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Dying AbroadDeath, it is generally agreed, is an exception from the list of social phenomena and facts of life about which man has a choice. It is given that every person must die. But, even this exceptional rule, has some nuances. The rich and powerful may not be able to make a choice about dying eventually, but they can choose where to die, almost in the same way that they use their wealth and power to choose where to live. Only the suicidal among the mass of the people can be said to possess equal leverage over where – and when - to die. The rich and powerful may not be able to replicate their palatial edifices, paved streets, lush lawns, swimming pools and sprawling comfort, wherever their spirits end up after their death, but they can negotiate where they will die. The poor and hapless in society hardly have such a choice. Death often ravages their ranks in their helplessness, and in different forms, in a way that folds their well-being and longevity with their material poverty. Many of them do not even have the dignity of decent burials, precisely because the rich and powerful in their society have so arrange their world in a way that it is impossible for them – the poor – to die well. But, the rich and powerful can transcend even the conditions they have created in their own society. They pursue value wherever they can find it. Where there is no competent health system in their own society – a condition of their making – they can travel out when their health is threatened. In this, they sometimes even make a choice on where to die. This idea of getting both medical check-up and emergency medical attention in foreign lands is not foreign to the African ruling elite since independence. This trend has continued, and even increased in the last three decades, when that largely treasonable cabal that is the African post-colonial ruling elite, by their actions and inactions, began to devastate the health care delivery systems in the continent. However, sometimes, by the time they get to Europe and the United States, it is too late for members of the African ruling elites to be saved by the medical expertise that they have failed to provide at home. Thus, they may also be choosing to die peacefully abroad. The story is familiar enough. But, it would seem that African dictators and other members of the continent’s ruling elite do not learn any useful lessons in enlightened self-interest, even from one another. Mobutu Sese-Seko, the imperious rogue, who ran Zaire for countless years, stole virtually everything in sight, and built himself palaces wherever he fancied - even on the seas, as his yacht was one that affirmed Mediterranean tastes. He also bought houses in the famed South of France. Yet, the scandalous despot did not for once think of building a state-of-the-art hospital to cater to his health within the country he devastated for many years. In the end, he died a vegetable in a European hospital, another evidence of the fact that Africa is largely run by contemptible elites. Only recently, the unimaginative Togolese despot, Gnassingbe Eyadema, after running and ruining his country for 38 years, could not find a single hospital in the country that was competent enough to attend to his ailment. He was in the bid to fly to France for medical attention – perhaps to die in beautiful Paris – when he expired in his lair. Eyadema could not build, even if only for himself and his family, a world class hospital in Togo. His son, who was one year old when his father killed people to seize power, the dour Faure Gnassingbe, without familial shame, and with the collusion of his father’s soldiers, also seized power, assuming the Togolese throne of bayonets that his un-edifying paternity constructed. Closer home are the examples of two recent former military dictators. When soldiers shot their way into power in Nigeria in December 1983, General Sani Abacha stated in the coup speech that one of the cardinal reasons why they took over power from the civilian government was the crisis in the health sector. He charged that the hospitals had become mere consulting clinics. But by the time Generals Muhammadu Buhari, Ibrahim Babangida and Sani Abacha, in that tragically serial order, ended their inglorious rule, the hospitals had become mere clinics, as most of the consultants had left for Saudi Arabia. Therefore, when Babangida was afflicted by radiculopathy, he had to first ensure the stability of his regime before he could seek medical help in Germany. Not at any time in his 8-year rule, did Babangida build and equip a good hospital even with competence only in radiculophy - his life-long ailment, as the media reports would have it. This is despite the fact that Nigeria is blessed with world-class medical practitioners, competent in all major areas of medicine. Also, as speculated in the media before he died, perhaps one of the reasons why Sani Abacha suddenly expired in his lair was because he could not seek medical help abroad. Afraid of the shadows he had created, particularly the ‘American shadow’, the dull dictator, desperate to hold on to power against all odds, could not reach out of the continent to get the treatment he desperately needed. In the end, his inglorious rule ended in circumstances made worse by high-quality rumours. It would seem that African dictators do not learn any lesson in enlightened self-interest, even from one another. The development of every modern society is predicated on the elite attending to their enlightened self-interest in ways that transform society and engineer phenomenal growth. The western capitalists needed the people as ‘market’ and so progressively increase wages to provide a purchasing power for the people to buy the goods they produced. They also wanted to live in peace, so they provided enough for the mass of the people so that they too could live dignified lives, which would hopefully preclude them from revolt and revolution. An American humourist, Sam Levenson puts it succinctly: “If you don’t call your brother ‘brother’, someone else will come along to call him ‘comrade’”. But, this simple lesson in enlightened self-interest escapes the African predator-in-power and the colluding elite. And their illimitable shamelessness is illustrated by their unapologetic and unending defence of the climate of fear, disease, uncertainty and death, which they have imposed on the continent since independence. The news media in Nigeria have been reporting in recent times on the medical trips abroad undertaking by members of the ruling elite. At least, three key members of this ruling elite have died in England in the last one year or so, while seeking medical help. Perhaps, by the time they arrived there, the time and stress of flying them to the UK were too grave to allow them to survive. Maybe not. But, whatever the truth, it is incontrovertible that they would have had better chances of surviving if the medical help they sought abroad were available in Nigeria. This is where sub-Saharan African ruling elites of all shades and colour remain, as a group, the most shameless pack in the troubling history of the postcolony. Despite their own undemocratic credentials, other tyrants in Africa, north of Lipopo River, at least have built enviable health care delivery systems, systems, which are strong enough to attend to their own health needs within their borders. Imagine in one case, before his recent ‘transformations’, if Muarmur Ghadafi of Libya were to go to the United States, Europe or Israel for medical checkup. He could as well have opted for hanging. If only the incompetent rulers and ruling elites in Africa, south of the Lipopo River, could learn from the enlightened self-interest demonstrated by their counterparts in the north. There are occasions when even air ambulance would not be able to provide the needed succour, where immediate medical competence and equipment are needed. So, why do they not have the commonsense of establishing such world-class health institutions here – if only exclusively for themselves? In Nigeria, the health sector has collapsed; the shadows that remain are the handiwork of super-patriotic medical doctors, nurses, ward-maids, auxiliary nurses, and other health workers, struggling under harsh and disheartening conditions to keep the veneer of healing institutions. People die without any form of dignity in hospitals all over the country. If the state of our teaching hospitals is anything to go by, indeed, those who still call what we have now as ‘health sector’, should be accused of criminal complicity in a matter of mindless disregard for health standards. Which would explain why whenever health workers threaten or indeed carry out the threat of industrial action, they are first disparaged, then ignored, and then implored, by an insensitive leadership, and even sometimes, ignorant public, to ‘return to work at any rate’. In less than two decades, to take one signal case, the University College Hospital in Ibadan moved from a world-class teaching hospital, perhaps the most famous and most accomplished in black Africa - visited by medical practitioners from around the world - and became institutionally-speaking, a medical scandal - a monument to the ascendancy of the criminally-inclined in our national leadership. The University College, of course remains, but it is hardly a Hospital today. When they accuse the health workers of caring too much about their own welfare, they forget that even an elementary definition of health involves such everyday sense of well-being. In the end, as the philosopher says, “there is a destiny that make us all brothers (and sisters): all that we send into the lives of others, come back into ours”. If a wholesome departure is not engineered today from this sordid state, the masses will continue to die unsung at home, and the ruling elite will continue to die abroad - even if they are undeservedly sung after their departure. Death then will remain the most important (national) resource that is shareable across classes, creed and faith. Condolences.
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