Cost Of Living Crisis: Sick Nigerians Face Borrowing To Pay For Healthcare

Adetayo Sadiq, 42, has had to depend on his wife and well-wishers to sustain his family of five since he broke his leg about two years ago. One morning in Dec. 2022, as he made to cross a highway, a bike on the wrong lane ran into him.

In February, after spending two months in the hospital, he was discharged. But he still has to stay at home to heal properly. He also has to visit the hospital in Lagos, southwestern Nigeria, every Wednesday for check-ups. The hospital is at least a two-hour drive from his residence in Matogun, a border rural town between Ogun and Lagos states. Sadiq was a dealer in phone accessories around Ikeja before the accident. But now he struggles to put food on the table and pay the school fees of his three young children. Besides that, another thing he increasingly has to worry about is getting money to transport himself to the hospital for his weekly check-ups.

On May 29, Nigeria’s President Bola Tinubu announced the removal of subsidies for petroleum in his inaugural speech. Following the announcement, the Nigerian National Petroleum Company directed its outlets nationwide to sell fuel between ₦480 ($0.6) and ₦570 per litre ($0.7), an almost 200 per cent increase from the initial price below ₦200. The hike immediately triggered an increase in transportation fares and prices of goods and services. This means people like Sadiq have to choose between basic necessities and getting the medical care they need.

Experts say one implication of the government’s policies is that healthcare has become even less affordable for the average Nigerian. People have to pay through their noses for treatment as the prices of drugs, bed spaces, and tests have increased. 

Life has become more difficult

Since June 2023, Sadiq has contemplated taking loans to ease the financial burdens that came with the fuel subsidy removal. 

“If I don’t take a loan, I don’t know how I will survive until I can get back on my feet. Things are very difficult now. It’s hard to go for my weekly check-up at the hospital,” he said. 

Before the subsidy removal, Sadiq spent an average of ₦1,500 ($2) on transport to the hospital. Now the same trip costs at least ₦4,000 ($5).

“My legs are healing already and I walk around with the help of my crutches. I don’t want my legs to deteriorate. I wish there were an affordable hospital close by, but Matogun is a developing area and we don’t have a government-owned hospital here,” he told me.  

According to Dataphyte, Nigeria has just 17 health facilities for every 100,000 people. There is a huge scarcity of affordable healthcare in the country. Not all the facilities have the capacity to meet medical needs as advanced as Sadiq’s too.

One health crisis away from poverty

WHO’s Technical Officer on Health Financing in Nigeria, Dr Francis Nwachukwu Ukwuije, observed last year that in some states of the country, a large number of people have fallen into poverty because of ill health and the inability to pay for healthcare. The National Bureau of Statistics (NBS) also announced in Nov. 2022 that the number of poor people in Nigeria stood at over 133 million (63 per cent of the population).

Poverty is a major obstacle to quality healthcare, and with rising inflation, it has become even more inaccessible to the masses. 

Hospitals are recording a drastic decrease in the number of people seeking healthcare. 

Tuesdays are usually one of the busiest days in the mental health clinic at the Federal Teaching Hospital Ado Ekiti. “After the morning review session, we usually have our reception brimming with patients,” said Agbaje Tosin, a doctor in the mental health department. “But last Tuesday, not a single person was waiting for us. At the end of the clinic, we eventually saw three patients. In the past, we used to have about eight or nine patients with about three or four new patients. Yesterday, there were no new patients.” 

He added that the facility recorded a reduction in people visiting other departments too, “most likely due to the increase in transport [fare]”. He emphasised that this is bad for healthcare delivery across the country.

Dataphyte states that for every 10,000 people in Nigeria, there are four doctors available to attend to them. Former president of the Nigerian Medical Association, Dr Francis Faduyile, noted that high rates of insecurity, unemployment, low remuneration, bad roads, and poor healthcare system are some of the reasons doctors are leaving the country in search of greener pastures.

“A patient came in on Tuesday complaining about the transport fare and how he still has to pay for his medications, food etc. This affects us as practitioners when people don’t have enough money to buy their medications or come for checkups. It strains our treatment,” Tosin said.

Increases in the prices of necessities mean the amount of money Nigerians are willing to put into their health reduces. “What this means for the country is that health problems that could have been nipped in the bud will be left to fester for so long they become an emergency situation, which could lead to death and affect a lot of people,” the doctor noted. 

Another danger is that more people will flock to alternative healthcare approaches, which could harm them.

Stanley Ikechukwu, head of Operations at SBM Intelligence, said many Nigerians are left with no choice but to turn to herbs. 

“We have seen an increase in the price of medical tests. The prices of drugs have also increased, the cost of bed space is on the rise, and the cost of drip has gone up. Checking blood pressure used to be free where I do my test, but there is a charge of ₦300 now. Medical fees have also increased and this has led people to seek health wellness locally. I was at the lab as recently as this week and my general yearly checkup price jumped from around ₦27,000 to ₦37,000 for the same number of tests,” Ikechukwu told me. 

What may seem like the way forward? 

For Doctor Tosin, the best solution is for the government to invest in primary health centres so that people do not have to travel long distances to access basic care. “Primary healthcare should be standardised because so many PHCs are outdated and cannot provide adequate health care to people,” he said. 

But despite promises from the Nigerian government, the healthcare sector still suffers neglect.

Ikechukwu advised the government to begin to move in the direction of the health system in the United Kingdom. 

“I thought COVID-19 would have taught us some real-life lessons that would make the government show serious interest in fixing the system, but four years after, we are still here. The healthcare sector is one of those sectors that we can begin to see results in the shortest possible time if the right type of investment is made.”

People like Sadiq with health conditions requiring constant visits to the hospital and the regular use of medications have to choose between sound health and other basic needs. Sadiq may spring back on his feet soon and have enough strength to repay his loans, but not everyone would be as lucky.

“We know the government is trying to pay our debts with these policies but they should consider people like us too,” he said.