Nigeria spends $2.1bn on medical tourism, LASUTH wants to cut it
…as partnership opens in advanced laser surgery, radiology
The Lagos State University Teaching Hospital is taking a shot at cutting Nigeria’s medical tourism that costs about $2.1 billion yearly.
Private healthcare facilities are already racing to domesticate the high quality of services many seek abroad, government-run hospitals are equally jostling to deliver at par and rebuild confidence in a system that has lost much in the public trust to negligence.
One of the three tertiary hospitals in Nigeria’s economic capital, the Lagos State University Teaching Hospital (LASUTH) is carrying out expansions of critical infrastructure and updates of equipment for advanced delivery.
These are areas of sub-specialities that public hospitals are often overlooked as lacking expertise, equipment, or low success rate.
From non-invasive surgeries on the brain to advanced laser eyes surgeries, transplants, or complex removal of weak organs, the hospital has built a crop of a well-resourced team of experts with international repute and has acquired the requisite tools for them to perform.
About 150 consultants in different sub-specialities are available at the hospital, armed with skills to stop the heart from beating, repair the heart and make it start beating again among others, Adetokunbo Fabamwo, a professor and chief medical director, LASUTH stated during a walk-through session with the media.
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While some can take out gallbladders or fibroids without tearing up the abdomen, others can change a bad kidney to a good one through a process of transplant.
These complex medical procedures top list of cases that drive medical tourism out of Nigeria, with about 500 patients who seek specialised treatment yearly in India, Germany, the United Kingdom, Spain, and Israel among others.
Although official data on health do not capture the actual expenditure on Nigeria’s medical tourism, an estimated 1billion is sent yearly.
International healthcare organisations who recognise the potential of Nigeria’s patient market leverage ties with primary healthcare physicians to penetrate.
However, LASUTH is vying for not just a bigger share of the pie, it is providing subsidised services in the following areas.
Ultra-modern Endoscopic Suite
The hospital is setting up an ultra-modern endoscopic suite that will hold about eight new dialysis units and a cardiac catheterisation laboratory where interventional heart surgeries can take place in real-time.
What this means, for instance, is that if patients who suddenly suffer cardiac arrest or stroke make it to the hospital in 30 minutes or an hour, they can get a life-saving intervention.
LASUTH interventional cardiologists had been carrying out this procedure before now but the new laboratory presents an ideal ambience to perform the procedure.
The laboratory at 70 percent completion will place LASUTH as the first public hospital in Lagos to set this up and ranks it in line with high-rated private hospitals such as First Cardiology and Evercare.
It is billed to begin operation by August, and it comes under a public-private partnership with Adcem Healthcare Limited, a private company that specialises in sourcing sophisticated medical equipment, consumables, drugs and vascular access products.
“There are so many patients that die because they do not get immediate intervention. They die from pulmonary embolism and heart attacks. A number die from haemorrhagic stroke leading to sudden death. Pulmonary embolism is when a clot is lodged from either one of the veins in the legs or the pelvis and then goes to block a vessel in the lungs. Usually, such a patient has a short time to survive unless theirs is intervention,” the chief medical director explained.
“So what a cardiac catheterisation does is that when such a patient is picked up, we have an interventional cardiologist who can go in and remove the clot. If it’s a myocardial infarction (heart attack), they go after the vessel in the heart that is blocked and remove the clot and the patient is dramatically healed. Having this lab should make things easier.”
LASUTH prides itself as the only public hospital that carries out frequent open-heart surgeries, after the Obafemi Awolowo University Teaching Hospital (OAUTH), Ile-Ife, Osun State.
And compared with going abroad at a cost as high as 15 million, the government’s subsidy maintains the hospital’s rate at a range of 1.5 million to two million. This is a rate that leaves no compromise on the quality of procedure as success cases have shown.
The distress that comes with roaming the hospital premises to get medical investigations done in scattered units could add salt to injury for patients.
However, this has been addressed with an upgrade of the medical and surgical emergency unit to a one-stop-shop where laboratory and radiological tests can be done and the pharmacy can be accessed with minimised movement.
Professor Fabamwo describes it as an “organisation of patient’s flow” that contributes to better patient outcomes.
The initiative is equally facilitated by a PPP arrangement with private companies to start providing all services in the emergency units where patients have the first contact with the hospital.
120 more beds coming
In addition to its combined capacity of 750-bed spaces, which scarcely handles patients’ demands, a 120-bed facility is under construction and will be completed before the year-end.
Lack of bed spaces has been a persisting challenge that often dictates survival for most patients. Emergency units are often filled with patients who might take days or weeks to be stable enough for transfer to the wards. This makes taking up new emergencies difficult, sometimes leading to loss of lives or worsened conditions.
BusinessDay’s investigation in 2019 found that patients unlucky to be admitted immediately received first aid treatment in private cars, taxis, commercial buses and even tricycles.
LASUTH’s two emergency units have only 40 beds each emergency with far higher demand from patients.
“This is going to solve the space problem that I referred to earlier because if you have 120 extra-beds to put our patients in, then we are likely to be able to take in more emergencies in all our units of emergency,” the chief medical director said.
The new 120-bed facility is a donation by the Sustainable Development Goals (SDGs) Office, through the special adviser to President Muhammadu Buhari on SDGs, Adejoke Orelope-Adefulire.
He added that plans are also afoot to construct a 600-bed iconic building in the hospital. It’s however at the planning stage, with expectations that the governor will assent to it.
Also, at the critical care unit, the hospital has a total of 20 beds including 12 under PPP and eight under direct administration of the management. It has a major advantage in rates.
To entrench patient-centric culture in its system, an automated feedback system has been set up for patients to communicate their level of satisfaction with services.
Aftercare, a patient can indicate if they are leaving happy, unhappy, slightly happy or very annoyed.
The hospital hopes to use this feedbacks as an assessment of its performance in the hope to keep improving its quality of delivery.
Sign languages are also coming to help direct patients around the hospital.
Call for partnership
According to Fabamwo, the management is looking to find serious commitment for partnership in certain areas it already has manpower but lacks the equipment to deliver.
In its eye department, for instance, foreign-trained experts who can handle laser surgeries are available but “we need advanced laser surgery equipment, which costs between N50 million and N100 million. We want partners to invest. We will run it and they will maintain it. We will operate and they will recoup their money,” he said.
Partnerships are also needed in the radiotherapy aspects of cancer care. Even though it has about five expert oncologists as staff, patients only stop at surgery and chemotherapy and are forced to seek radiotherapy treatment outside.
In general, LASUTH has displayed its commitment to take healthcare further. It has a governing body that is headed by some of the best hands in Nigeria’s private healthcare sector and they have brought to bear their wealth and experience to help deliver a public healthcare system that works.
These areas of strength open opportunities that patients can fully leverage, without leaving the shores of Nigeria.