Medical tourism is growing amongst better-off Nigerians due to the high cost and low quality of healthcare services in the country. A little-noticed trend is the growing number of patients travelling to Egypt for corrective surgeries after failed procedures in Nigerian hospitals.
A Personal Ordeal
Yusuph Olaniyonu, a communications strategist, journalist, lawyer, and public affairs analyst, shared his harrowing experience with the Nigerian medical system, which nearly cost him his life. What was supposed to be a routine elective surgery at a government hospital in Abuja turned into a five-month nightmare involving nine trips to the surgical theatre, six major operations, and three minor procedures.
“I went into the government hospital for a simple surgery, expecting to be home in two days. Instead, I spent six days in the ICU, underwent multiple surgeries, and lost 20 kilograms. I was reduced to a mere sack of bones and became totally dependent on others for basic functions,” Olaniyonu recounted in a publication by Premium Times.
Failed Procedures and Emergency Interventions
The initial surgery on February 19 was to address an enlarged prostate, a condition discovered during routine check-ups due to a family history of prostate cancer. Despite being a careful and health-conscious individual, Olaniyonu was pressured by his urologist to undergo the procedure. Unfortunately, the surgery went awry when the surgeons ruptured his bladder, leading to a series of complications.
“During the first surgery, the surgeons ruptured my bladder and hurriedly placed a catheter, which was not properly inserted. This caused urine to revert to my genitals, resulting in grotesque swelling. Despite three more trips to the theatre, my condition only worsened,” he said.
“Since that fateful Monday morning, I have gone into and out of the surgical theatre nine times for six major operations and three minor procedures,” Olaniyonu recalls.
The Initial Misdiagnosis and Subsequent Complications
Despite being a hands-on person who rarely needed medical intervention, Olaniyonu had been proactive about his health, especially after his father’s death from prostate cancer. Regular check-ups revealed an enlarged prostate, which was initially managed with medication. However, his urologist at the government hospital in Abuja insisted on surgery, warning that the prostate enlargement could impact his kidneys.
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“He was the expert, so I yielded to his pressure and agreed to do the surgery. That turned out to be a major mistake,” Olaniyonu admits. The surgery’s aftermath was a series of errors and negligence that left him incapacitated and in constant pain. “I have lost 20 kilogrammes in five months and was reduced to a mere sack of bones. I have lost the use of my limbs and, like a toddler, I had to learn to walk again.”
The hospital’s approach to patient care further complicates matters. Patients did not have direct access to their test results, which were only shared with doctors electronically. This lack of transparency meant Olaniyonu was unaware of the full extent of his condition and the potential risks of the surgery.
Fighting for Life and Seeking Intervention
At a critical juncture, when his chances of survival seemed slim, Olaniyonu’s wife, Odunayo, took decisive action. Realising that the medical team had reached its limits and was on the verge of giving up, she sought help from influential contacts.
Her efforts, supported by friends and colleagues, including Mr Nduka Obaigbena, Chairman of THISDAY and Arise TV, and Dr Abubakar Bukola Saraki, former Senate President, brought much-needed attention to his case.
“My wife, Odunayo, rose to the occasion. She thought that what was needed to save my life at that point were some ‘muscles’ that would compel the doctors to give me proper attention,” Olaniyonu explains. The involvement of these high-profile individuals ensured that the hospital could not afford to neglect his care.
“My wife became my lifeline, ensuring I received the attention needed to survive. Calls were made to the Minister of Health and other top officials, leading to my return to the theatre for a more thorough intervention,” Olaniyonu shared.
A New Wave of Anguish
Despite these efforts, Olaniyonu’s health continued to decline. After being discharged, he suffered from severe pain and further complications, including a septic infection that nearly proved fatal. The hospital’s response to these emergencies was often slow and inadequate, prompting Olaniyonu and his family to seek treatment abroad.
“At the private hospital, I was diagnosed with sepsis, a life-threatening condition where the body’s response to infection causes organ failure. The doctor urged us to return to the public hospital, but the delays and nonchalant attitude of the staff there were alarming,” he explained.
Turning to Egypt
As Olaniyonu’s condition deteriorated, his family arranged for treatment in Egypt. This decision came after repeated failures and a loss of confidence in the Nigerian medical system.
“We had lost confidence in my urologist and started to make arrangements to find a hospital in Egypt to continue the treatment,” he says.
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The final straw came when he began to lose control of his limbs due to cervical spondylosis, a condition that resulted from the botched surgeries and subsequent infections.
Supported by Dr Saraki, who provided financial assistance, Olaniyonu travelled to Neuro Espitalia Hospital in Cairo, where he underwent critical surgery. On May 13, he flew to Egypt.
The Egyptian Experience
In Egypt, Olaniyonu’s experience was markedly different. Upon arrival at Neuro Espitalia, he underwent a series of tests and a crucial surgery to address the damage caused by the previous procedures.
The surgical team, led by Professor Ibrahim Lotfy and Professor Dalia Rushdi, discovered that Olaniyonu was suffering from tuberculosis of the vertebrae, which had caused the loss of function in his limbs.
“In Egypt, I received timely and effective treatment. The surgery was successful, and the medical team discovered that my condition was caused by tuberculosis of the vertebrae, a stealthy thief that had been robbing me of my limbs,” he said.
“After the successful operation, the surgical team decided to culture fragments of bones and tissues extracted from my back to determine what went wrong in the first place. It was an investigation that took days and a lot of blood tests,” Olaniyonu recounts. The discovery of the tuberculosis infection explained the severe and persistent pain he had endured.
The treatment in Egypt not only stabilised his condition but also set him on a path to recovery. He had to relearn basic functions, such as walking and using his hands, a process that underscored the gravity of his ordeal.
“This was when I realised how much grateful humans should be to their creator for even the most simple things we take for granted every day,” he reflects.
The Cost of Failure
Olaniyonu’s story is a stark reminder of the deficiencies in the Nigerian healthcare system, which include poor medical practices, lack of transparency, and inadequate facilities. His experience is not isolated; many Nigerians face similar challenges and are forced to seek medical treatment abroad, often at great personal and financial cost.
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The high cost of medical care in Nigeria, coupled with its low quality, has driven many citizens to countries like Egypt, where healthcare services are perceived to be more reliable and effective.
“At the government hospital in which I was almost killed, a night’s stay in the ICU costs N150,000. I doubt that many hotels charge that much for a standard room,” Olaniyonu points out, highlighting the exorbitant costs patients incur for substandard care. “In contrast, the care I received in Egypt was prompt, professional, and life-saving. This disparity is unacceptable,” he added.
He continued, “We are not even talking about the cost of medication and drugs. The same hospital sold Tavanic 500mg, an antibiotic used for the treatment of infections for N42,000, while a pharmacy located only a few metres away from the hospital sold the same drug for N20,000. In Egypt, we bought the drug for 124 Egyptian Pounds which is about N4,092, at the exchange rate of N33 to one.”
The Healthcare Sector Problems That are Driving Medical Tourism in Nigeria
Nigeria used to be a beneficiary of healthcare tourism in the 1970s and early 1980s when patients from other African countries travelled to Nigeria to enjoy the nation’s vast tertiary healthcare system. Despite problems on uneven access (rural areas were poorly covered), Nigeria stood out in the Commonwealth as the oil boom enabled rapid expansion of infrastructure and medical education. Economic difficulties from the mid 1980s led to problems of maintaining and replacing infrastructure and retaining trained personnel.
The key problems of the system include:
Inadequate Funding
Tertiary healthcare facilities in Nigeria often suffer from insufficient funding. The health sector received only about 4.2 per cent of the total 2023 national budget, far below the 15 per cent recommended by the Abuja Declaration.
Could inadequate funding be the reason for the low-quality services in Nigerian hospitals? Could it be the reason medical practitioners in Nigerian healthcare centres act as if they are forced to stay in the profession?
“Why do our doctors behave as if they are being forced to be doctors; as if there is no minimum standard to which they must comply; as if they can do anything and get away with it; as if it was enough for them to just claim that they tried their best?” Olaniyonu asked.
“The Egyptian hospital was replete with stories of Nigerians who come there to correct surgical operations that had been performed in Nigeria, some from glamorous hospitals in Abuja where they charge exorbitantly,” he added.
Shortage of Healthcare Professionals
The doctor-patient ratio in Nigeria is about 1 doctor per 5,000 people, significantly lower than the World Health Organisation’s recommendation of 1 doctor per 600 people. This shortage leads to overworked staff and compromised patient care.
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Poor Infrastructure and Equipment
Many tertiary hospitals in Nigeria lack modern equipment and proper infrastructure. A 2018 survey revealed that over 70 per cent of medical equipment in public tertiary hospitals is outdated or non-functional.
Brain Drain
There is a significant emigration of Nigerian healthcare professionals to other countries. It is estimated that about 9,000 Nigerian doctors are practising in the UK, USA, Canada, and other countries. This brain drain exacerbates the shortage of skilled professionals in Nigeria.
High Cost of Healthcare Services
The cost of healthcare in tertiary institutions is often prohibitive for the average Nigerian. Out-of-pocket expenditure constitutes about 77 per cent of total health expenditure in Nigeria, making it difficult for many to afford necessary treatments and procedures.
“How did we find ourselves in a situation where government hospitals have become the most expensive and the most inefficient in Nigeria? Health workers, doctors, nurses, etc., in private hospitals may not be any better, but at least they appear committed to their jobs.
“Public health workers in Nigeria behave as if they would rather be somewhere else, as if they are actually doing the patients a favour. The painful truth is that they don’t care whether you live or die. There is work here for everyone – the government, professional bodies and training institutions,” Olaniyonu said.
The Need for Reform
Olaniyonu’s ordeal calls for urgent reforms in the Nigerian healthcare system. Key areas that need attention include improving the quality of medical training, ensuring transparency in patient care, and upgrading medical facilities. Additionally, there needs to be a mechanism for holding medical practitioners accountable for negligence and malpractice.
“In Nigeria, patients are often left at the mercy of doctors, with little recourse when things go wrong,” Olaniyonu notes. “We need a system that prioritises patient safety and ensures that medical professionals are competent and accountable.”
Yusuph Olaniyonu’s experience is a powerful testament to the need for systemic change in Nigerian healthcare. His journey from a failed surgery in Abuja to successful treatment in Egypt underscores the stark contrast between the two systems.
As Nigerians continue to seek medical care abroad, it is imperative that the government and relevant stakeholders take decisive action to address the failings of the domestic healthcare system.
Culture and Governance
A consultant in a high-profile hospital in Lekki, Lagos told Arbiterz that besides the problem of inadequate personnel and equipment, the pervasive lack of accountability in the system is also responsible for the sort of traumatic experience that Mr. Olaniyonu had with hospitals in Abuja.
According to the consultant, the first line of defence against poor standards is the internal reporting system in hospitals. The internal reporting system ensures, amongst other things, that doctors and consultants faithfully report the quality of care that patients who undergo procedures have received in the hands of other doctors. This creates an incentive for doctors to provide as high a quality of care as possible.
The consultant noted that though the medical bodies responsible for monitoring standards and sanctioning erring medical personal and establishments are also poorly resourced, hospitals could help them by strengthening their internal reporting system and passing on cases of malpractice.
In 2020, approximately 60 doctors had their licenses revoked in the United Kingdom due to various forms of misconduct, including malpractice, criminal behaviour, and ethical breaches. In countries such as the UK, there is a more transparent and structured system for reporting and addressing medical malpractice compared to Nigeria. Improving Nigeria’s handling of medical malpractice require strengthening legal frameworks, enhancing regulatory oversight, increasing transparency, and promoting patient awareness and advocacy.
