Dr. Aminu Usman, the Medical Director, Federal Medical Centre, Bida, Niger State, is one of the Senior Chief Executives of the nation’s Medical Centres. A consultant per excellence, had held sway as the Medical Director of FMC Bida for the past seven years now, and for this reason, he had seen it all as far as hospital administration is concerned. He holds so many radical views on how to make Nigerian Health Sector more responsive to the demands of Nigerian patients.
In this interview with the Group Editor-in-Chief of Education Monitor Newspaper, Waziri Isa Adam, he spoke on many issues, particularly, Medical Tourism which he said, his hospital is focusing on and working hard to prioritize.
Dr. Usman is of the view that Medical tourism can be discouraged in Nigeria by the provision of adequate medical services and experts, which he revealed that FMC Bida is working hard to achieve. This initiative, he said, will help save billions of dollars for Nigeria. Even though, on another breath, the Medical expert disagreed with Nigerian Senate’s directive to President Buhari to end his medical trips abroad, saying that the president deserves the best of everything. Excerpts:

HM: You have long been talking about medical tourism. What precisely is your take on this issue and what do you want to see government do about it?
MD: Our government, like any other government in the world should work hand-in-hand with medical professionals to see how best we can collectively look after ourselves, our people – the great citizens of this country. It should matter to all of us in our government that the health of each and everyone of us is given the attention and seriousness it deserves.
Just like in other parts of the world, we, as citizens, as individuals, as Nigerians, will naturally want to be assured that as much as possible, whatever health challenge we have, we are able to be looked after. And we have the professionals to do it to have the resources to do it.
So, as far as I’m concerned, the aspect of medical tourism as it were, is just unfortunate that yes, we have taken a kind of negative connotation, negative in the sense that basic things that can easily be done for us here, if you don’t do them very well, it become more difficult to do more complicated things.
And this complicated things, unfortunately, are what people see being done in other parts of the world, beautifully, and successfully. So it is a difficult thing to convince someone who has the resources to go and look for those services outside the shores of this country, not to do so.
So the only way therefore, is to provide the template, the platform on which we can do some of those things. We said it severally that most times when people go outside the country, they end up being attended to by Nigerian professionals. So, it means we need to create the same environment where they’re able to do more here. Perhaps some of them will come back. But most importantly, those of us here who have reason to also feel that sense of achievement and be able to look after our people.
HM: MD, this issue of medical tourism has been discussed, time and again, but without a new concrete step taken by the people in the health sector. Now that taking up this challenge, how do you want the government to come in to support you to achieve this?
MD: The government to come actually I will say on my own side, perhaps I’ve been lucky, the government has been on my side in trying to address this. The management here, the board and management of this center has been working on this, I think for the past six, seven years. The intent being that if we are not able to retain our professionals to do what their colleagues are doing outside the shores of this country, the tendency for our people to still think the best is outside the country will remain.
So what we’ve tried to do here is most of our professionals, especially the Medical Group, the consultants as we have are aware of this and most of them have created a soft specialty for their own in their own different areas, and are looking at how best they can develop this.
And To this end, what we try to do is to see how we can empower them so that we’ll do what we call, reverse referral, patients we have here, we tend to refer them to bigger centers as it were. But now we are having reasons to ask those patients to start coming back here. So most of the cases that we were referring people for, are now treated here. That will naturally require, apart from training, also expanding our facilities and capacity to handle some of those cases.
It is to this end, that the permanent side of this hospital, is primarily targeted to see how it will have Advanced Care Centers both for surgery, surgical cases, medical cases, and reintroducing the services that we don’t currently have, technically trying to expand our menu of services and to capture some of these areas. So, I believe that over the last three, four years, especially with the coming of the Buhari administration, we have spent a good chunk of fund trying develop the permanent side, and I’m happy that yes, there is so much to show for it. And I believe by the time we are done, based on the plan and successes we’ve gotten so far. I can tell you a good section or aspect of Medical tourism will start biting into them.
HM: you talked of surgery, medical cases etc, which other area, do you want to work on to develop to such an extent that people would prefer to be here than waste other resources to go abroad for similar treatment?
MD: Let me tell you why they will prefer to be here, If we are able to do this the way we are hoping to, it will be far cheaper for our people to get similar services here, in fact not just because it is cheaper in terms of financial aspects, but if you have to travel to like halfway round the world to get surgical services that you can get at 50-60 or hundred kilometers from your base, I think even the toll on you as a person has been reduced. But yes, when we say surgical services it means medical condition that are equally, perhaps, best amenable to surgical intervention.
So in this case, it ranges of course, from neurosurgery, Ear, Nose Throat (ENT) related conditions, gyneacology conditions, cardiac surgeries, oncology (cancer as people call it) you will realize that these are most of the conditions that necessitate a lot of people to go on medical tourism. But of course, other medical conditions are hypertension and it’s complications, diabetes and it’s complications, people who need, real intensive, attention of intensivist, and stuff like that. So all of this, are what we are working on, we care to start with the surgical because it is the strength of this initiative. I’m sure some other hospitals who tend to be needing medical related things may also choose to start with that just to cover full spectrum.
HM: Can we conveniently say this initiative will help in saving Nigeria millions of dollars?
MD: Exactly, millions of dollars, that is if we are talking about the monetary side, but one great advantage of this initiative is that it will also help to reinforce our confidence in our own country and our own people and our professionals. This is what we cannot afford to lose. The greater loss for us is people who have the skills and the knowledge to do some of these fanciful things you hear outside the country, once they start living, it creates a big gap for you to train and replace those people. You will discover that such experts have the ability to train 15-20 people. Once he leaves, he creates a gap that these people will end up doing something else. So, this is a greater loss.
HM: Sir, Medical doctors in this country have been having running battles with government in terms of welfare and other demands, how can you sustain this with this nonchalant attitude of government toward addressing needs of doctors?
MD: incidentally, I will not say nonchalant, the main challenge has been that we all have to agree that government itself has its own limit to its resources. And it is impossible to meet up with all the demands of Doctors. As far as I’m concerned, the best solution will be for government to look for further means of funding the health sector. It can never be from government alone, once we say everything is going to come only from government, we will be very restrictive. It is going to limit our progress. And I think this is what has happened over the years on one side, it will be good to look for alternative ways of funding healthcare.
And for me, I think the better alternative approach will be to have, a framework, a plan, a way of getting people to pay for that services. We all know that the concept that we’ve had over the years is government to build hospitals, to employ the staff, to provide the funds, equips the hospitals. And you as a citizen your own is only to go and queue up anytime you are fortunate to be sick.
We all know very well that this has not worked very well, it has not worked because what it entails is that if you are sick, you go to the hospital and you are told to pay for card, pay to see a doctor, pay to go and do investigation all these payments as much as people don’t like them, you have to realize that actually they are subsidized by government funding. So, the balance of subsidy is what you expect from individuals that are coming to assess these services. So to me, my concept could have been that, government has done this much because it can take a good chunk of the money, funds to spend on poor people.
But the fact that people need to dip their hands in to pockets to pay for services at point of need, I think is where the fault is. So, the balance side of it would have been that government needs to come up with a framework on how to empower the people or individuals who need to assess these services. And I don’t know how it was been framed in many ways to improve health insurance for everybody or contributory health scheme. And this you can do in many facets, while the individual coming is empowered to access the health care because he was contributed over time. He has a health insurance coverage and put it that. He also has the ability or tendency to dictate which hospital he wants to attend. This empowerment is one of the reasons to show all the services because the hospital will now know that the person who is coming is coming with this fund, to access services.
So he’s coming as a king because obviously we want to make him happy. You want to ensure that you provide the services he needs, otherwise he has the ability to move to another facility and I think the outcome will now be hospitals will now be the ones looking for how to please patients, to make sure patient get the best services.
HM: Do you have the manpower to sustain this initiative or you have to rely on foreign experts for you succeed?
MD: Let us discuss manpower, the most important aspect of the manpower to a patient is the one that is locally available. That is the Consultant. If you create a sub specialty that you want to use as your reference in this case, you have to develop that particular individual, so that if it is necessary for you to bring a foreign manpower to augment whatever he is able to do, he is going to be the linchpin, because when they leave, he is going to be the one that is going to look after the patient that he attended to. And this will also expand this ability to do more.
So, for me, yes, we can, because we want to start, or rather, as far as am concerned, now we are starting small way, but we have the capacity to expand as we move on. Once you bring in a team from outside, even if they spend one year, from day one, they start counting when they are going to leave, and when they leave, the services they rendered within these periods is curtailed.
So, to me, it is still the local manpower that we need to work on and then get the foreign manpower if and where necessary. Of course, it will require a lot of collaborations, cooperation with places outside the country as we stand. But certainly, I think the key thing is to develop our local manpower.
HM: This issue of relying on external or foreign experts is being driven out of the country. What I mean is if you go to Dubai, US, you see Medical doctors from different parts of the world working there but in Nigeria, you see only Nigerian Doctors, why is it so? Because the collaboration in terms of physical practice is add up to the experience and ability of our local doctors to work.
MD: It is so because if you look at what people pay there, we have Nigerian professionals that are working in those places. They left for two reasons most times, one for a good number of them is to achieve self-actualization, ability to be able to do what you have long loved or dreamt to be a Super specialist, and this is where they get the facilities to achieve their dream. The second reason is perhaps, the pay is better, or, very good there. And this is because when Nigerians, for example, go outside, they go with millions of naira to pay for services, that if you tell them to pay just half a million naira here, they will say No, that it is too high.
But you will recall that in the last, 20 – 25 years ago, we had a lot of expatriates, Indians, British and a lot of other people that were working in Nigeria. Why were they coming here then? they are coming because of two things. Our naira was strong and the pay was excellent
EM: Finally, MD, recently while considering the budget for the State House clinic, the Senate, urged the president to reduce travelling outside the country for medical treatments. They argued that, year in, year out, billions of naira are allocated to the State House Clinic, yet there is nothing there to show for it. Do you concur with the senate?
MD: No, I don’t. As far as I am concerned, we should want the best for ourselves, not just our president. So, if the best that the president deserves is outside our shores, and because we can’t afford it here? I think we should give him the best.
HM: Why can’t you challenge him to try to give the country the best?
MD: No, the challenge is on us, each and every one of us, we are the ones that need to recreate that scene where we are able to do a lot. Why we are discussing the president because he’s our No. 1 citizen. But will it matter if it is a cleaner that needs the same surgery as president needs? It should matter to us in that case, what do you expect? Perhaps somebody of lesser status to do.
We should have a package, a system where those people will equally be attended to. And I think that is one of the things we need where we must develop our own resources and capabilities to handle. So whether the President or not the President, we will still be able to look after ourselves and I think that is meant for each and every one of us.


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