When people fall ill, they often have the ability to choose where they wish to have their treatment obtained depending on their station in life. Sometimes, they have no choice and that is due to no fault of theirs. Some are simply too poor to even afford some of the most basic care. For these ones, the quality of care they eventually get is dependent on others for good or ill. Others are struggling middle class types who are often very well informed and know where to go but may find themselves hampered by paucity of funds. Then there are the stupendously wealthy folks who can afford to pay for any kind of care wherever the best is available. Medical tourism is thus something not peculiar to Nigeria alone.

Indeed, medical tourism is a phenomenon that is growing around the world. Every year, hundreds of thousands of westerners migrate to Asia to obtain treatment for a range of diseases whose treatment ranges from organ transplantation to plastic and reconstructive surgery. The top destinations for such western types are Singapore, Thailand, Hong Kong and India. Many have concerns about the last on that list because of certain ethical considerations ranging from practices that do not meet the best international standards to reasons such as kidnapping people on the streets to provide organs by force for transplantation. In our country, the top destinations are India, South Africa and Egypt. It is the upper middle class and the very rich who take their treatment in Europe or North America.

Among westerners, Mexico and lsrael are seen as good enough alternatives to their home countries because even in their very best hospitals, they can obtain top of the range quality of service and treatment at a fraction of the cost in their home countries. In countries like the US, where the lack of health insurance cover to as many as 50 million people can be financially ruinous should they fall ill, these alternatives are very good. More than twice that number lack any form of insurance for dental care. So it is like obtaining treatment at home for only about 60 per cent of the sum. Even more to the point is Israel where the state of health facilities can compare with any in western countries. There, there is plentiful expertise and the standards are jealously guarded. In the area of In Vitro Fertilisation (IVF), they return averages that are better than many western nations. Many people feel safe in Israeli hospitals and they can get yet cheaper bargains when they take such treatment in a place like Cyprus delivered by the same Israeli experts.

In the end, it is all about choice and affordability. Israel holds a particular attractiveness for westerners because of its excellent tourist destinations. Many people seeking treatment there usually merge their health care needs with their vacation so that they get a twin bargain for the price of one tour.

Nor are the less vaunted hospitals in the less fashionable countries altogether disreputable: the association some people in our country have had with such institutions has compelled them to return home to try to emulate what they have seen elsewhere. The results may not be shinning through at this time but that day is surely on its way. A country like Israel is something of a genuine revelation for as far back as 1974, she could perform open heart operations in field hospitals in the midst of battle or do so airborne in flying hospitals equipped to do all kinds of things while off the ground. Those are not capabilities that simply develop overnight; they are helped along by a wide range of policies targeted at meeting certain objectives in the public health sphere that are seen as critical to the self preservation of the state. In that country, the military corps have been very instrumental in helping that effort along.

In the US and elsewhere, military hospitals have remained at the forefront of service delivery and research which is why top military and political leaders go there for treatment. This is an issue we have treated before on this page and we simply have to deliberately enact policies that will help get things done. Many people in authority today are simply saying things that the ordinary people wish to hear; nothing in reality is on the ground to determine that there is a genuine commitment to such an effort.

To the extent that such is the case, medical tourism in Nigeria is set to grow. It will not abate or level off; it will simply get worse. The reason is simple: in many western countries, people engage in medical tourism because they are often unable to afford similar treatment at home. Here, such similar treatment is often not available and so the people who can afford it simply vamoose to the places where they can bet on the value of what they are spending money on in order to obtain the kind of treatment they are advised they need.  On a personal level therefore, there is nothing wrong with medical tourism as currently engaged in by many of our countrymen and women. It is in the realm of people in public office that this is seen from a different perspective where it is perceived as a form of abuse of privilege. Elsewhere in the world, public officers make it a point to return home for treatment when they are sick abroad. One recent example of this was the late King Hussein of Jordan who when told he had a terminal form of leukaemia at the Mayo Clinic in Rochester, Minnesota with no options of further treatment available, bravely departed for his kingdom. An accomplished air force pilot, he flew his own plane home and died barely a week later in his palace. In Africa, such a leader would rather die in the US.

The perspective therefore matters and people should stop seeing the ability to have treatment in a foreign country as a kind of status symbol because as those nations milk you of the precious foreign exchange notes in lieu of the treatment you want, they plough it back into their economy and hospitals to guarantee their continuing development. On Friday, a sparkling new hospital for children has been opened in Johannesburg, South Africa in the memory of Nelson Mandela. Here at home, nothing anywhere seems to be happening in terms of organised growth in the provision of health care other than that now seen in private hands. Until we have a united front therefore, led by state and military formations, there will be a limit to how much the private institutions can ultimately grow.

Ask the doctor

Dear doctor, how are you sir?  I want to say thank you for your insights and medical coverage. I enjoy reading you. Thank you for pointing out the grey areas in our health and most especially, sound moral and Christian insight (a Saint Luke-like insight). God bless you immensely sir.   07032xxxxxx

Thank you so very much for your contribution. God will honour you as well.

Dear doctor, for the past three weeks, I have been experiencing pains in my lower abdomen and there is a milky, smelly discharge from my vagina which itches. When I insert my finger inside my vagina, I can feel a bulge and the discharge is usually around the bulge. Please, I would like to know the cause and the solution. Thank you and God bless you. 0816xxxxxxx

First of all, you need to see a doctor for a thorough evaluation. You will have to undergo certain tests and as part of your examination, a scan may be necessary to help determine what the bulge means and where it may have grown from. It is a very difficult thing to assume that the discharge you complained about comes from around what you call a bulge. It is only by directly visualising that swelling that you will be able to tell where the discharge is coming from but I can assure you that it is more than likely to be from the walls of the vagina or the cervix or both.

PUNCH has fine writers in content and flow. I do not miss SUNDAY PUNCH because of your helpful topics and responses to peoples’ issues through great articles. I am 70 on blood pressure and ulcer drugs. I have lost erection. Does it add up and is there a way out? Please pardon me if you think I flatter you. 0803xxxxxxx                          

Thank you very much. Depending on what medications you are taking, depending on what drug combination you have been placed on, it is possible to lose erectile function in your penis. All you will have to do is to see your doctor with your currents complaints so that those medicines you now take can be reviewed. A review means that the dosage you presently take can be reduced or the entire drug combination can be changed. When that is done, your loss of erectile function should return.

Dear doctor, kudos to you. I want to ask that if a woman has sex during her period, can she become pregnant? Or when do you think a woman can be pregnant? Thank you. 0814xxxxxxx

That can actually happen if you have a very short cycle or if you have a tendency to have long periods which is the number of days you bleed for while menstruating. A short cycle of only 22 days can see ovulation happening only a few days after a period ends so that fertilisation can occur. Since the sperms can survive for up to six days within the reproductive tract, conception can occur if sex has taken place during the period. The sperms will simply wait around until ovulation occurs a few days after menstruation and there’s fertilisation.

Dear doctor, I would have loved to call but you insist on only SMS. Please, I want to know how safe prostatectomy is. Thanks.  0803xxxxxxx

In the hands of those surgeons trained to do that kind of operation. The operation is safe. Like any other major operation however, it has its peculiar hazards but that knowledge helps to mitigate any problems that could arise.

Dear doctor, how can someone know if he has a sexual infection even when it is showing in his body?  0806xxxxxxx

Well, there are several types of screening tests designed to determine if there is a sexually transmitted disease in the body. What you must do if that is the sole reason for wanting to conduct a test is to let your doctor know that that is your wish and he will direct you on what specific screening tests you must conduct. When you do so, you will be basing your information on fact rather than guesswork.

Dear doctor, I went for a pregnancy test recently and the result says weakly positive. Does it mean I am not pregnant?  0703xxxxxxx

You are indeed pregnant. A faint line means that the test done has detected some increased level of human chorionic gonadotrophin in the urine or the blood as the case may be. The blood test is much more sensitive than the urine test. The fainter the line is, the more recent is the pregnancy provided that the test has been done correctly and the strip used has not expired. By and large, even though false positive tests can result, that is a rare occurrence. When there is room for doubt, you can wait for several more weeks and repeat the test or in the alternative have a pelvic scan done to determine whether there is indeed a pregnancy.

Dear doctor, I am a 23-year-old undergraduate and my problem is that I did not see my period last month and this month as well. I would have thought I was pregnant but there was no sign of pregnancy. Please help me. 0813xxxxxxx

Occasionally, problems like that can happen even in the absence of any pregnancy. Hormonal changes within your body brought about by various kinds of stress can be responsible for that. But above all, you must make a conscious effort to ensure you have been properly examined and tested by a doctor to be certain that you are not pregnant. In that regard, you are not only looking for signs, you must also be looking to do a confirmatory pelvic scan.

Dear doctor, I read your article in the SUNDAY PUNCH recently. I am 23 years old living with my aunt but I am tired of abuse from her. I have not engaged in any relationship for the last five years because of her. Please advise me on what to do.  0816xxxxxxx

It is clear that you are unhappy in the company of your aunt. At 23, you are mature enough to live on your own. If you are working, it will be much easier to get a place of your own no matter how small it is. However, if you do not work or are in school, then look for a friend or classmate to stay with as a squatter or as a co-tenant. If these alternatives are not viable, report the matter to the larger family so that all can make contributions that will work for you. Good luck.

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