There was a time when almost nobody travelled abroad for medical attention.
However, this has changed recently as an increasing number of people, and not just the rich, arrange for family members to receive treatment abroad, with India a favourite of many Kenyan families.
The choice of India is based on its relative affordability and the good reputation of its medical profession.
The reason why more people are seeking treatment abroad, which they previously did not, has also to do with globalisation, the phenomenon that has brought greater contact among different peoples of the world, where previously none existed.
The globalising world, which enables more people to seek medical services abroad, also enables people to buy other services and goods abroad.
In addition to medical services, people are also increasingly seeking justice abroad, as a service.
The two World Wars led to massive atrocities and, in response, two tribunals were set up in Nuremberg, Germany, and Tokyo, Japan, to try those regarded as bearing the greatest responsibilities for the atrocities in the second war.
Thereafter, the international community responded to the crimes committed in the Rwandan conflict in 1994, and former Yugoslavia since 1991, by establishing two ad hoc criminal tribunals for the two countries.
More recently, the International Criminal Court has been set up as a permanent court and, amid significant political challenges, is now handling cases from several situations in Africa.
The increasing globalisation of justice was evident in last month’s arrest in Belgium of Martina Johnson, a Liberian national, for crimes committed in her country’s two civil wars.
Johnson became a member of Charles Taylor’s National Patriotic Front of Liberation (NPFL) in 1990 and allegedly led a major military operation, known as Operation Octopus, in which NPFL attacked the capital Monrovia in October 1992 as part of its war against the Liberian government and the regional peacekeeping forces, Ecomog.
She was allegedly involved in the murder and mutilation of five American nuns, an act that drew international attention to the Liberian conflict.
Johnson was a commander in the NPFL and is implicated in crimes against humanity and war crimes, and is alleged to have killed the relative of one of the three victims who brought the complaint that led to her arrest. The victims still live in Liberia.
When the war ended, with Taylor taking power in Liberia, Johnson got a job in the government, and remained safe from possible accountability.
However, when Taylor was ousted in 2006, she migrated to Belgium where she currently lives with her family.
She is currently under house arrest, with an electronic monitor, the alternative to prison custody, which the judge ordered as she awaits her trial.
The case against her became possible because of years of work by Liberian and international civil society campaigners, including the Liberian journalist, Hassan Bility, himself a victim of the Taylor rebels, and a Geneva-based organisation, Civitas Maxima.
The case against Johnson was brought in Belgium in exercise of its universal jurisdiction, which allows states to claim competence to try certain serious crimes irrespective of where they were committed and irrespective of who the victims were.
The previous exercise of universal jurisdiction by European countries, particularly Belgium, against nationals of Congo, Rwanda and the former Chadian president Hissene Habre, led to much consternation within the African Union which alleged abuse of such jurisdiction to embarrass African leaders.
In a recent article, Roland Adjovi, an African academic and former employee of the ICTR, predicts that the arrest of Johnson is not likely to please the AU, and may compound the difficulties that the Kenyan cases have brought in its relationship with the ICC.
Adjovi, however, also makes the point that the discourse of African states often, if not always, does not address the failure of their legal systems to provide remedies to the victims of the crimes.
In the case of Liberia, there has been no effort at providing justice for victims of the crimes even though this was recommended by the report of the country’s Truth and Reconciliation Commission.
He points out that although Taylor has been out of power since 2006, the Hellen Sirleaf regime has also failed to address the need of the victims to know the truth and, more importantly, to see at least some of the perpetrators sanctioned.
It became possible for Belgium to arrest Johnson only because Liberia is not prepared to bring justice for the crimes that occurred on her own soil, in which an estimated 250,000 people, including in neighbouring Sierra Leone, were killed, out of a population of 10 million people.
Going back to the example of globalisation and medical services, the decision to seek treatment abroad, rather than at home, is based on necessity.
It would be difficult to justify stopping people from seeking treatment abroad if they derive a value they cannot find at home.
In the same way that globalisation has facilitated treatment abroad, the failure to provide justice for crimes committed on African soil is driving the search for justice abroad, with globalisation playing a facilitating role.
The assumption is that justice is a necessity for Africans. In that case, the arrest of Johnson in far-away Belgium should embarrass both Liberia and the AU.
The only way in which African countries, including Kenya, can justify the condemnation of Western intervention in their justice affairs is by providing their own justice at home.
The vilification of international justice arrangements merely masks the fact that African governments have badly failed their people.