HealthThe Stethoscope

Get with the program, people!

Okay, you have to help us here.

A patient came over complaining of back pain, leg pain and was really truly miserable. He was diagnosed with severe lumbar spondylosis (that’s what he has) which required surgical intervention. He was given a bill of N3M (three Million Naira) for the operation and went off to think about it.

So, a month later he comes back and volunteers the following information.

His friends have begged him to go for the operation in India. The Indian hospital gave him a bill of N1.5M for the operation. However, he would need to travel to India with company and stay in a hotel for about 2 weeks. The likely total cost for the trip including the operation would be about N3.8M.

Okay, he doesn’t really want to go to India and would be happy to have the operation performed in Nigeria. The big question was this, ‘Doc, could we do the operation for N1.5M in Abuja?

The Indian Angle
Nigerians often find out the Indian angle only after landing in Mumbai. The surgical estimate does not include consultations, investigations and so many other issues that the Indians drum up once you are in Delhi.

Before you can say, Kolkata, the N1.5M is spent making you ready for surgery and then you have to find another N1.5M for the operation! So, before you know it, N3M is gone and you are phoning home for more money and someone to help you sell your last shirt at Balogun market.

Unqualified Success
Regardless, let’s say you have had a successful surgery and treatment in India and return home. A few days, months or years later, you develop a complication. As you know, shit happens and ‘’oh, they did not tell me that’’. So, what was qualified as successful in India turns out not to be perfect after all.

What happens then?

We find that the first experience, the rigors of travel (it’s not like travelling to Abuja!) and the sharp practices, puts many Nigerians off returning to India for another ordeal. Many put things in perspective and opt for a review, follow up and management in Nigeria.

Five alive
We have had five such returnees with complications treated at the Brain and Spine Surgery hospital in Abuja. These were five male patients who had travelled abroad for medical tourism and presented with complications. Patient one had two lumbar spine surgeries and subsequently developed adjacent level disease in the thoracic area requiring further surgery. Patient 2 had lumbar spine surgery complicated by infection and leakage of brain fluid in the back.

Patient 3 had malpositioning of lumbar pedicle screws fixation requiring repeat surgery. Patient 4 had progressive lumbar spondylosis requiring further intervention. Patient 5 had lumbar surgery in India (laminectomy) and developed instability plus cervical myelopathy requiring intervention. All five patients were managed successfully with good short term outcomes. Such patients become strong advocates against medical tourism. But, they learnt the hard way!

It could be concluded that resolving complications and getting good outcomes for our patients following medical tourism abroad will improve local confidence. This was presented at the National conference of the Nigerian Society of Physiotherapy that held recently in Abuja.

So what?
We are interested in improving care in Nigeria and only Nigerians can fix any health care issues we have. Going abroad for medical tourism is rosy only when things go well. When things fall apart, many patients return and are forced to rely on the same system they did not give a chance in the first place.

We are preaching that the ‘’Nigerian Patients are worth it’’. This is the theme of the on-going NMA summit in Abuja. We are convinced that the Nigerian patient deserve the best and are worthy of the investments in health. Yet, we need money to invest and we need people to believe in us, and have their care here.

If you stay home and have your care here, we can keep improving and as we get better, the poor health indices recover. You cannot, like my client above, screw the system and hope to get a great outcome. Or like the others who return with problems, now saddle us with your misery. First, you abuse us and then return to see us.

As they say, a prophet is not recognised in his country. Yet, many times, what you are looking for in Sokoto are in your sokoto. Shine your eyes and look around for the gems before you go abroad.

Final note
Please, don’t be like my patient. Good health care that delivers great expectations is not cheap. You must understand this, get with the program and help us to help you.

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