A US-based Architectural Designer and medical tourist to Nigeria narrated the following very recent personal experience: “I had a tooth problem in the US and visited a dentist. She took a couple of X-rays and explained to me that I needed some root canal treatment and crowning. She overwhelmed me with how bad it could get if I didn’t get treatment started immediately and gave me a breakdown of the treatment and cost. She billed me $5999 after insurance. I went home feeling depressed and thinking about how to get $6000. A month later, I came to Nigeria for my wedding and I decided to try out a dentist in Ibadan. The same root canal treatment that was $5999 in Chicago was done in Ibadan for N130,000 (less than $100). My point is that we need to trust the expertise of our brilliant Nigerian professionals with their affordable prices.”
To provide a medical practitioner’s perspective on the increasingly complimentary reputation of Nigerian doctors and increasing confidence in the Nigerian healthcare system, this column sought the interview reported below with a highly-regarded Lagos-based medical doctor who is in his early 40s. Nuances: To start, could you tell us a little bit about yourself, Doctor?
Ninalowo: My name is Dr Hammed Ninalowo. I am a native of Lagos and grew up in this city. I went to America when I was 16 and rounded off my higher education in the United States. I trained at the University of Pennsylvania and qualified as a Consultant in Vascular and Interventional Radiology in 2016. I went into the area of Vascular and Interventional Radiology because it was something that was basically very scarce in Africa generally and even in America; there’s not a lot of us. It’s a field of medicine where we use minimally invasive techniques basically to diagnose and treat diseases. I started bringing back my practice and expertise to Nigeria in late 2018. At the time, we would come to Nigeria about every six weeks, for one week, offer our specialised services, and then go back to America. Quickly, it became very apparent that my services were very much needed in Nigeria. This increased my passion for even spending more time here. In 2019, I made the big decision to move my family to Nigeria. So, I started working in Nigeria for six weeks and going back to America for two weeks until COVID-19 came, and kind of disrupted that. So, I had an option to either stay in Nigeria or go back to America, but I have always had a passion for coming back to do medical work in this country. Therefore, I have been in Nigeria since, but I still go to America for about one week every eight weeks to run my clinic in the US.
Nuances: Doctor, the trend of coming to Nigeria from abroad for medical treatment appears to be increasing. Is this really the case?
Ninalowo: Yes, absolutely, that’s the trend. There are two different groups of such patients. One group of patients are Nigerians in the UK, Canada, in the US or abroad generally that have a lot of difficulties, especially with social healthcare issues like NHS in the UK and Socialised Healthcare in Canada, where they have to wait in line for a very long time to get even simple tests like CT scan or MIR scan done. Conversely, in Nigeria, you could simply walk to any diagnostic centre and within 30 minutes you can get a CT or an MIR scan. Similarly, as far as accessing doctors is concerned, it is so much easier to access doctors here, even very highly-specialised doctors, because basically, we don’t have a long line waiting. And the skill level in Nigeria is even getting higher and higher as more patients keep coming. I am sure you’ve seen this trend in the field of plastic surgery. A lot of patients are coming to Nigeria to have plastic surgery, especially a lot of Nigerian women in the UK and in the US. And the reason for that is the price point. For the plastic surgery here, you can get it done for about 30 percent of the price you can get it done in America; and you still achieve the same result. And it’s the same thing for most of the parts of healthcare here in Nigeria. And then, I also have another group of patients, who are not Nigerian; patients from countries like Zimbabwe or other usually West or Sub-Sahara African countries, who do not have these services available to them.
For example, we do something called fibroid embolisation, which is a minimally invasive technique to treat fibroid where we don’t need to cut people open. There are only two doctors in Sub-Sahara Africa that offer that currently, and it’s me and another gentleman in Ghana. So, patients come from all over Sub-Sahara Africa to get those services done. Same thing as things like biliary interventions – all of these interventions – treatment for brain aneurysms, which we do now without cutting people open, which we do through a pinhole.
Nuances: Do we have people coming to Nigeria from the Western countries, for example, the way they have been going to India?
Ninalowo: I’ve not seen that yet. I think we are going to get there and I will discuss how we are going to get there. But I don’t think we are there yet, where people are coming from Western countries. But it’s going to happen soon because we now have the framework to make that happen.
Nuances: Thank you. What are the things that could make Nigeria a more attractive destination for medical tourism?
Ninalowo: If you look at what they did in India and even in Dubai, there were concerted efforts to make their countries or cities centres of medical tourism. But we don’t have that yet as the initiative of the Nigerian Government. I am an advocate for Lagos medical tourism and I talk about this on social media. And, you know, because of what I have been doing on social media, letting people know that the expertise is available in Nigeria, even more doctors with more expertise, are willing to now come back to Nigeria, full-time or part-time. But I think we need a concerted effort from the Government, even if it’s just Lagos State to start with, to basically bring all of the private and public institutions together and say what services are now available in Lagos. What services can we now go out and advertise? How can we work together to advertise Lagos as a centre of medical tourism and as a centre of excellence for healthcare? A lot of healthcare facilities have opened in the last few years, which is why people like me could be comfortable practising here. All the same, we still have a ways to go in reaching the A-plus standards that we have in some healthcare facilities abroad as in places like India.
Nuances: Now, in specific terms, what can Nigeria benefit from medical tourism?
Ninalowo: Number one, when you have a place where people are coming for medical tourism, that is definitely significant dollar inflow, because when people are coming into the country to access healthcare, they are not coming with naira, they are coming with dollars, and we’re going to charge in foreign currency. Then number two, an increase in tourism is an increase in the visibility of the country as a whole. Again, if you look at places like Dubai and Turkey, when people know that you have good healthcare, people are coming to your country for healthcare and when they know that it is safe to be in your country, I think the biggest thing is revenue gain for the Government, and national exposure.
Nuances: I have noticed some doctors coming to Nigeria as a team from the UK or the US to offer services on a periodic basis. Do you think these volunteers can complement the initiative?
Ninalowo: Quite honestly, we’ve been very appreciative of medical missions. I think medical mission has its place in Nigeria, but it only has a very small place because these people who come to volunteer are not engaged for a long time with the patients. But the most important thing they do most time when they come in is skill transfer. They come and transfer skills to local surgeons, and that happens, especially in the areas of cardiac surgery and heart surgery. In fact, there is a foundation called the Voom Foundation. They’ve been coming to Nigeria for a very long time. They used to go to places like LASUTH (Lagos State University Teaching Hospital). Now, they are based in a place called First Cardiologists Consultants, Ikoyi, in Lagos. These guys come around about every three months; they treat many patients and they also train surgeons. Some of these surgeons that they’ve trained are handling related cases independently now in public and private hospitals. So we do gain from these experiences; but as a whole, when we talk about setting ourselves up as a place for medical tourism, I think the foundations have limited significance. We need to make sure that the experts are here. When they are here, they can handle both the procedures that are done and complications that happen from procedures.
Nuances: Thank you very much, Doctor. Are there any general thoughts on these issues that you can share with us?
Ninalowo: As I said, I came to Nigeria very young in my career. You know, and I truly believe that we need to sacrifice to take care of our own people and this is what I preach to my colleagues. I have another of my colleagues, who is an orthopaedic surgeon who is about my age and who is moving his own family to Nigeria now. We have people like Yemi Johnson, who did this a while ago and who set the stage for us to do this and to explore this opportunity. And I think more and more people are coming in. So, we definitely need to continue to look at things like government initiatives which encourage people to invest in healthcare. We still need government interventions like low-interest rate loans, which the government is already doing; and making sure we’re not frustrated at the ports. We’re not supposed to be paying duty for importing medical materials or medical equipment, but that is still happening because things like theatre lights are still considered as chandeliers or regular lights by the Customs Services. So, we still suffer quite a bit from the import duties and the frustration of registering products. We still have a long way to go.
Nuances: Doctor, thank you very much.
