Health  

Medical tourism: Ondo health facilities, others waiting in the lobby for specialists

Medically, Nigeria is the proverbial man in the middle of a large ocean, who flounders around due to the soapy water that discomforts his sight, groping around aimlessly for a cure. This ugly scenario pictures the medical potentials that trifle away in the nation as a result of unbridled medical tourism abroad despite the available resources lying dormant.

It has become a major concern for stakeholders, who lament the huge money Nigerians are wasting abroad in search of medical treatment, developing other countries while the hospitals in the country which have the capacity to do same, if given necessary priority, can do better than the foreign counterparts.

Though some critics blame the failure, usually a litany of excuses, on the unpatriotic attitudes of the country’s policymakers, who appropriate less priority and underfunded the sector; the politicians and leaders, who cease every opportunity to siphon public funds; and the masses, who often times seek the glamour of travelling abroad for funfair and tourism.

These are evident in the alarm raised by the First Lady, Aishat Buhari, who decried that the State House Hospital did not have ordinary syringe despite the huge amount of money allocated annually in the budget; and the serial medical vacations embarked upon by President Muhammadu Buhari since 2016.

In August, the Director General of the Voice of Nigeria, Mr. Osita Okechukwu, at a 2-Day national health dialogue organised in Abuja by the Premium Times Centre for Investigative Journalism (PTCIJ), lamented that the trend by Nigerians, as at the time President Buhari was still receiving treatment in London, “is draining our reserves.”

Recently, too, the Minister of Health, Prof. Isaac Adewole, decried the upscale and rising forex loss to medical tourism, revealing that Nigeria loses over $2 billion yearly and contributes to the Gross Domestic Products (GDPs) of the countries which her citizens visit for medical treatment.

Whereas, Ondo State, among other few states in the country, has the medical wherewithal to provide most of the services which Nigerians travel overseas for in the Medical Village and University of Medical Sciences, Ondo (UNIMED) established by the immediate past governor, Dr Olusegun Mimiko in Ondo West LGA during his two-term administration that ended in February 2017.

Unfortunately, the incumbent governor, Oluwarotimi Akeredolu, since he came to the saddle nine months ago, a significant month for delivery after conception, had not come up with any policy to show the chart that will either sustain the gains inherited in the health sector or surpass the legacies.

Though, Akeredolu had embossed a negative signal on the wall, which is fast reversing the giant strides achieved through the Mother and Child Hospitals that now charge for maternity services; and the Traditional Birth Attendants (TBAs) have gone back to business as usual, which then pegged Ondo maternity mortality at a ratio of 576 per 100,000 live birth (NDHS 2013) and the worst in Western Nigeria before Mimiko administration.

Aside the Medical Village in the state, Nigeria has a number of flourishing health facilities like the Lagoon Hospital that was recently upgraded and the Nicholas Hospital in Lagos State; Afe Babalola University Ado Ekiti Teaching Hospital (ABUADTH) and other university teaching hospitals in the nation which are largely under-utilized.

In 2014, his predecessor signed the bill to establish the institution into law after the state Assembly had appropriated N2 billion for its kick off, declaring that “we are not just building a university but a specialized one that will beat all national benchmark. The university will be a global reference point in medical care.”

The former governor, Mimiko, whose efforts won several national and international awards and recognitions, noted that the existing Trauma Centre, Mother and Child Hospital, Kidney Centre, Gani Fawehinmi Diagnostic Centre, Emergency Medical Services (EMS) and several more in the same axis would be tremendously complemented by UNIMED; and most importantly to avert brain drain.

Some of these medical facilities that pioneered the university and had been in operation as early as 2011, have modern equipment like Magnetic Resonance Imaging (MRI), mammogram, auto-analyzer, CT Scan and other state-of-the-art medical facilities; recreational centres, staff school, shopping mall, staff quarters, heliport just to mention a few as planned by the Visioneer, Mimiko.

At inception, there were about five consultants in the state, but these new medical drives increased the total number of specialists and consultants to over 72 in various fields of medicine, resulting in over 3000 screening of in-patients and out-patients at the Kidney Care Centre (KCC), Ondo.

The KCC was established in 2013 and commenced full clinical services in March 2014 with the core values to uphold the three tiers of kidney care namely: primary prevention of Chronic Kidney Diseases (CKD), the secondary CKD and tertiary CKD with 374 new cases and 888 dialysis sessions from March to December.

While in 2015, there were 1,000 new cases, 383 admissions and 2571 dialysis sessions from January to December, making KCC the first centre in Africa to discover and report the rare co-existence of lupus nephritis and autosomal dominant polycystic kidney disease through painstaking researches.

According to the former Commissioner for Health, Dr Dayo Adeyanju, while delivering a report at the last Ondo State Council on Health in 2016, the medical breakthrough was significant because only 32 cases of the disease complex had been reported globally.

Also rated by the preliminary report from ADCEM Healthcare Ltd, the sole representative for Fresenius Medical Care, Germany and the most recognised supplier of dialysis machines and related products in Nigeria, KCC is the second largest dialysis centre in the country. Only Nicholas Hospital Lagos surpassed it due to over a decade existence.

Adeyanju added that KCC was the first centre to host the peritoneal dialysis training for nephrology nurses in the country, with notable institutions like LUTH, UNILORIN, National Hospital, Abuja and others in attendance. It produced the first renal dietician in Nigeria to join the Nigerian Association of Nephrology in January 2015.

“KCC is the only viable dialysis centre for infectious cases. We have the capacity to dialyze patients with transmittable infections such as HIV/AIDS and viral hepatitis B and C,” he said.

No wonder, in the build-up to the 2016 governorship election in the state, Mimiko had publicly taunted President Buhari and the All Progressives Congress (APC) that if only he had shelved London to the Medical Village for his ear treatment before the last 103 medical vacation, he would have been treated successfully with the modern medical facilities and available expertise.

However, Adeyanju, the Executive Director of Guaranteed Health Care Foundation (GHCF), stressed that “the problem with that is that one does not know the exact ailment, so we couldn’t say that it could be treated in the Medical Village.

Nonetheless, he remarked that “If we had known the exact ailment, one could have said yes it could be treated; but the kind of facilities that we have in the medical village offer range of services that right from trauma and surgical, kidney care, obstetrics, gynaecology and diagnostics. We don’t know the exact ailment, and of course, that is confidential to him.”

Without mincing words, he lamented the quantum of the fund that is going to medical tourism, stressing that if the government, policymakers and Nigerians would have a rethink and redirect their priority to the nation’s health sector, emphasizing that “We truly can generate close to N500 billion.

“This is a whole lot, this would have gone a long way to add tremendously to our IGR and will save us a lot of lives because it will also be affordable for our people; and then means that our fund is being retained in this country.”

Nevertheless, he identified disparities in some existing health facilities that range from infrastructural deficits, the dearth of modern equipment and acute shortage of medical personnel. But, he iterated that it is the responsibility of the Federal Government to forge a strong nexus in such areas to make them work as a strong whole.

“If it is the cardiac centre that we have in the UCH, Ibadan, and other places; we can see how we can coordinate in such a way that any ailment that needs to get out of this country, we find a place in any of the health facilities that are built in the country because I have seen the ones they built in Kebbi, Akwa-Ibom and I know Lagos State has just built a critical unit and modular DNA lab,” he said.

The GHCF founder, leveraging on the effectiveness of the strong nexus and ties among the various hospitals for optimal performance, declared that “For Ondo State, what we left behind in the health sector, there can’t be any match of that in any part of the country.

“So all of these, what we need is just to let the people be aware that they are in existence and ensure they offer quality services. We then create that awareness that people don’t need to travel outside this country to seek medical care.”

And on the recurrent drift of medical personnel out of the country to foreign countries for greener pastures, Adeyanju noted that “the medical personnel have always left this country to go for greener pasture. Most of the doctors doing well abroad, quite a number of them are Nigerians, doing fantastically well. Why did they go? There is no enabling environment for them here to practice.”

The former commissioner tasked government on providing enabling environments for the medical personnel to operate in Nigeria and fete them with good welfare package so as to retain the ones available in the country, as well as to attract those that are currently working overseas in the search for greener pasture.

“When they have a good working environment, they will come. We might start from things like a sabbatical, asking them to come and do their vacations here; or come for a sabbatical. It is when they are here and they feel secure, they see how they are helping to save lives; they will be more than willing to start coming back home for quality service gradually.”

Moreover, he urged the government to also tackle headlong the incessant strike and industrial actions often embarked upon by medical personnel in the country, identifying it as one of the job insecurity syndromes, social malaise and labour abnormalities that necessitate the longings in search for a more better life and comfortable living elsewhere.

“That again has a lot of roles to play in reducing medical tourism, because even if the facilities are there and we don’t have the human resources to man them, it will still amount to unabated foreign drift for greener pastures and the work done will be zero.

“There is need to pay attention to qualified personnel working in a good working environment, and of course, with good welfare package. All of these will improve greatly the health services that we provide here, drastically reduce medical tourism abroad and tremendously swing the pendulum of medical tourism to Nigeria from other countries.”

While the UNIMED Vice Chancellor, Prof. Friday Okonofua, confirmed the mass exits of Nigerian medical doctors to foreign countries, revealing that major medical breakthroughs overseas are mostly achieved through the uncommon contributions of African doctors, especially Nigerians.

Okonofua, who is a Professor of Obstetrics and Gynecology, explained that he had to abandon his appointment in Europe and come back to Nigeria so as to immensely contribute his expertise in developing medicine in his fatherland rather than exhausting his talent to develop another man’s land while Africa is in need of such manpower.

He kicked against the attitude of Nigerians to the medical facilities available in the country, which he attributed to the overzealousness and idiosyncrasies of some migrants towards unhealthy tourism and safari in Europe, America and India.

The Vice-Chancellor, who is also a public health expert, narrated the sad story of a woman who was diagnosed with cancer and prepared for chemotherapy at the Medical Village. “But she refused to receive treatment in our facility, she preferred travelling overseas for treatment.

“The woman was flown to India and she was eventually made to go through the same chemotherapy treatment which she refused to undergo here. Unfortunately, she died at the airport. Imagine the stress, time and chances she might have to survive if she had received an early medical attention here.”

Meanwhile, public analysts have pointed out that the new health thrust in the state, the advocacy for the prevention and treatment of cancer through Breast Cancer Association of Nigeria (BRECAN), would be another feather to the plumage of the medical village as the coincidental demands for cancer treatment centre might possibly get accelerated approval.

This, they attributed logically to the overbearing influence, which the BRECAN founder and wife of the governor, Betty Anyanwu-Akeredolu, could wield on her husband and the earnest demand by Okonofua.

“In view of the high level it has attained in health care, Ondo State needs to have a good referral facility for the treatment and rehabilitation of advanced cases of cancer. The University of Medical Science is the ideal location for such a facility,” Okonofua earnestly demanded.

Leaving indelible prints with the just concluded 3rd International Symposium on Cancer and the 20th BRECAN anniversary in Akure, having over 2,000 participants and seven renowned resource persons globally, the governor may easily yield to the demands for cancer centre like Lord Lugard yielded to Flora Shaw; and Nigeria was born.



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