BUHARI'S MEDICAL LEAVE AND THE RESIDENT DOCTORS' STRIKE
By Ayo Olukotun
Notwithstanding a flurry of last minute activities to avert the strike, resident doctors nationwide began what was described as an indefinite strike on Thursday over poor conditions of service. Among other demands, the doctors who make up a high proportion of physicians in the tertiary sector are asking for an upward adjustment of the current hazard allowance, the payment of COVID-19 inducement allowance, particularly in state owned tertiary institutions. Interestingly, the resident doctors' strike coincides with the medical leave of the president, Maj. Gen. Muhammadu Buhari (retd), who left the country on Wednesday for the United Kingdom, in order to undergo what has been described as 'routine medical check-up'. The two issues have expectedly generated spirited conversation, not just on the status of healthcare in the country but also on the insistence of top political leaders to enjoy, at tax payer's expense, the luxury of medical tourism. The conversation will not go away soon as the practice and pastime of overseas medical trips, reduced significantly by the COVID-19 pandemic, usually, at least in normal times, increases correspondingly with the decay in our health sector. In other words, for as long as our health institutions remain in the disarray, that they currently are, for so long will medical tourism become outstandingly attractive, not just to public office holders, but to all who can afford it.
Let us get to the heart of the matter. If Buhari is a private citizen, the issue will probably not be worth talking about, for then, he will be spending hard earned money to look after himself which he perfectly has a right to do. So, the discussion and controversy have arisen because it involves the alternative uses of public funds spent on medical tourism, especially in the light of the existence of Aso Rock clinic for which budgetary allocations are made annually. In several other climes, a linkage is made between national security and the health of presidents and top politicians. For example, it is unthinkable that any political helmsman in a developed country would allow himself/herself to be treated by doctors belonging to another country. It is not just about national pride but about security as well, especially in the age of resurgent nationalism and beggar-thy-neighbour economic policies. The issue goes beyond that, taking into account the years when the world was divided between liberal capitalism and socialism. Presidents of countries like Cuba which were surrounded by enemy states would not have considered it an option to be treated in what they considered hostile territory. For some reason, this dimension of the problem has not featured very much in public discussion just as our abject dependence for the supply of arms and ammunition on other countries has been taken for granted as normal.
There are various redemptive possibilities, one of them linked to the promise made by Buhari during the campaign that he would put an end to medical tourism by enacting a law that would forbid, even penalize, public officials who engage in it. The story was told of a former Prime Minister of an Asian country, who in the course of a visit to England, refused to wear an English made fabric because it was against the law of his country for a public official to so do and as Prime Minister, he felt he had a duty to obey his country's laws even on foreign soil. Needless to say that Nigeria never developed this kind of nationalism and national attachment of its elites to its country's laws as everyone is seeking for loopholes by which they can increase private satisfaction at the expense of public good. That is probably why Nigeria had been called a market rather than a nation but it is still possible for our political elite to develop the kind of nationalism exuded by great nations in the course of rapid development. It was hoped that COVID-19 will have taught the important lesson that it is extremely risky to depend on the medical infrastructure built by other countries for the day may come when such infrastructure is not accessible. Were this lesson to have been learnt, we will have been busy investing on the state of our medical institutions, tertiary and basic, or retaining through motivational policies, Nigerian medical personnel who are leaving the country in droves, and on saving up for the rainy day, scarce foreign exchange, currently being frittered away. Obviously, this has not happened and is perhaps not about to happen, meaning that our medical facilities will remain many more years, in the doldrums to which they have been consigned by the political and military elites. Evidently, Nigeria's dysfunction, especially in the health and educational sectors has provided a bonanza for other countries around the globe who have turned our lack of innovation and initiative into their opportunities. Hence, in the same manner as the British Council once projected that, in the foreseeable future, Britain will continue to benefit from the lack of quality in Nigerian education and should brace up for the pickings, Britain and other countries can confidently predict that because Nigerian leaders lack attention to the things that count most, they will continue to reap windfall dividends from medical tourism given that Nigeria's health sector remains in tatters. Medical tourism to the U.K. directly benefits the British tax payer as it is estimated that close to N1 billion, annually, is spent by the Nigerian political and business elites looking for medical succour outside Nigerian shores. It is not just that, the number of Nigerian trained doctors working overseas continues to rise by the day especially after a series of advertisements in the wake of COVID-19 seeking for doctors from Nigeria. Insecurity may today be Nigeria's no. 1 problem but that is partly because it is the most vivid and dramatic. Who, for example, is keeping a tab on how many Nigerians die daily because of the abandonment of medical infrastructure or because of the tardiness in paying outstanding allowances to overworked doctors in search of escape doors to countries which have the good sense to privilege medical institutions and workers?
Politicians are busy scheming for the next elections but most Nigerians are busy wondering when the running saga of governance failure and incompetence will come to an end. As this columnist has repeatedly maintained, the politicians appear to be deaf and dumb concerning the issues that touch us most, disconnected from the unflattering reality of our daily existence and trouble. True, some of the problems are entrenched and may take several years to resolve but pray, what is wrong in making an inspiring start as several other countries have done? A reversal of the dismally low budgetary allocation to health is the first order of business in the search for meaningful change. As known, for several years, health has been tragically underfunded hardly ever reaching up to 5% of total budget in contrast to many other countries, some on the African continent, who devote as high as 20% of their annual budgets to health. Nigeria has the capacity not just to bounce back but to become a medical hub where the ailing from many other countries can be cured or remedied. Sadly, however, the journey to that destination is yet to commence.
- Prof. Ayo Olukotun is the Oba (Dr.) Sikiru Adetona Chair of Governance, Department of Political Science, Olabisi Onabanjo University, Ago-Iwoye.
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