Private Men, Public Lives
By: Alexactus T Kaure
WHEN I read the article titled ‘I am in good shape, now leave me alone’ in The Namibian of last Friday, the immediate question that came to mind was: why do our leaders, especially presidents, go abroad for medical treatment? The favourite destinations for our leaders whatever ailment they have has always been France, Germany, UK, India, Dubai, and of late South Africa and Cuba.
This question has been posed by others before but it keeps on popping up like the proverbial frog on the beer mug. Dr Abraham Iyambo, our Minister of Education, was candid with that “leave me alone” statement (we wish him well though). (Just in passing, the story about former President Sam Nujoma having gone to SA for treatment, whether it was true or not, caused my friend Max Hamata his editor job at Informanté newspaper).
Here, I do not intend to raise any questions about the rights of our leaders, as well as any other citizen, to go anywhere in the world for the very best of medical care to save their lives. Thus, I have no qualms with that because, hopefully, they all pay for such trips and the medical care out of their own pockets.
My interest is more with the ‘why’ issue. I venture here that there are broadly three main reasons that I can think of presently. First, there is the issue of privacy; then availability of money, but the more important one, in my view, speaks to the state of medical systems in many African countries.
The issue of privacy about one’s medical condition is important both for ordinary citizens and the rich as well. Most people would prefer to keep their medical condition as private as possible but obviously not confidential because we all go to medical facilities to get treatment and one’s medical card can go through so many hands – nurses on different shifts, for example, some whom might personally know you. And if your condition is one of those that has been ‘stigmatised’ then this can easily become the talk of town. Thus, those with money would prefer to go to hospitals abroad where they are not as well known.
The other, that I hinted at earlier on, is the issue of money. Some of our citizens, and indeed presidents, have some of the best medical schemes. And in a capitalist democracy like Namibia, everyone has the right to choose where in the world to seek medical care. It is supposed to be a system based on choice but, of course, many of our people don’t have those choices. The catch-word here, however, should be self-sponsored and not clandestinely paid for by the taxpayer. But, unfortunately, we all know that high-level government officials would always use some state resources for private trips abroad. The bodyguards, and convenience catering services to ensure the president’s comfort and safety, for example, all add to our financial burden as they are largely paid for by the state.
The term ‘flown abroad for treatment’ has become such a cliché that we don’t even think about it seriously. We take this for granted or feel hopeless because there isn’t much we can do about it; but this issue of ‘medical tourism’ speaks to a much broader problem that goes at the very heart of our medical systems and facilities in Africa.
Everyone knows the problems, but very little discussion takes place on this. However in order to find solutions it is useful to understand the reasons why the problems exist in the first place. One of these reasons is the inadequate funding for healthcare in many African countries.
Indirectly and ironically, perhaps, Iyambo seems to confirm the poor state of affairs prevailing at some of our own health facilities, and in Africa at large, when he said that he has ‘a high regard for the Cuban medical system’. Ironically, we have even been receiving both doctors and medical training from Cuba for years now, but we have been unable to reach the height of Cuban medical standards yet. The problem – funding.
Our medical staff, especially the doctors and nurses, are not adequately cared for (last year’s threat by nurses to strike attested to that) and supported to improve their skills, or expand their careers into specialised fields. We don’t have enough experts in other supporting areas, like radiology.
And even if we do, there is the issue of infrastructural inadequacies in the hospitals to enable these experts to perform at their best. We under-fund our few specialised facilities for healthcare like the cardiac centre, and we do poorly in funding research by our own experts in medicine.
And this is why President Pohamba’s commission on the state of health system is long overdue so that, hopefully, our leaders can start to address the myriad problems facing us in this area. But this can only be done when our leaders stop this culture of ‘medical tourism’ and fix our own system instead.