Reverse medical tourism

A few days ago, the coordinating Minister of Health and Social Welfare, while briefing State House correspondents, disclosed that, “People are now beginning to come to Nigeria from the region to receive quality healthcare. This is already happening, including people from far away, places like the United Kingdom and United States.” The honourable minister revealed […]

A few days ago, the coordinating Minister of Health and Social Welfare, while briefing State House correspondents, disclosed that, “People are now beginning to come to Nigeria from the region to receive quality healthcare. This is already happening, including people from far away, places like the United Kingdom and United States.”

The honourable minister revealed other things, amongst which is the approval by the Federal Executive Council (FEC) for the ratification of African Medicines Agency treaty. However, it was the statement that people are coming from first world countries for medical care that made headlines. All major news outlets carried the same story, “Minister says people from UK, US are coming to Nigeria for medical treatment.”

Well, to tell you the truth – the minister is absolutely correct. Nigeria is currently experiencing a surge in reverse medical tourism.

The roots of medical tourism can be traced back to the ancient Greece, where individuals embarked on journeys from across the Mediterranean to Epidauria, seeking healing from Asklepios, the revered god of medicine. In the modern era, the concept of medical tourism primarily involved individuals from developing nations travelling to more advanced countries in search of medical services unavailable in their home countries. However, a noteworthy shift has occurred in recent years, giving rise to a new phenomenon known as “reverse medical tourism.” This trend refers to affluent individuals from wealthier nations embarking on medical journeys to developing countries. It can also be defined as when patients living in other countries seek medical care in their home country. Motivating factors include the allure of lower healthcare costs and the unavailability of specific medical services in their native lands. Additionally, the decline in quality of medical care and extended waiting periods for treatment has further contributed to this emerging pattern.

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In the United States, for example, more and more people are travelling to South America for treatment. Mexico (because of its proximity to the States) attracts an average of 1.2 million global tourists each year seeking medical procedures. Cities like Mexico City, Cancun, Tijuana and Los Algodones are some of the top destinations for medical tourism in the country.

The major reasons for this are cost-effectiveness, high quality of care and shorter waiting times. Medical procedures in Mexico are 50–70 per cent less expensive than in the US and Canada. Many people travel to Mexico to save on healthcare costs and avoid substantial medical debt. Furthermore, Mexico has a range of certified healthcare specialists who provide attentive and high-quality care. Many hospitals and clinics are accredited by organisations such as the Mexican Medical Board and IFSO, ensuring safety and quality. Also, many surgeons are board-certified and have extensive experience. Patients can also avoid lengthy waiting periods. Appointments and procedures can be scheduled relatively quickly, allowing for prompt medical attention.

Imagine this: A trip to the doctor no longer means a quick drive over to your neighbourhood clinic; rather, you pack an overnight suitcase, dig out your passport and head south to your favourite border-crossing site.  This is the case for an increasing number of Americans. With health care expenditure in the US nearly 10 times what it was in 2002, many Americans are looking for ways to access more affordable health care and services.

Over 90 per cent of US residents who cross the border for healthcare cite “low cost” as the reason for seeking care elsewhere, followed closely by ease of access and language barriers. Of those who travel to Mexico for healthcare, 63 per cent cross the border seeking dental care and 82 per cent pharmaceuticals, making these two services the most commonly sought-after health services in Mexico.

As for British citizens, the rate of reverse medical tourism is even higher. Waiting times in the NHS can be as long as one year before one even sees a specialist, talk more of a procedure. Many Nigerians living in the UK often travel back home for procedures that have been denied them because of long waiting time or high cost.

Take dental care for instance. Dental surgeons and orthodontists in Lagos and Abuja will tell you for free that many of their patients are from the UK and US. For things as simple as a root canal or fixing braces (procedures not covered by the NHS in the UK and which therefore cost an arm and a leg), patients often rush down to Lagos during holidays to sort out their dental care.

Also, fertility treatments. These are issues not covered by insurance, and so, if a couple is trying to do IVF, it means coughing up a significant amount of money that they simply do not have. Waiting times in the UK can be as long as three years, and choice of a donor is often limited. In just a little over a year, a fertility centre in Lagos, recognising the gap in care and a lucrative business opportunity, set up innovative partnerships with three fertility clinics in the UK.  In addition, they held informational seminars hosted in the UK for potential donor egg patients. Before long, Nigerian British fertility patients, who need to use donor eggs rather than their own, flocked to the centre because in the UK, egg donors are neither paid nor guaranteed anonymity; and donor eggs are scarce.  

However, the most significant example of reverse medical tourism is particularly for kidney transplants. Speaking on Thursday during a courtesy visit by the Nigerian Association of Nephrology (NAN) at the Presidential Villa ahead of the association’s 37th Scientific Conference, Vice President Kashim Shettima said, “There is reverse medical tourism these days, fundamentally because of the level of care at some of our hospitals. Recently, 13 patients from the United States came to Nigeria for kidney ‘transplants at Zenith Medical and Kidney Centre because it is much cheaper here, and they receive the same level of expertise available anywhere in the world.”

Patients all over the world with end stage renal disease requiring a kidney transplant have since started looking at other countries. India, Turkey, Dubai, Saudi Arabia and Thailand have since established themselves as medical tourist countries. Countries in South America like Mexico, Brazil and the Dominican Republic have also perfected their medical tourism act. It is time for Nigeria to key into this investment.

I sometimes laugh when I hear of patients travelling to the US for medical procedures. For what? For exorbitant prices? It truly amazes me. Or maybe it is because I am too poor to understand? Because nobody who has earned his money rightfully (not Nigerian National Cake abeg!) will pay almost $30,000 for a hip transplant when a top-notch private hospital in Naija can do it at N5 million!

Like the minister rightfully said about reverse medical tourism, “We need to sustain it, and we are investing; we will continue to invest in that direction.”