African leaders’ preference for overseas medical care destroys local healthcare systems

Olusegun Akinfenwa: Sierra Leone Telegraph: 20 May 2021:

Poor healthcare system is a perennial challenge in many African countries. Shortage of medical professionals and dilapidated facilities are common experiences in the continent. (Photo above: President Julius Maada Bio of Sierra Leone). Apart from a few countries like South Africa, Egypt with relatively improved healthcare, most other countries lack state of the art medical facilities, leaving experts to improvise or helpless in many situations.

This explains why the continent records a high rate of preventable deaths every year. Despite that, however, political leaders from many of these countries have an insatiable appetite for medical tourism and seem not bothered with the unpalatable medical experiences their citizens daily undergo.

In early April, President Buhari’s medical trip to London generated strong reactions from Nigerians home and abroad as people protested against his one-too-many health tourism to the British capital.

Ironically, while he was in London enjoying the best healthcare, doctors in Nigerians were on strike protesting against poor working conditions and salary arrears.

Since he became president of Africa’s most populated country six years ago, Buhari has travelled to London for medical attention several times and spent more than 175 days in all these trips.

In 2017 alone, the 78-year-old Nigerian leader spent more than 150 days in just two trips – nearly doubled the entire time he stayed in his own country.

But Buhari is not alone in this practice. The “shameful” and selfish act is a common pattern across the continent. Many past and present African leaders have demonstrated their sheer preference for foreign healthcare. Presidents Patrice Talon of Benin Republic, Ali Bongo of Gabon, former presidents Jose Eduardo Dos Santos of Angola and Abdelaziz Bouteflika of Algeria are some of the leaders who have recently made the headlines for the same practice.

More shameful is the fact that many African leaders have died abroad in the past two decades while seeking healthcare in foreign hospitals. They include Zambia’s presidents Levy Mwanawasa in France in 2008 and Michael Sata in the UK in 2014, Gabon’s Omar Bongo December in Spain 2009, Umar Musa Yar’Adua of Nigeria in Saudi Arabia 2020 and Ethiopia’s Meles Zenawi August in Belgium 2012. Robert Mugabe was also a frequent visitor to health facilities abroad during his days as Zimbabwe president. The sit-tight leader who left office at the age of 93 in 2017 later died in a Singaporean hospital in 2019, aged 95.

The reason behind this age-long practice isn’t farfetched – African leaders lack faith in the system they oversee. Healthcare in many countries is in a sorry state due to the lack of adequate funding.

According to Brookings, Africa makes up 16% of the world’s population but only accounts for a meagre 1% of the overall global health expenditure. In other words, it is the continent with the least investment in healthcare. In per capita views, the rest of the world spends 10 times more on health than Africa.

The continuous negligence has thrown the continent into dire health challenges, ranging from deplorable facilities to a shortage of experts in various medical practices. The continent is ravaged by 23% of the overall global disease burden, resulting in a high child and maternal mortality rate as well as short life expectancy.

The most affected region is the sub-Sahara Africa, where most countries suffer acute health financing gap. For instance, in Nigeria, public expenditure on healthcare is just 3.89% of the country’s $495 billion GDP.

Compared to developed countries like Germany, the United States, and Canada, with 11.43%, 10.79%, and 16.89% per GDP, Nigeria lags far behind in healthcare funding. In Zimbabwe, there have been cases of lack of hand gloves, resulting in bare-handed surgeries by doctors. At the peak of the coronavirus pandemic in 2020, the whole of Central Republic Africa could only account for three ventilators.

Shortage of hospital beds and other equipment is another perennial challenge in many African countries. For instance, Nigeria needs an estimated $82 billion investment in healthcare real estate and around 386,000 additional beds to meet up with the global average of 2.7 beds per 1,000 persons.

It is then not surprising that the sub-Saharan African region has some of the worst health indicators in the world. In 2018, 54% of the global child mortality occurred in the region, as 1 in 13 children die before the age of 5. Lesotho, Nigeria, and Sierra Leone, all from sub-Sahara Africa, are the three lowest-ranked countries in terms of life expectancy.

(Photo: President Bio of Sierra Leone spent hundreds of thousands of dollars on hotel and private medical care in Lebanon last year).

Whereas the WHO recommended doctor to population ratio is 1: 1,000, Africa can only boast of a distant 1:10,000. And from all indications, the shortage of physicians on the continent will hit a whopping 4.3 million by 2035.

Despite that, the few qualified workers are also migrating in droves to Europe, the Americas and Asia, due to the frustrating working conditions at home.

For example, 1 in 10 doctors in the UK are from Africa. Many of these doctors reside and work in Britain on indefinite leave to remain migrant status, an indication that they would most likely retire there without ever returning to work in Africa.

Unfortunately, the same African leaders who should be bothered about the poor state of things in their countries are the ones travelling abroad to enjoy the best care while their citizens bear the burden. Many of these medical trips are sponsored using taxpayer money. In 2016, Africans spent an estimated $6 billion seeking medical attention abroad.

Such a huge amount could go a long way in fixing the deplorable health system in many of these countries. It also means a substantial gain to those continents where the funds are spent and a huge loss to Africa.

The concerned African leaders will have to start demonstrating strong political will needed to turn the poor health system in the continent around. There must be targeted efforts toward closing the huge funding gap in the system and creating a pleasant working and encouraging environment for healthcare professionals on the continent.

It is high time the leaders started leading by example by patronizing the health system in their home countries instead of running abroad for their medical needs. This will allow them to know the true state of their countries’ health sector, help build the confidence of their citizens in the system and reduce the annual multi-billion dollar spending on health tourism.

About the author

Olusegun Akinfenwa is a correspondent for Immigration News, a news organization affiliated with Immigration Advice Service London. IAS is a leading UK immigration law firm that helps people migrate and settle in the UK.