A wise person visited a sultan and when the latter requested for a cup of water, asked, “If you were refused this drink, would you bargain for it with half your empire?” The sultan said yes and drank. The wise person then asked, “If, due to some sickness, you were unable to discharge this cup of water from your body, would you pay half of your empire to be able to do so?” The sultan said yes. The wise man said, “There is no value in a kingdom that is not even equal to a drink of water.” In other words, there is no value in a kingdom that is equal to good health.
When you or someone you love is ill, you will give up everything you have to be well. This is what makes health political. Forward-thinking nations ensure citizens and their families are not destroyed by ill health – either through subsidised health care, like Britain’s National Health Service, or like Germany, by ensuring citizens have health insurance and the medical sector is thoughtfully regulated.
Health has become even more critical as we face increasing pandemics, epidemics and other ills caused by global warming and the global version of what development is. Twenty-one years ago, African countries pledged to allocate 15 percent of annual budgets to the health sector. Nigeria has never met this threshold – not even during the first pandemic in 100 years. In 2022’s budget, 4.2 percent was allocated for health across the 36 states and the Federal Capital Territory and at least 70 percent of that goes to administration and overhead costs.
When I was diagnosed with breast cancer in 2019, along with over 26,000 women diagnosed annually in Nigeria alone, breast cancer had killed 11,564 women the year before. Breast cancer, when detected early, is not the life sentence it used to be and the survival rates are good when you have the best that advanced medical science can offer.
Although the data available indicates that women in sub-Saharan Africa are diagnosed with breast cancer at lower rates than in the Americas and Europe, cervical cancer and breast cancer are the biggest causes of cancer deaths among women in sub-Saharan Africa with mortality rates as high as 70 percent in some countries.
As I processed the diagnosis and considered my options, my enduring thought for a while was that I would get treatment at home in Nigeria. With time, I reconsidered. It was less about the scary stories of queuing for access to medical equipment in the few locations where they are available and more about the promise of beating cancer successfully. I went to Germany. Not because I am special or more worthy of better health care than the average Nigerian but because I was fortunate to work for an organisation that understands that good health care is a human right.
During my experience, I joined a WhatsApp group of cancer survivors and family members managing cancer survivors. The stories of those who can only get treatment in Nigeria are distressing and enraging. The ecosystem of caring cancer patients and survivors that I have had the fortune to meet is what is special. This is a collective of people, having tasted ill health, want to help everyone who is experiencing it too. They understand how important information sharing is and are generous with advice on diets that work, treatment protocols, how to mitigate side effects and even with fundraising for each other.
It is a mystery how President Muhammadu Buhari, despite his experience with ill health, remains untouched and uncaring about the health sector in Nigeria, at least as far as public, official acts and utterances go.
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Anyone can fall ill and we do. But not everyone who has suffered ill health has the opportunity to influence health care in their country, state, or local government. There is not a hair-thin indication of empathy from Buhari towards the thousands, maybe millions of Nigerians, who suffer what he suffered. There is no indication from health policy and budgets or from Independence Day speeches that he sees an opportunity for additional research and development in any illness.
No doubt, health is private, but it is not private when you put yourself up for the highest office in a country – not if you want to lead – but maybe if you want to rule. Buhari’s detachment from Nigerians, while conveniently using public resources to get the best health care possible in another country should be offensive to every Nigerian who has had to be a medical refugee and every Nigerian who has loved a medical refugee. And this is why health is political and must be political when we go to the polls in 2023, 2027, 2031 and every election thereafter.
That the APC presidential candidate – from the same party and generation, with the same sense of entitlement and same ideology towards power – is also allegedly suffering from an undisclosed illness should make thinking people pause. It is not about his personal wealth providing him access to the best hospitals in the world, it is about the people he claims he wants to lead and whether they have the same or better access. It is about: if he needs to give away a kingdom to be better, whose kingdom will he give? It is about what we know about his antecedents and utterances and if there is any concrete indication that he will use his office to ensure quality healthcare access is improved for all.
It is hubris, not determination, to have a life-threatening or debilitating illness but still contest the presidency of a broken country. There is no arrogance with ill health – it humanises, and makes people kinder, more caring, more giving. If these are not the traits that we see in candidates even before they enter into office, we will not see them when they have power because as Michelle Obama points out, power does not change anyone; it makes them more of who they are.
Those whose bodies do not function like they used to or should, whose bodies are attacking them, will give anything to be well-whole again. We are all one serious illness away from being impoverished and changing the fortunes of our families and we will give our kingdoms – all we have – to be well again. Decent, accessible, affordable public health is a right, not a privilege and we should not give our votes to those who see the best health care as their entitlement and sub-par health care as a privilege to us.
There is no value in a kingdom that is equal to good health.
Ayisha Osori, author of ‘Love Does Not Win Elections’, writes for BusinessDay for Nigeria Decides 2023 series every fortnight on Wednesdays.
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