Medical tourism in the western world is alien and almost outdated because the quality of healthcare obtainable in this region does not encourage it.
ABSTRACT
Decades of practicing in the medical world, more particularly in Nigeria, gives me the full knowledge of the events of the country’s medical health and its resultant diminishing wealth.
Where we have found ourselves as a country is a proof that the health sector has not been in the hands of proper medical professionals but political professionals. However, there are many, who still continue to live in denial of this. The health system has incessantly failed the people of the nation and even the people’s representatives will not subject themselves to the system. Nigeria is fighting a battle unprepared and she is not making appreciable effort in fighting back. We may have been lucky in the fight against Covid-19, evident by comparing the casualties of other nation with significant population as ours just as we made India a medical tourist point for health solutions, these Indians that we relied on for medical treatment is unable to help herself. This has more than ever highlighted the fact that the health itself needs a physician.
This article therein will be looking at the general reprehensible issues of the health sector that has put us in a disadvantage position in the league of nations with serious health, infrastructure issues and the way forward to ensure a rejuvenation and restructuring of the health sector to deliver the enormous wealth of the nation.
MY CONCERN AND THE WAY FORWARD ON COVID-19 VACCINES: REQUIRED RESEARCH FOR THE BLACK RACE
Medical tourism in the western world is alien and almost outdated because the quality of healthcare obtainable in this region does not encourage it. We are receiving vaccines that have not been well researched on our genetic and racial makeup. We hear various happenings post vaccination with AstraZeneca. We should be conscious of our physiology before we inject into our citizens not well researched vaccines that may not be very suitable with our genetic compositions. We continue to heavily rely on foreign countries, hook line and sinker to proffer solutions to our medical health challenges. Some of these countries’ negligence are the driving force for the health challenges faced by the whole world today. Covid-19 has had a significant adverse effect on Nigeria, we are yet to recover from same. This virus is directly precipitated by the negligence of the Chinese authorities. Some Nigerians in a class action filed a lawsuit against the People's Republic of China before the Federal Capital Territory (FCT) High Court over its alleged culpability in the spread of COVID-19 and are demanding a $200 billion compensation over the effects of the pandemic on their livelihoods. These lawyers accused China of failing to act in accordance with the Articles and the provisions of the International Health Regulations of 2005, which it ratified on June 15, 2007, and failing to promptly inform the World Health Organization (WHO) of its discovery of COVID-19 and sought a declaration that the China’s handling of the Covid-19 outbreak violated the Claimants’ humanitarian rights guaranteed under the Universal Declaration of Human Rights, resulting in social exclusion, loss of human dignity psychological trauma and social deprivations. The said may however not be successful against China due to the lack of locus standi and a jurisdictional issues but it highlights the fact that we can not continue to rely on these countries for health solution. The Chinese Embassy has on several occasion reacted angrily to the suit rather than apologize for bringing the world to its knees.
It is indeed unfortunate that our leaders seek medical treatment outside the shores of Nigeria because those services are excellent. These leaders do not believe in our own medical institutions nor reckon with Nigeria’s health system. The reason the leaders travel or seek medical tourism is that they lack faith in the country’s health system. The time is crucial and not right for medical tourism. It is high time to be concerned for the common man. What should the rest population who cannot travel for medical treatment do?
In 1975, doctors in England went on strike, which gained public support, that in turn yielded the much-needed result for health professionals. Our doctors in Nigeria are constantly agitating with frequent strike actions and our leaders have done very little to put an end to this ugly trend rather they have continued to patronize foreign health services. I am afraid this will give birth to a public uproar in our country. Perhaps this is needed for the change we so much desire in our dear country.
In the 1970s when health workers went on strike in Britain, the public gave their maximum support to the agitation of the health workers (see the below pictures for illustration) and in return the people of Britain gained for themselves and their future generations a reformed system that our leaders now travel to enjoy. The same health system that our leaders are traveling and clamoring to utilize and benefit from, they have failed, refused and neglected to replicate same in Nigeria for selfish reasons. The medical sector as a whole deserves a better infrastructure and pay structure with a robust hazard allowance as many have lost their lives during the pandemic.
Recently, I met with a cardiologist who sought arthroscopic surgery in England, he enlightened me about the fate of our doctors in our dear country. In his search for a successful surgery in England, he was informed that the best surgeon in that field is a Nigerian, who later performed the surgery on him. Such Doctors should have been encouraged with decent pay and grants to setup befitting structure that will give back a better medical treatment to the Nigerian citizens. This, among others, immensely contribute to the brain drain we are experiencing in Nigeria, which I strongly advocate against.
The vital role played by the medical laboratory, which is the bedrock of modern medicine, cannot be overemphasized. Though the level at which these laboratories operate in this country is far below expectation compared with its contemporaries in Europe and the United States. I will be the first to admit as well that the federal government has taken some good steps in the past considering the budget allocated during President Obasanjo’s VAMED project. I also recall that during the immediate past regime under President Goodluck, there were adverts on national dailies about the need to upgrade the medical laboratories in the country. This course was championed by a philanthropist, Tony Elumelu foundation, but unfortunately it ended on the dailies and never saw the light of the day. Some of the private contractors and investors who showed interest at that period were told to invest in private-public-partnership (PPP), which also sadly ended on the papers, without much being done in that regard.
Since inception of this regime, nothing substantial has happened both in the medical laboratories and the health sector as a whole. Except for the recent contracts to build molecular laboratories in different Federal hospitals during the pandemic. I believe the failure in this sector is a result of leaving the vital decisions involving the medical laboratories in the hands of those who are not laboratory scientists and know little or nothing about the laboratory processes, infrastructure and instrumentations. Consequently, the country has consistently failed to achieve the desired result in medical laboratory services delivery which is very important in patient management and generation of critical data necessary for health decision making, despite the huge investments. To buttress this, while discussing with one of the staff in the Medical Laboratory Science Council of Nigeria’s research center, he highlighted the need for adequate financial support to enable proper validation testing of COVID-19 test kits in Nigeria.
Before now, the country has experienced several pandemics and presently we are facing one of the biggest ‘monsters’ of our time, COVID-19. Believe it or not, in the future more pandemics will come up which may be more violent than what we are faced with now. These viruses tend to mutate and can wipe out the entire human race. The earlier we as a country start being proactive and make projections into the future, the better our future will be.
I was a frontline personnel of the HIV/AIDS Pandemic in the 80s precisely in 1982 at Wayne State University Teaching Hospital during the treatment of soldiers that returned from the first Gulf war. I never realized my role or contribution; I was working with enthusiasm. A British man, by name, Mr Neol Connonoly when he visited Nigeria, commended in his remarks that our company provided a large-scale solution for HIV/AIDS patients and we touched over 70% lives infected with HIV/AIDS in Nigeria during the PEPFER (US President’s Emergency Plan for AIDS Relief) intervention.
The diagnostic laboratories in the country are calling for serious attention starting from the grassroots. The time for complete revamping, modernization, and upgrading is now. Take a look at the Medical Laboratory Council of Nigeria’s validation laboratory at Yaba. It urgently requires modernization structurally and with equipment to reflect modern technological advancement. In the 70s and 80s Nigeria as a country was into vaccine production at the institute in Yaba where I met Dr. Abdulsalam Nasidi, Mrs. Funmilayo Jaja, Mr Egbewunmi etc. on my arrival from the United States while attached to the NNPC clinics. If I may ask what happened to the Vaccine production lines?
Health workers in some states sometimes go without salaries for over a year. This is crude enslavement; there must be an end to this cycle of the impoverishment of the health workers. These people are helplessly saddled with the poverty mentality imposed by corrupt politicians.
Going by the CNN reports, the negative impacts of SARS-COV-2 on the black community in the USA makes me wonder if the available treatment is counter-productive for the blacks.
The SARS-COV-2 virus is a family of viruses that causes the regular common cold.
How are we sure that the research that has been done and viral marker assays carried out outside Nigeria or even other African territories captured our black “African” genetic makeup in our territory. I guess that Africans that are immune-compromised with underlying diseases like Cancer, HIV, Diabetes, Hypertension, etc, cannot fight COVID-19 viruse due to their compromised state and genetic composition. Nigeria has become a haven for clinical trial for foreign pharmaceutical companies and our government continues fold its hand as it is deemed not possible to affect them. These foreign bodies take advantage if our corrupt system, and makes us their human guinea pig. The COVID-19 vaccines that is being championed by our government has not been thoroughly tested by us and despite the rejection of same by some developed countries, we continue to inject our citizens with it.s
The above shows that we have a lot of research work to do, and we cannot keep waiting like helpless people always wishing for handouts. If we can improve on our research centers, it will do us, our children, and generation yet unborn a lot of good.
Therefore, I strongly advise the federal government to build reference medical centers equipped with modern laboratories for evaluation and validation of the safety and efficacy of vaccines in the six geopolitical zones, which can compete with and/or collaborate effectively with other facilities around the world.
We can relate with other African countries to come up with our vaccine mandate and efficacy. The black man must be healthy before he spends his fraudulent and embezzled funds (which is bad in itself) around the globe. Our funds must not be embezzled in any way, rather be used for the benefit of the masses (See pictures attached on what the extraordinarily rich and wealthy do with their money for the public health system).
Recommended steps
Revamping of government-owned laboratories nationwide; I have shown a good example with my resources at Federal Medical Center Ebute Meta, Lagos.
The medical laboratory science profession should be redressed holistically, taking a look at their counterparts in the western world. This will help us as a country achieve what those countries have achieved in the field of effective diagnostic tools, vaccines production, and advancement in health research technology and instrumentation.
Regarding the mentioned Medical Laboratory Science Council of Nigeria, these services should be situated in the six geopolitical zones to serve as the backbone and training ground for the young and upcoming scientists. Also, it will ensure continuity is borne and sustenance in the nation’s medical diagnostics system should be our watch word.
The federal government should identify and pay health workers and teachers whom the state government has failed to pay their salaries from the state budget allocation directly from source before disbursement of funds to various states.
Those in the western world know how to immortalize their names on medical facilities and hospitals for the good of everyone and society at large. Buildings that live after them- Forever immortalized and remembered by family and the public. These buildings below are typical examples of medical centers or hospitals built by philanthropists and well-meaning individuals.
The James Cancer Hospital
David H. Koch to the memory of Sloan- Kettering Cancer Center
T. Denny Sanford to Sandford Health
Ernest Rady to Rady Children Hospital Foundation
Herbert and Florence Irving to New York Presbyterian
Beaumont Hospital
Henry Ford Hospital
Detroit Medical Center
Grace Hospital
John Hopkins Hospital
It is not about temporary donations, Nigerians are fond of fire brigade approach. It will be a welcome idea if meaningful wealthy Nigerians like those with Oil Wells (https://nigerianinfopedia.com.ng/oil-well-owners-in-nigeria/) can do as listed above in the western world, that will give us modern hospitals and healthcare facilities.
Over the years, we have often seen the incumbent administration blame the former administratione for leaving behind a corrupt system which is why the country is still very backward. One of the qualities of good leadership is taking responsibility for the current situation and making the best out of it. However, our current political leaders would rather apportion blame than take responsibility.
I would like us to take a look at a common case study:
A state with a budget of N1.3 billion as allocation for Hospital Management and Teaching Hospitals with an expected expenditure of 130 million Naira monthly. However, the hospital only generated between 20 to 30 million Naira monthly.
It is now a common practice that most state health practitioners and workers have their private practice and “personal runs” which automatically affect their productivity in their main employment. The above-mentioned scenario is a common practice nationwide which is still the reason why the country is where it is currently.
As a way of contributing my quota to the development of the country, I invested in rescuing the situation at Federal Medical Center, Umuahia when I realized that people were dying due to lack of proper healthcare system and diagnostic tools. As at the time this project was embarked upon, there was a promise from NHIS to refund every penny spent on their patient tests. No payment has been received from 2018 till today on treatment rendered at FMC, Umuahia. This action or attitude of NHIS further shows how deteriorated the Nigerian system has become.
One of the best ways to come out of this situation is for the government to privatize some of the institutions in Nigeria, healthcare for example. Many people are losing their lives daily as a result of the bad healthcare system. If there is an affordable insurance scheme made available to the poor and lower class, the rate at which people die as a result of a bad healthcare system will drastically reduce. The US, for instance, has a healthcare system called “Medicaid” and “Medicare” which is affordable for the vulnerable masses, the poor, children, and the elderly. It is high time the government takes action and cater for the citizens that voted them into power.
The bad healthcare system in Nigeria has gotten worse with the advent of COVID-19 because the country wasn’t prepared. The COVID-19 outbreak came at a time when the country is currently battling with Lassa fever of which several people had lost their lives through the disease. The country’s unpreparedness was most obviously evident from the low testing rates for COVID-19 in the country. Nigeria currently can test only about 2,500 samples a day and just half of these are administered each day because of the shortage of human resources, testing kits, and laboratories. What this means is that Nigeria has only tested less than 1% of its entire population. The Nigerian Government has taken numerous health, social and economic measures to curtail the impact of covid-19, however, some of the policy responses have weaknesses and taken together, are not commensurate with the magnitude of the problem. If urgent public health preventive measures are not taken to contain the spread of the deadly and highly infectious virus, the situation will surely get worse with viruses that are yet to manifest.
Nigeria has been blessed with so many resources but does not have good leaders that will be able to maximize and manage these resources dexterously. The majority of the leaders Nigeria have had are leaders who are corrupt and selfish, whose sole aim of seeking political offices is to embezzle public funds for their personal gains. Unfortunately, this societal greed has crept into government structures in the health sectors, where people no longer represent the interest of the people but rather, their personal and selfish endeavors.
As a matter of urgency, the health sector needs reform. Many are dying because they cannot afford the Nigerian healthcare system. Affordable health insurance schemes should be made available to the poor masses and finally, it will be in the interest of the Nigerian Government to privatize some healthcare sectors for efficiency. The effect of the settlement of the ’70s in Britain is what our leaders continue to benefit from. The astronomical foreign medical expenses spent abroad are from our budget for the selfish few, who failed to manage the country properly.
As many of us appreciate that medicine is a noble profession evident with self-sacrifices, challenges, which I have witnessed first-hand, through the experience of my children, nephews, brothers who are doctors.
Therefore, unilateral salary increment should not be the focus because it does not encourage or promote harmony and togetherness within the allied health professionals to be able to favorably compete with the outside world, which is devoid of mismanagement.
The lessons learned from this Pandemic are to mirror our health infrastructure and prepare us for the future by putting systems, services, and procedures in place. It is an eye opener to plan for the unknown future. The unabated marginalization of the laboratory scientist is saddening and they do not wish to further cripple the polity, but a continued neglect by the government may force them to take drastic steps to ensure that the change the seek is obtained.
Chairperson,
Board of Trustee,
Association of Medical Laboratory Scientists of Nigeria
AMLSN
PUBLIC STRIKE ON BEHALF OF RESIDENTS DOCTORS IN UK BY DOCTORS AND ALL THE PUBLIC BENEFICIARIES
These are treatment centers donated by philanthropist to the public majority-
Dear Wealthy Nigerians, Put your money where your mouth is.
Written by: Chief Mrs. Adunni Udu, a philanthropist, and astute business icon and thorough-bread Medical Professional lives in Nigeria since her return from the United States of America in the 90s.