BY VICTORIA OJEME, Abuja

Global Hospital, Chennai, India, offers advanced healthcare in including liver transplant

WITH the advent of globalisation, the world has shrunk into a global village and Nigeria is part of this village. With globalsiation comes the emergence of the concept of “medical tourism”. This is devised to help citizens in one country, enjoy their tours to other countries, under cost-effective, world-class quality medical healthcare.

Medical tourism is a growing trade because it eliminates higher costs, long waiting lists, medical insurance policies and stringent visa regulations. But perhaps the best attraction is that it reduces strain on healthcare infrastructure. Expert argue that medical tourism is a provision of ‘cost effective‘ private medical care in collaboration with the tourism industry for patients needing surgical or other forms of specialised treatment.

In so many ways medical tourism is becoming a common form of vacationing, and covers a broad spectrum of medical services, mixing leisure, fun and relaxation with wellness and healthcare. Unconfirmed statistics show that every year, hundreds of Nigerians troop out of the country to seek medical treatment in foreign hospitals. Medical tourists as they are known overseas, present all manner of ailments, from the critical to the mundane just to jet out of the country for foreign medical attention.

This emerging scenario was top on the agenda of a round table between medical doctors and health reporters in Abuja last week.

Serious medical conditions such as heart disease, have been known to force many of these tourists abroad, while the not so serious reasons suchas the fad to be delivered of their babies are also regularly recorded.

Leading the discussions on the cost and implications of the growing list of Nigerian medical tourists, were Dr. Felix Ogedegbe, an expert in trauma and orthopaedics; Dr. Biodun Ogungbo (spine and hydrocephalus); Dr. Amina Abubakar (plastic and reconstructive surgery) and Dr. Evelyn Ogedegbe (internal medicine and skin).

Ogungbo, who is Consultant Neurosurgeon, Cedacrest Hospital, Abuja, notes that medical tourism is a big business in countries such as India, United States, United Kingdom which are the usual destination of the horde of Nigerian medical tourists. For him, “this is big business for India and they are actively pushing this activity and generating huge revenue from Nigeria. We are losing significant revenue to India and other countries.”

Within the last decade or so, India has emerged as the preferred destination for medical tourism, capitalising on its strengths of “lower cost skilled personnel, cultural factors, natural endowments and unique forms of medicine. With a projected revenue of $1-2 billion in 2012 and current yearly revenue of $260 million from Nigerians alone, medical tourism is regarded as a major foreign revenue earner, so much so that, the country’s National Health Policy declares that, “treatment of foreign patients is legally an ‘export’ and deemed ‘eligible for all fiscal incentives extended to export earnings.” This huge yearly revenue from Nigerian medical tourists to India for ailments whose treatment is readily available in Nigeria represents a huge loss to the economy.

The lose of such huge revenue to the nation’s medical sector has no doubt created depleted capacity, since a huge part of this revenue would have been deployed in improving capacity, hence stem the tide of the growing number of Nigerians seeking medical treatment abroad.

Ogungbe drew attention to what has been described as ethical hypocrisy, going by the fact that, medical ethics forbids advertorial, but it is common knowledge that companies acting as fronts for foreign hospitals advertise in Nigerian medium seeking patronage.

“Medical tourism is facilitated through many companies who openly advertise here in Nigeria. Some of these companies representing hospitals in India advertise in Nigerian Hospitals, in collusion with the medical directors are allowed to speak to doctors directly. Nigerian hospitals and doctors are not allowed to advertise. Yet, many of these hospitals and businesses in India, Egypt and South Africa do not subscribe to the same ideals we practice. They openly advertise and solicit for patients. They often invite doctors in these hospitals to refer patients to them for a 10 percent return on the total cost of treatment. This money is added to the cost of treatment and then surreptitiously paid to the doctor,” he added.

Explaining further on the shady effects of medical tourism on the national economy and medical practice, he alleged: “We have also heard reports of patients and their relatives being asked to become touts in Nigeria for some Indian hospitals. They are asked to refer other patients to India for a percentage of the treatment costs. Some have ended up being coerced into providing fake medical reports and making all sorts of unsubstantiated claims as this becomes a new source of income for them.

They dismissed as incorrect, the impression that treatment abroad is cheaper. They agreed that there have been reported cases of patients going abroad for treatment, only to find out, after consultation, that their ailment may not require any major medical procedure.

Ogedegbe, another participant affirmed: “It is more expensive in many cases to have treatment abroad and sometimes that money is wasted if the hospital cannot treat you. If for example, you do not need treatment, the cost of travel and consultation is wasted. In other cases, additional costs accrue from having a companion travel with you. You will need to provide money for travel costs, feeding and accommodation for your companion while you get treatment. Besides injury to the nation’s economy, the immediate impact on the health sector has been colossal and almost irreparable.

It has not only eroded the fabric of the nation health services, through the depletion of medical facilities and expertise. “This trend, demoralises local medical practitioners and increases the brain drain. It reduces training of medical students, further creating sub-standard and poorly trained doctors to look after us all in the future.

“We recognise the fact that over time, Nigerian doctors and hospitals have lost the trust and respect of patients. Rather than seeing this as a reason to seek medical attention elsewhere this should be a call and pressure applied to the government to optimise and improve our facilities and expertise. Patients are best served by medical treatment provided close to where they live; particularly in emergencies,” she added.

She said the penchant of government officials to seek medical treatment abroad, even for the slightest ailment, has not helped matters.

“The colossal sum of money spent abroad could have been used to equip many hospitals in Nigeria to provide equitable standard of facilities and care for all Nigerians. Sadly, Nigerians, and many politicians and government officials do not support their local hospitals both morally and financially. They forget that some illnesses are so acute requiring immediate medical attention that cannot wait for the flight to other countries,” she added.

Dr. Amina Abubakar said supporting the local hospital and ensuring that it has both personnel and equipment may be the difference between life and death. Conditions such as road traffic accidents can kill within minutes to hours if nothing is done, precluding time to get a visa, air ambulance and even the foreign exchange necessary to travel out.

The round table insists on the new for a change of attitude in the new year, calling on “the political aspirants to ensure that the health of the people is supreme in their political manifestos. The importance of the health of the nation must be central in their objectives and aspirations. But, the people need concrete ideas and programmes to resuscitate the medical sector in Nigeria. The vast amount of money spent on medical tourism to other parts of the world could be directed inwards and spent on developing our own health sector. Our future depends on it.

The bottomline is judging by the growing number of specialist treatment in Lagos, Abuja and other big cities. Nigeria is an attractive destination for medical tourism.