad to meet? Do you know that 70% to 80% of medical practitioners in the United Kingdom are from Nigeria? I heard from a reliable source that even our president was treated by a Nigerian.
“Presently, there’s a brain drain. Our best hands are leaving this country. How would people not go there when our best hands are all there? I would definitely go there and receive care if I have the money. You spend billions of dollars to enrich other foreign health sectors and yours is dying. It makes no sense,” he said.
In his own contribution, Babafemi Adenuga, an Associate Professor of Family Medicine and consultant, Family Physician at Marcelle Ruth Specialist Hospital, Victoria Island, Lagos, said it was safe to say that Nigeria was ready to end medical tourism.
He listed various pieces of evidence that supported his position, like the influx of Nigerian physicians into the country who used to practice abroad, and the development of “centres of excellence” that were comparable to hospitals anywhere in the world.
“I think there are a lot of things that show evidence that medical tourism should be a thing of the past in Nigeria. One is that you have an influx of Nigerian physicians who are abroad, who are actually coming to Nigeria to provide their services,” he said.
Commenting further, Adenuga who was a former Special Adviser on Health in Ogun State, said, “Then you have quite a number of centres developed, centres of excellence that are very much comparable to hospitals abroad. By the time you put those things together, it is safe to say that tourism can actually become a thing of the past.”
Quizzed about the reason Nigerians ran abroad for treatment when care could be gotten here, Adenuga said trust could be an issue. “People still don’t have the full trust in the health system here, and you can’t really blame people because we’ve had quite a number of situations of missed diagnosis, health providers not being vigilant in terms of ensuring that some of the information that comes from tests you do are correct,” he said.
Adenuga also said another factor responsible for health tourism was the frustration of practicing here.
According to him, the health system was quite fragmented and required proper coordination, and physicians needed to understand that part of the service of providing care was also ensuring that the care was coordinated and the patient was placed at the centre of that coordination. He also added that information was not fully disseminated wide enough for people to know that there are centres of excellence in Nigeria they could actually go and see the sort of doctors they would see abroad.
