Ethical implications of President Buhari’s many medical trips to England

During the electioneering campaigns, one of the promises made by then General Muhammadu Buhari and his brand new All Progressive Congress, APC, is to place a general ban on all government officials from seeking medical care abroad. President Buhari seemed to repeat the promise, though, with a caveat, in April 2016 in a speech to the Nigerian Medical Association (NMA) that the government would cut back spending on sending public officials abroad for treatment when there was evidence of expertise in Nigeria. The president has not kept any of the promises. A month after making the promise to the NMA, he travelled to London to treat an ear infection after the presidency said he was evaluated by his personal physician and an ENT specialist in the capital Abuja. Dr Osahon Enabulele, a former president of the Nigerian Medical Association described Buhari’s medical trip then as a “national shame” despite the presence of more than 250 ENT specialists in Nigeria and a National Ear Centre in Kaduna state.

Last year alone, the president spent a whooping 154 days in the UK on medical leave without any explanation to Nigerians who are picking the bills for his treatment on what ails him. Besides the questions about his continued fitness for office and the political and economic uncertainties his frequent medical journeys entails, there is the question of the morality of the trips. How does the president feel travelling each time at the country’s expense for medical treatment in the best hospitals abroad when the health sector in his country has almost collapsed under his watch and where health workers have been on strike for more than a month without the government doing anything to resolve the problem?

The health sector under the president’s watch has received one of the lowest budgetary allocations. The sector got N259,751,742,847 (3.82 percent of total budget) in 2015 and N250,062,891,075 (3.82 percent of total budget) in 2016. In 2017, it got N304, 109,961,401 (4.17 percent) was allocated to the health sector. On the average, the country spends about N1700 per annum on the health of its citizens – one of the lowest such spending in the world.

The consequence has been catastrophic as expected. Primary healthcare in Nigeria, which ought to be the first port of call for every citizen seeking medical care, are either ineffective or moribund thus pilling pressure on the tertiary healthcare facilities that are also grossly inadequate. Nigeria is the second-largest contributor to under-five and maternal mortality rate in the world. A recent UNICEF report indicates that 145 women die daily during childbirth in the country. In the country’s worst affected areas, 1 in 13 women die during childbirth. Nigeria also loses about 2,300 under-five year olds every single day, 25 percent of whom are new-born babies. More worrisome is the fact that more than 70 percent of the estimated under-five deaths in Nigeria are caused by preventable or treatable infectious diseases such as malaria, pneumonia, diarrhea, measles and HIV\AIDS.

Recently billionaire philanthropist and founder of Microsoft, Bill Gates reiterated the grim statistics bluntly to the president and his team when he said: “Nigeria is one of the most dangerous places in the world to give birth, with the fourth worst maternal mortality rate in the world, ahead of only Sierra Leone, Central African Republic, and Chad.

The collapse of health infrastructure isn’t limited to the ordinary citizens alone. Even in Aso Rock, where the clinic reportedly receives a budgetary allocation of N4 billion naira, the President’s wife and daughter recently alleges that the clinic couldn’t even boast of common syringe or paracetamol. For Mrs Buhari, even though the clinic was supposed to cater for the immediate health needs of the first family, ministers and presidential aides, her aides advised her not to use the facility because it wasn’t functional and they advised her to seek medical treatment abroad for any medical complaints.

Perhaps, it is time the president re-evaluates his trips in the context of the situation of his countrymen and women at home whom he claims to love so much and on whose behalf he claims to act always.