Making money with ill health in Kenya and Nigeria

Wednesday April 07 2010

Immunisation such as this one in Nigeria’s capital Abuja are a good preventive measure. Photo/File

Medical practice in Nigeria and Kenya share several tribal marks. For one, money is made from it mainly by
treating infection and disease and not for keeping beneficiaries free from illness.

Money is made from the art of using knowledge and unconfessed guesswork to come up with a ‘diagnosis’, actively assaulting
the money to repair damage or deficiency (such as mending broken bones or opening up the stomachs of women unable to deliver babies naturally), and selling the power of tools and medications used to ensure a condition of repair or cure.

Inflammable rhetoric

The late Senator Edward Kennedy became a hero to millions of Americans from fighting for legislation that would tame the fire in companies, hospital administrators, shareholders and doctors wanting to make riches out of the illnesses of potential and actual patients.

President Barack Obama is currently continuing the same war over healthcare.

Former President Jimmy Carter has recently thrown some inflammable rhetoric onto Obama’s struggle by asserting that racism was inciting the vitriolic campaign against Obama’s struggle for legislation by America’s parliament (Congress).


The campaign would make healthcare available to all Americans (including poor people), because treatment was covered by insurance. This debate is alien to most of Africa because under colonial rule, families and clans relied primarily on self-help and the politics of Uhuru promised care in government-owned clinics and hospitals.

Since the mid-1980s the World Bank and the International Monetary Fund have commanded African governments to betray this legacy of free healthcare as a dividend of Uhuru and anti-colonial nationalism.

In Zimbabwe, for example, the effort to roll back the popularity of Robert Mugabe’s Zanu-PF government started with hanging the promise to loan it funds for development on the termination of free health care in rural and urban clinics.

Oil money

In Nigeria, an abundance of oil money from 1970, and the open declaration by General Yakubu Gowon that his military government’s dilemma was how to spend the vast sums of money rolling in daily from the international oil market sharpened appetites in the healthcare sector.

Enterprising minds and hearts rushed in with demands for building teaching and general hospitals equipped with the ideology of putting in them equipment that was “of international standards” and “available in civilised countries”.

Whether the bulk of Nigeria’s citizens suffered from infections arising from drinking raw water into which rain had washed human waste dropped in bushes, or in which vectors of malaria, bilharzia and hookworm existed, was irrelevant.

What was primary for all those rushing to cash in on the boom was the enabling of officials and practitioners to award contracts for importing pharmaceutical drugs and other medical tools at highly inflated costs. A new twist has come in through the open window of sites for offering treatment.

Opened a floodgate

In 2003, the government invented a “gesture of sponsoring patients to go to hospital outside the State”. The number of those so “sponsored” soon began to “run into thousands”.

A complete package of providing air tickets, accommodation and feeding, and medical treatment, including prescribed drugs, opened a floodgate through which many Nigerians seeking treatment in hospitals in Egypt passed.

A press report estimates that over 200 patients from Kano township alone have benefited from this politicised ‘medical package’ in the last two years.

It is paradoxical that Egypt’s medical market was the destination of choice.

Both Egypt and northern Nigeria hold large Muslim populations, with Al Azar in Egypt being a famous centre for theological learning in Islam.

Islam in Nigeria did not, however, imbibe the tradition by Mohammed Ali of bringing into Egypt European scientific knowledge and education so that Egypt could build military and industrial power to compete with Europe.

Allowed to flourish

British colonial officials ruling over Egypt, Sudan and Nigeria ensured that while Western education was allowed to flourish in Egypt and Sudan, it was actively campaigned against among Nigeria’s Muslims.

The government of Alhaji Ahmadu Bello (1960-1966), which showed determination to reverse this condition, was terminated with his violent assassination in the military coup of January 15, 1966. The roots of the “Boko Haram” (or ‘Western education is sinful’ cult) that exploded into arson and death in several states across northern Nigeria in July 2009, had a long memory.

In healthcare terms, this has meant that the region lacks the medical doctors and nurses to compete with what Egypt can offer.

The common failure

An official has asserted that “lack of modern medical facilities in line with international best practices, and a near absence of specialists in specific medical areas”, fuels the fact that in every flight from Nigeria heading for Cairo, “a good number of passengers on board are referral cases”.

The point of this narrative is to challenge medical institutions and professionals in East Africa to ask themselves what they can do to compete with Egypt for demand for high quality medical care by Nigerians.

Kenya’s medical institutions, specialists and witchdoctors do not have to share the common failure to meet the medical needs of Nigerians hungry for care.

Prof Okelo Oculi comments on African issues from Abuja, Nigeria

Africa Insight is an initiative of the Nation Media Group’s Africa Media Network Project