Daniel Emory is going on 35 years. He has spent 15 of his years in a bed, paralysed-after a raging bull ran into him on the streets of Onitsha.
The impact snapped at least two bones in his neck, some more in his legs and has left him bedridden ever since.
His treatment has moved from Onitsha and Enugu to Calabar and Abuja. The next stop for his treatment is a choice between hospitals in India and the US.
His surgery bill ran up to $36,000. Two years ago, foreign exchange rate put that cost at around N6m. today, his surgery would cost N11.3m. And Emory is still in bed.
A bill of $36,000 shouldn’t be that massive for the raft of surgeries Emory needs, but the value of the naira has made those surgeries unaffordable.
It is official! Nigeria is in recession, and the naira has been in freefall against the dollar. Mid-January, Senator Ben Murray-Bruce tweeted a composite photo of a dollar bill next to a N500 note. That’s the day it took half a thousand naira to get a single one-dollar bill.
And hospitals abroad quote fees in dollars. There isn’t just enough naira to round up all those dollars needed to pay hospital bills in India, the UK, Germany and the US. Now the sea of clients flooding overseas for medical treatment is drying up.
The drought hasn’t gone without notice, say medical tourism facilitators- the middlemen who link prospective patients (read: clients) with hospitals abroad.
Facilitators fix everything from consultation and travel tickets to international accommodation, transport and everything in between. In return they get a fraction of all payments as commission for each successful facilitation.
A government weary of medical tourism on the lips of its citizens and dominating headlines frowns at the facilitation business in principle. Now it can cool its heels. Recession has bitten deep into that business.
“It is very noticeable. It is not a hidden thing,” says Emeka Francis, who manages Care Point, one of the pioneer medical tourism agencies in Abuja facilitating medical treatments abroad. “It has affected general travel, not only medical travel.”
Facilitators estimate medical trips have declined up to 60% since last year, well before Nigeria officially announced it was in recession.
But it isn’t just an economic term. What’s real is the reason that’s brought different groups into street protests: poverty.
“The general problem all over is poverty. Poverty is a killer, and it seems sometimes life is meant for the rich to enjoy,” says Francis.
Since the economy reached the edge of a cliff, it has become clear every tiny bit of sale, service, manufacturing is pegged to the dollar.
First Rivers Hospital, based in Port Harcourt, has affiliated itself with a partner hospital in India. Cases it cannot handle in Nigeria get referred abroad-widening the reach of Indian hospitals into the Nigerian market. It is also listed on businesslist.com among dozens of centres facilitating medical travels in Nigeria.
But the partnership hasn’t been spared by the naira-dollar exchange rate.
“You are not even talking about ticket, accommodation or someone going with you,” says Dr Sola Olanrewaju, medical director of First Rivers. “The cost of consultation alone. Maybe $2,000 last year [in consultation fees] would have been N500,000. But right now $2,000 is over a million naira.”
Medical tourism’s service isn’t a commodity you can hold in hand. At different times, it is a fancy plastic surgery, a routine physical, a quality-of-life procedure, a life-or-death surgery.
One agent who worked with a medical tourism facilitator in Abuja tells Daily Trust the industry has been hit hard even before July last year, when the signs were clear the country was headed for full-blown recession. “We didn’t get any medical traveller. People were still travelling but not as much as before.”
Up until September last year, the Indian High Commission in Abuja still issued around 40,000 visas monthly-90% of them medical, a source in the commission admits.
It charges $252 in visa fees. Within days the equivalent naira jumped from N92,000 to N96,000 and then past N100,000. It has never come down since then.
Facilitators suspect increasing naira equivalent is driving away clients. There’s also a second supposition, says the respondent who isn’t named. “It most likely could be that people have decided to cut out the middle to reduce their cost,” she says. “If you contact a medical tourism company, we have to have our own cut for facilitating your treatment.”
That in itself doesn’t look good for both client and country. Facilitators insist medical travel without proper legal representation leaves patients vulnerable to abuse and mistreatment. But not every middleman is a legal representation.
“The impression people have is that using a middle man means you are at risk of having a higher cost of treatment. This government is not in support of [facilitation], but it is part of increasing gross domestic product. There is nothing you can do about it; quite a lot of people are gainfully employed through this process,” Francis explains.
“If you do direct transaction with these hospitals, nothing comes back here. If you pass through an affiliate, at least 20% of the money you put there will finally end up here.”
Here is where Victoria George has been since being aged eight when a massive growth in her gum quadruped the size of her jaws.
Oncologists have since confirmed the tumour is not cancerous-and doctors from Jos to Abuja have written up medical reports referring her for further evaluation, testing and surgery abroad-specifically in India.
That was in 2015, and the cost came up to N3.2m-money her family and donations couldn’t afford. Two years later, the cost has doubled with exchange rate. Now she’s looking for surgery, just any surgery-even one by philanthropic organisations anywhere in the country.
President Muhammadu Buhari has already been abroad twice for medical check-up, a signal people still travel for medical reasons. Emory cannot.
