In my job here in the UK, every now and again, I am called-in to see private patients. About four years or so ago, I saw a patient that had been flown-in from Nigeria. He was definitely a Nigerian ‘big man.’ He had suffered some kind of acquired brain injury.
After initial assessment and intervention I began to leave. As I made my way out, a lady who introduced herself to me as the wife of my patient stopped me in the posh waiting area. She thanked me for my input and asked if I was Nigerian. I responded that indeed I was. A look of amazement came to her face. I was curious and wanted to know why she had that look but I wasn’t going to ask, as I had to rush off to my next appointment.
As I made to leave, she stopped me again and asked if I was the leader of the team that attended to her husband as I appeared to have been to her own observation. I replied again in the affirmative. She smiled and looked at the rest of her small entourage with open pride. She grabbed my hand and announced to the room that she was very proud. Then she became agitated. Whilst still holding on to my hand, she said something like, “Ah, our children are trying o! Our people are really trying o! Imagine what we are losing in Nigeria. If people like this can come home and help us…”
I wanted to, but I did not have the heart (given her husband’s situation then, and the pressure on my time that day) to give her a small lecture about how people like me would love to be home but that it was precisely people like her and her husband that have made millions of Nigerians like me economic exiles and refugees the world over, wasting the most productive years of our lives outside our fatherland.
Another reason I did not deliver that short lecture was probably because, deep down, I believed that the lady would not get it. I have since discovered that the very rich, the elite, the political establishmentarians in Nigeria (and perhaps elsewhere) live in their own very insular world. They do not relate to you and I, and are therefore, in the main, unable to truly relate to matters that concerns or bothers us. Their A to Z resides only in that little rich cocoon of theirs with its own peculiar rules and regulations where wealth-based rivalry and profligacy are the norm. They all possess a highly fine-tuned sense of entitlement and never understand why regular people challenge or question this. In fact, quite a lot of them think that the ordinary Nigerian is the problem. They believe that the average Nigerian is an ungrateful and a difficult to manage entity.
But let me now attempt to put together what I could have said to that lady and her clique using their current front man – Yar’Adua - as a case study:
Yar’Adua had just spent another week or so in Saudi Arabia getting pumped full of steroids. He had invited himself, and was pretending to be interested in the opening of a university in that far away land at a time when all the universities in his own country were shut down. Clearly, irony is not his strong suit. Shortly before that, he ran out to the same Saudi clinic for “treatment and the lesser hajj.” Before that, he was again in the same clinic, via Brazil, during the heat of the ‘boko haram’ crisis. I can count five trips already this year. This has become the pattern. In short, his medical trips out of the country have been incessant. But this same Yar’Adua was the governor of a State for eight long years. For a majority of those eight years, he was a regular dialysis patient. His dialysis centre was in far away Germany which he visited, at one period, at least every fortnight. He had other concomitant ailments as well.
Because of his poor health, Yar’Adua’s government in Katsina was only a government on paper. The State’s Executive Council actually met and sat far less than a third of the times available to it. Also, because of poor health, Yar’Adua was unable to do things, spend or chop money to the extent that he otherwise would have done. Most of what was spent went to his German doctors. The rest of the money just sat there in the treasury; hence Obasanjo was going around in early 2007 telling the whole country that Yar’Adua was not corrupt as he was the only governor who left some money in his State coffers. (OBJ was wrong: Abubakar Audu left a whole five hundred thousand Naira in Kogi in 2003!)
But in all of that time, and with his health problems and personal experiences, Yar’Adua never thought it expedient, necessary or desirable to spend a fraction of all that money to establish a specialist renal and related diseases hospital in Katsina that would treat him and others in his State. If he had done that, the facility might today be serving as a centre for clinical excellence and possibly now be a national and West African regional referral centre. Such a centre would not only have met his and others’ medical needs, it would also have provided a good standard employment for specialist clinicians and allied professionals in Renal Medicine, Nephrology and Urology. It would have attracted expert Nigerians and other medical personnel from elsewhere. Post graduate medical training would have flourished there. The facility would also have been an easy cash cow; a nice little earner for his State. He wouldn’t even have had to build one from scratch; he could just have developed an existing facility.
However for him, flying out to German private clinics to take care of himself was the only logical thing to do. Others would and should take care of themselves anyway they could. That all the money he was spending on his own personal healthcare was depriving others in Katsina of even basic healthcare amenities just never occurred to him. If it did, he probably thought the State owed it to him as governor - even if it consumed all of the State’s resources.
Now, two calamitous and barren years into his tenure at Aso Rock, Yar’Adua has continued where he left off in Katsina. As his health has worsened, so has the government he pretends to head. It is on good authority that, most days, this man spends less time in his office, or on State matters than Obasanjo spends at the meal table. But more importantly, he hasn’t deemed it necessary at all to do anything about healthcare in Nigeria. He continued flying directly into Germany until Nigerians let him know that they would rather he resigned on health grounds. Since then, he has perfected the art of stealing into Saudi Arabia at the slightest excuse for treatment.
In 2008, following the huge outcry over his constant jetting out for treatment, Yar’Adua announced that some $20 million would be spent to upgrade the Aso Rock Clinic. $20 million! That clinic is for his exclusive use. But there is something called the “National Hospital” in Abuja that I understand was founded by Maryam Abacha. This is the Nigerian premier hospital but still our big people will not patronise the place. The National Hospital started off as a women & children’s facility to reduce morbidity and mortality rates amongst that population and was formally opened in 1999 by Abdulsalami. By May 2000, the place has been designated a national hospital as it began to take on male patients. Its operating cost in 2008 was nearly N4.3 billion but it is only known for its IVF focus.
Apart from the national hospital, there are other public healthcare institutions dotted across the country but these places are largely under-funded, mismanaged and near desolate. There are plenty of private hospitals as well, but Nigerian big men and women only spend, at best, the first day of their illness in these places before they are flown abroad.
The national hospital was initially managed by the International Health Group brought in from the UK to manage the hospital for 10 years. But in 2003, Obasanjo sacked the management board for incompetence and installed his Special Assistant and Lawyer, Musa Elayo as head of the interim board. Obasanjo also appointed his personal physician, Dr Olusegun Ajuwon the Chief Medical Director.
But since Yar’Adua took over, nothing at all has happened. Even the funny and kickback laden contract that Obasanjo awarded (again, to another one of his former aides!) for the building of one health clinic each in all the 774 Local Government Areas of the country was revoked by Yar’Adua but Yar’Adua had never suggested an alternative policy nor did anything himself. At this rate, and at Yar’Adua’s pace, our elites would soon be heading out to Ghana and the Gambia for medical care.
During Obasanjo’s second term, I sent in a detailed proposal to his last Health Minister on ways to revamp and run a functional primary care health service, but nothing came out of that effort. All I got back in response was a standard email reply and that was that. But healthcare in Nigeria is still completely neglected. I don’t know how many Nigerians go to Germany, Saudi Arabia, USA, Portugal, etc for medical attention, but I do know that the traffic into London alone is very heavy.
From Obasanjo to Atiku, Turaki, Buhari, Babangida (his own preferred destination is France), Emir of Katsina, Awoniyi, Gen. Malu, all the State governors and nearly all other government officials; they all flock abroad for medical care, annual medical check-ups and eye tests. And most of these people are ferried abroad and are treated at public expense. Quite a few of them die abroad because it is usually too late to do much for them by the time they arrive and because acute emergency medical response back in Nigeria is under-funded and inadequate. Others (like Eaglets coach, Yemi Tella) die whilst waiting to be flown abroad. There was even the pathetic case of Gen. Abdulkarim Adisa, a former Works Minister who died in a London hospital following a road accident in Nigeria.
Yet, Yar’Adua continues to lead the way with unending trips out for treatment. He is constantly under sedation and what not. I wonder if anyone in his circle has thought about the possible national security implication of this. Entrusting the elective medical care (as different from emergency intervention) of a country’s leader continually in the hands of foreigners and in foreign countries is fraught with risks and danger, is it not?
But I know that Yar’Adua, his cohorts and others like him think that they cannot entrust their lives to the inadequate healthcare provision in Nigeria. They continue to flounce to foreign lands and foreign hospitals that are, in any case, suffused with Nigerian doctors and nurses. So why not do something about the dysfunctional healthcare system at home? Why not make it adequate? Why not invest in it – publicly and privately? Make it functional. Make it effectual and Nigerians will come home. Lay a credible foundation or, minimally, start to show some believable effort and others will be more than happy to come and join-in and help build a sustainable healthcare system.
When Yar’Adua was campaigning, before he got caught out and landed in a familiar German hospital with “sinus” problems, he famously declared that he was a regular squash player. Throughout his eight years in Katsina, as he preoccupied himself with playing squash and lying on foreign sick beds, Katsina State consistently came dead last in the National Examinations Council (NECO) and GCE exams. I wonder if he still plays squash. I know that he plays with Nigeria; the problem is that it is not funny anymore.