The past few days have witnessed protests by some U.K. based Nigerians calling on their president Muhammadu Buhari who is currently receiving medical attention in London, to return home and fix the deplorable healthcare in his home country.
Within his 6 years as president, Buhari has spent more than 175 days in the United Kingdom seeking medical attention. Between January to August 2017, he spent 152 days there on medical holiday – nearly doubled the entire time spent in his own country. Also, about the same period, President Patrice Talon of the Republic of Benin was in France for two operations, one on his prostate and the other on his digestive system.
From the northern to the southern part of the continent, many African leaders have shown that they prefer overseas to local medical care. Their favourite destinations include the Americas, Europe, and Asia – a clear indication that they lack confidence in the system they provide and oversee. In that same 2017, former presidents Robert Mugabe of Zimbabwe, Abdelaziz Bouteflika of Algeria, and Jose Eduardo Dos Santos of Angola all made headlines as some of the African leaders with the most frequent foreign health tourism.
Unfortunately, from their body language, there seems to be no end in sight to this pattern. Presently, President Buhari is in the U.K. on yet another medical "check-up" and due to return to the country in the second week of April. But for most Nigerians, it won’t be surprising if he ended up staying longer, judging by what played out in 2017. In what started as a short "medical vacation" on January 19 2017, Buhari kept extending his stay in London and didn't return until March 10. In less than two months after that, he flew out to London again on May 7 and returned to Nigeria on August 19, after 103 days.
Despite the dwindling economic situation and abject poverty ravaging Africa, many of its leaders prefer to spend the continent’s limited resources on other countries’ health service. They thereby improve other countries healthcare system while their own back home suffers years of degradation and negligence. In 2016, Africans spent more than $6 billion accessing medical care overseas. For example, reports show that Nigerians spend around $1 billion annually seeking medical care abroad.
Moreover, African leader’s fast and easy access to foreign medical services, which is largely funded by taxpayer money, is the reason why the continent’s healthcare suffers a huge financing gap. A 2010 report by the U.N. showed that the average amount spent on health per person in Africa was $135 – far lower than the $3,150 in high-income countries. Given the bogus amounts they spend on themselves and families abroad, it is safe to say many African leaders are not ready to improve the status quo and could as well be described as saboteurs of their own systems.
In recent years, many African presidents have died while seeking healthcare abroad. They include Zambia’s Levy Mwanawasa in August 2008 in France, Gabon’s Omar Bongo in December 2009 in Spain, and Nigeria’s Umaru Musah Yar’Adua in May 2010 in Saudi Arabia.
The lack of healthcare investment by these leaders glaringly explains why many African countries have the worst health challenges. Daily, children and adults die from various preventable conditions like malaria, diarrhoea and measles. A report by World Health Organization (WHO) shows that hundreds of thousands of Africans die from malaria, and most deaths occur in children under 5 years of age. Child mortality and maternal death remain crucial challenges facing the continent’s healthcare system. Dishearteningly, 1 in 13 sub-Saharan African children dies before reaching the age of 5 due to the deplorable healthcare in the region. A look at the global maternal rate also shows that the so-called giant of Africa, Nigeria, has the worst case in the world. The country has an alarming maternal mortality ratio of 814 per 100,000 live births. The lifetime risk of a Nigerian dying during pregnancy, childbirth, postpartum is 1 in 22, compared to developed countries with an estimated 1 in 4,900. It is also one of the countries with the global lowest life expectancy.
Lack of adequate facilities is another year-long challenge facing Africa’s healthcare. In 2015, Ethiopia was reported to have just three hospital beds per 10,000 population, compared to at least two dozen in Europe and U.S. In Zimbabwe, doctors carry out bare-handed surgeries due to the lack of gloves. And in the whole of Central African Republic’s health sector, there were only three ventilators in April 2020.
It is sad to note that the leaders from the same continent faced with all these dire health challenges are comfortable galivanting health facilities abroad, spending huge amount of money that could help better their countries’ situations. This vicious cycle of selfishness and lack of empathy for their citizens has largely contributed to the massive emigration among African health professionals. Whereas the World Health Organization recommended doctor to population ratio is 1:1000, Africa lags far behind and can only boast of 1 doctor for 10,000 people on average. By 2035, the shortage of doctors in the continent is expected to reach 4.3 million.
Despite the shortage, several African-trained doctors and other health workers travel in droves to other continents in search of greener pastures mainly due to poor, unfavorable government policies, ranging from poor remunerations, lack of facilities, and sheer corruption in the political system.
Findings showed that one in 10 doctors working in the United Kingdom are from Africa. Many of them have been granted indefinite leave to remain status and would rather retire in the foreign nation instead of their home country. Apart from the U.K., other developed countries, such as the US, Canada, Australia, and UAE, have a good number of African-trained professionals in their healthcare sectors. African doctors have helped many of these countries improve their doctor per population ratio and overall health system, while the condition back home worsens by the day. Of course, a lot of these physicians would have loved to work in their home countries, but the situation back home is anything but encouraging.
Unfortunately, this high emigration rate among African health professionals means a huge financial loss to Africa and other countries' gain. African nations spend an estimated $21,000 to $59,000 to train each doctor. So, using the knowledge acquired in Africa in hospitals abroad indicates billions of dollar investment loss. The highest foreign beneficiaries include the U.K., the U.S., Australia, and Canada. Some of these countries billions and hundreds of millions of dollars from this brain drain of African doctors.
An African idiom says if a man does not eat at home, he may never give his wife enough money to cook a good pot of soup. There lies the concern of an average African living in Africa. His leaders’ insatiable appetite for foreign medical care means he may have to suffer the poor system for long.
For Africa’s healthcare system to be effective like those in other continents, African leaders need to lead by example. They need to show leadership by investing in and patronizing the healthcare services in their countries. Other possible solutions include stopping the use of taxpayer money for health tourism by African leaders. There must also be improved remuneration and working condition for African medical practitioners to help curb the brain drain and reduce the shortage of professionals across various medical practices.
Olusegun Akinfenwa is a political correspondent for Immigration News, a news organization affiliated with Immigration Advice Service London. IAS is a leading U.K. immigration law firm that helps people migrate and settle in the U.K.