Hypocrisy of another kind

IN January 2007, months before he was named the winner of the unresolved presidential election, controversy broke out about the true state of Umaru Musa Yar'Adua's health. Sixteen months later, Yar'Adua's health condition has returned to the front page of national newspapers. Although his minders have been quick to play down the seriousness of the President's health, there is no indication that the debate would disappear soon. Even as he signed the long-delayed 2008 budget on Monday this week, Yar'Adua looked pale and unwell.

By training, medical doctors (at home and overseas) are skilled to assess the conditions of their patients, to diagnose symptoms that could prove terminal if undetected, and also to assist in treating their patients. Prompt diagnosis serves as early warning signals and helps to detect future trouble spots. There is no better place to seek medical check-up or treatment than a highly equipped and professionally staffed hospital. Of course, healthcare in Nigeria is in a mess. But governments are elected to solve problems and to provide for the basic needs of the people. Healthcare is a basic need.

The debate about Yar'Adua's health has also raised questions about whether it is appropriate for a president to shun the services provided by local medical hospitals and consultants in preference for overseas medical facilities and specialists. We are in awe of overseas medical institutions. No. Our political leaders are in some kind of debt to overseas medical hospitals, specialists and consultants. It is hypocritical for political leaders to encourage us to patronise national institutions in the name of patriotism while their actions contradict what they preach.

There are troubling contradictions that must be resolved by anyone who seeks to justify Yar'Adua's decision to go overseas for medical check-up. Yar'Adua has a personal physician who is paid by the state to look after the president's health. But Yar'Adua also prefers to patronise the services of overseas medical specialists. This much we can deduce from the media statement attributed to one of the president's special assistants. Each time Yar'Adua rushes overseas for medical check-up or treatment, he casts an adverse vote of confidence on his personal physician and the medical facility that is attached to the presidency in Abuja. Each time Yar'Adua goes overseas for medical treatment, he makes an unmistakable statement that neither the president's physician nor the Abuja hospital is capable of dealing with the president's medical condition.

It might seem alright for the president to patronise overseas specialists because he can afford to pay for their services but that kind of behaviour also suggests the president has no regard for the quality of medical services available to the rest of us in public hospitals in the country.

The last time Yar'Adua staggered on the floor of his presidential campaign podium and his doctor noticed some unusual movements in his heart, he (Yar'Adua) was rushed to Germany straight from his campaign camp for medical attention. That was in early March 2007. One year later, Yar'Adua, now president, has hopped off to Germany because something unusual has gripped his health and it was deemed urgent enough to hurry him overseas for proper attention.

We can now glean a standard response from the Presidency each time Yar'Adua shows signs of fading health - don't muck around with "ill-trained" medical doctors and poorly equipped hospitals in Nigeria. Take the president to an overseas medical facility once you notice anything unusual in his medical condition.

As president, Yar'Adua's health deserves priority attention. But does priority attention justify taking him to an overseas medical hospital or clinic even for a check-up? What message is Yar'Adua conveying to the nation by patronising overseas medical institutions and belittling local doctors and hospitals? Is he saying that public and private hospitals in the country are not good enough to attend to the president's health? Is he suggesting that it's alright for political leaders to undertake medical check-up overseas because they can afford to do so? Is he suggesting that political leaders are morally entitled to shop at overseas medical institutions whenever their heartbeat goes off their regular rhythm?

Is Yar'Adua implying that medical specialists and consultants in the country lack the professional training and skills to treat political leaders? Is the president hinting that medical institutions that train doctors in Nigeria are glorified high schools? Is Yar'Adua insinuating that it is better for university teaching hospitals in the country to shut down, relocate overseas or auction their facilities to the highest foreign bidder? Is the president implying indirectly that the sustained campaigns by the Nigerian Medical Association (NMA) for better funding of public hospitals are justified or unjustified? Surely, if public hospitals are not good enough for our political "servant-leaders", they cannot be good for anybody.

There are antecedents to Yar'Adua's latest health scare. Amid swirling rumours of his poor health early last year, journalists sought to clarify directly from the man the true state of his health. So, when Yar'Adua visited President Olusegun Obasanjo at the presidential villa in Abuja on Thursday, January 4, 2007, Yar'Adua was asked pointedly whether he was in good health or poor health. He responded: "I am fit and healthy." Yar'Adua added he would be happy to prove his enemies wrong by engaging them in a game of squash. "I will invite them to a game of squash. If they can play 12 straight sets with me, they are welcome." He missed the point. Good health is not all about playing squash.

Yar'Adua's claim to good health did not jell with public opinion because the Nigerian Tribune of Thursday, January 11, 2007, noted how Obasanjo had acknowledged that Yar'Adua once suffered from ill health but Obasanjo also insisted that Yar'Adua had since been "healed" as far back as 2001. Not many people, in particular medical doctors would accept Yar'Adua's argument because playing squash (or any game for that matter) is clearly not sufficient evidence of good health. There are many people who don't play squash but maintain good health. Playing squash might be a very good form of physical exercise but it is incorrect to assert that a good game of squash is all we need to maintain excellent health. Good health is like a nutritious salad. It comes with the right mix of ingredients, such as regular medical checks, good exercises, as well as healthy food.

For clarity, the rush to overseas medical institutions by Nigerian leaders did not start last year. At a point during his eight-year dictatorship, Ibrahim Babangida dashed to France to treat a recurring knee problem. At about the same time that Yar'Adua was guest of a German medical facility in March 2007, vice president Atiku Abubakar was also flown overseas for urgent medical treatment of his problematic leg which, we were informed, developed after an accident during a round of physical exercise.

Even the disgraced Bayelsa State Governor, Diepreye Alamieyeseigha, also went to Germany for another kind of medical treatment -- to repair a bulging tummy. That medical trip marked the beginning of his troubles because it was on his way back from Germany that Alamieyeseigha decided to stop over in London. His predicament multiplied in London when he was picked up by the Metropolitan Police and charged with money laundering.

The quality of services provided in our medical institutions and hospitals will never improve if political leaders continue to shun their responsibilities. Yar'Adua and his ministers must show greater commitment to improving the deteriorating medicare situation in the country, not by running to overseas medical hospitals for personal medical treatment. The question that confronts all of us is: how can the nation ever uplift the standard of medical practice in the country and the poor state of diagnostic equipment in hospitals when the policy makers are more interested in superior services offered by overseas medical institutions?