THE BUSINESS OF (HEALTH) CARING

Nigeria 2018 | HEALTH & EDUCATION | FOCUS: OUTBOUND MEDICAL TOURISM

Nigeria's healthcare sector is suffering from significant brain drain due to workers' unfavorable conditions, while failure to invest in medical facilities is encouraging patients to seek treatments abroad with significant economic consequences.

In August 2017, Clare Omatseye, President of the Healthcare Federation of Nigeria, stated that Nigeria loses USD1 billion annually to medical tourism. Despite many reasons for a country to experience outflows of medical tourists, the most notable motivation in Nigeria is the lack of trust in the domestic healthcare system. For decades, better-off Nigerians have disregarded in-country treatment in favor of foreign destinations with more attractive healthcare services. According to The Business Day, a Lagos-based newspaper, India attracts 47% of outbound medical tourists. Other top destinations, for obvious language and cultural links, are the US, the UK, and Dubai.
The curse of a moribund healthcare system mainly surrounds public hospitals. Such hospitals receive poor funding and are equipped with shabby machinery and run-down infrastructure, to the point that they have been called “theaters of death" and “final bus stops." Premature babies not making it into their second week because of scarce incubators and electricity outages are not nightmares or stories from the 20th century but a painful reality many Nigerian parents live. For those who can afford it, medical tourism is thus no surprise.
Moreover, doctors and specialists have migrated too, causing Nigeria's healthcare sector to experience a serious brain drain in recent years. Continuous strikes staged by public hospital staff are proof of the unattractive conditions doctors in Nigeria claim. The straightforward consequence of uncompetitive wages and poor working conditions is that those who are willing to leave their home country and their loved ones leave seeking a more fortunate career elsewhere. Ironically, many Nigerian medical tourists end up being treated by none other than their compatriots, highly-trained medical professionals whose talent would not have been fully unleashed at home the way it has in a foreign land.
Though, it is not all bad news. A few public institutions, for example the teaching hospitals of Delta State and Benin State Universities, boast state-of-the-art facilities and world-class specialists performing the most advanced operations, including kidney and marrow transplants and hip replacements. In addition to this silver lining in the public sector, Nigeria enjoys a vibrant private healthcare sector. St. Nicholas, Reddington, Lagoon, Nisa Premier, and First Consultants Hospital are just some of the country's top-class private hospitals.
Dr. Oladapo Majekodunmi, CEO at Saint Nicholas Hospital, told TBY that in many cases the required treatment can safely be performed in Nigeria; however, people still go abroad for their operations. “It is a matter of building confidence through publications, demonstrations, and citing examples," he said. When asked what the government should do to enhance the sector, he answered: “The Ministry of Health can do more to equip doctors with what they need to do their jobs. In teaching hospitals, they need to do audits to bring up the standards."
The answers to augmenting Nigeria's health sector are more easily articulated than implemented. First and foremost, Nigerians need to better understand the domestic economic consequences of outbound medical tourism and the benefit it provides to the tourism destination. As is the case with changes of many social behaviors, stemming the flow of outbound medical tourists begins at the top. If the political elite chose Nigerian hospitals over British or Emirati ones, Nigerian hospitals would gain credibility and overall confidence and trust in Nigerian healthcare facilities and institutions would grow.
On a practical level, the government needs to take seriously its commitment to improving the sector and inject larger portions of its budget into upgrading existing facilities, building new ones, and incentivizing local talent to pursue their dreams in domestic hospitals.
Lastly, Nigeria should capitalize on one of the world's largest diasporas. Creating a more enabling healthcare environment to attract the diaspora alone would be an enormous step forward. Only when the healthcare business is taken seriously will Nigeria be able to start dreaming about exporting healthcare, and not just oil.