Issaka K. Souaré

Victim of a stroke while attending a meeting in Saudi Arabia on October 24, 2018, Gabonese President Ali Bongo Ondimba (ABO) was immediately hospitalized in the Kingdom’s capital where he reportedly had surgery. About one month later, when it came to transferring him to another place to “continue his recovery”, both his biological family and the Gabonese government considered the UK capital, London, and then the Moroccan capital, Rabat, as options.

He was finally transferred to the Moroccan capital on November 29. At no point in this story was the option of returning home to Gabon mentioned. Since then, on a few occasions, he returned to Libreville “on a visit,” then flew back to Rabat, from where he “governed” remotely. While we wish him a speedy recovery, one cannot help but recall that his father, late Oumar Bongo Ondimba, died in June 2009 in a Spanish clinic in Barcelona, rather than in a Gabonese hospital.

Nigerian President Muhammadu Buhari spent seven weeks straight at a medical clinic in London on what has been called “medical leave”

Zambian President Levy Mwanawasa fell ill in late June 2008 at an African Union summit in Sharm el-Sheikh, Egypt. On July 1, two days later, he was moved, not to Lusaka, but to a military hospital in Clamart, near Paris, where he died on August 19. Six years later, on October 28, 2014, his successor, Michael Sata, died in a London clinic where he had been urgently evacuated some 10 days earlier.

In February 2005, Togolese President Gnassingbé Eyadéma died as he was being evacuated to Israel. He could have been rescued if he had been taken care of while looking for where to transfer him outside Togo, where he fell victim to the crisis that killed him. Even more recently, to avoid continuing with the long list of cases, in early 2017, Nigerian President Muhammadu Buhari spent seven weeks straight at a medical clinic in London on what has been called “medical leave”.

Now, the logical question that prompted the drafting of this article, and which you may have guessed, is: Why these endless medical evacuations of our African leaders abroad?  The answer is simple, but worthy of meditation.

The simple answer is that these leaders know that there is no reliable, quality health infrastructure in their countries

Let me first acknowledge this: when somebody experiences discomfort, it is absolutely normal for them to be looked after on the spot, wherever they are. However, those cases listed here – as well as those spared – were planned cases, involving travel, often over thousands of kilometers, either from their country (the cases of Eyadema and Sata) or after preliminary care that stabilized them for travel (the current case of ABO and the past case of Mwanawasa). So why these evacuations or non-return home after initial care?

The simple answer is that these leaders know that there is no reliable, quality health infrastructure in their countries. However, it is their responsibility to change the situation, especially those who spent enough time in power, to be able to address the deficiencies they would have inherited from their predecessors. They really have no excuse.

Many African leaders are evacuated abroad because of the lack of health facilities in their own countries. So, how come they do not invest even in a referral facility?

Beyond the image this gives of their country and the embarrassment they cause to their fellow citizens, they sometimes create confusion at the highest levels of the State, especially when institutions are still fragile and succession mechanisms, in case of death, are less proven. We are all witnessing what is currently going on in Libreville. However, these leaders are also showing the world, if proof were needed, that they are leaving their poor fellow citizens to their own fate.

Now let us meditate a little on the “simple answer” that I have just proposed. Many African leaders are evacuated abroad because of the lack of health facilities in their own countries. So, how come they do not invest even in a referral facility? Perhaps they compare the “relatively lower” costs of such evacuations individually with the financial bill for such an investment. But isn’t that a sign of a lack of vision and patriotism, or even poor economic reasoning?

Admittedly, building, equipping, and maintaining a modern health care facility would require significant funding. But imagine how much money it would take to treat a head of State overseas. Knowing that these people do not travel modestly, especially for a medical stay of this kind. To cover the usual amenities, there are costs for care, housing, security, and everything else needed.

Countries like Morocco (where the Gabonese president was treated) South Africa, Rwanda, Kenya and Tunisia are equipped with facilities worthy of the name, thanks to the foresight of their leaders that others should follow as an example for their own dignity and that of their fellow citizens

Then multiply this by the number of such evacuations and subsequent medical follow-ups of the Head of State. Add to this the same treatment for the ministers and other government officials over the years. There is also the time required for the evacuation, which would have been sufficient to save the life of the eminent patient if they had been hospitalized locally. Then imagine the human toll that people are paying because of the lack of this infrastructure.

Here in Guinea, for example, where there are many medical evacuations – and the same situation, I think, exists in many other West African and African countries – medical professionals have ready-made recipes, depending on who the patient is. When the latter is a wealthy person, evacuation abroad may be recommended, often with a physician accompanying the patient to the destination, of course at their own expense. But when the patient’s look betrays this sort of prognosis regarding wealth, relatives are kindly advised to take them to their family, to the village… just imagine the implications!

Before ending this article, it should be noted, fortunately, that some African countries are doing well in this saga, which some would describe as scandalous. Countries like Morocco (where the Gabonese president was received), South Africa, Rwanda, Kenya and Tunisia are equipped with facilities worthy of the name, thanks to the foresight of their leaders that others should follow as an example for their own dignity and that of their fellow citizens. However, these facilities are not free of charge since patients are charged either in cash or through health or social insurance programs to which they contribute or may contribute.

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Crédit photo : Golfe Info