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A few days ago, a hospital in Ahmedabad, India, published a video to advertise itself. In the video, General Abdulsalami Abubakar, our former Head of State, appeared as a model and was shown walking the hospital’s corridor beside a nurse. He was advertised as recovering from knee replacement surgery. The video clip carried a message which read: “Former President of the Federal Republic of Nigeria and General undergoes knee replacement surgery at Krishna Shalby Hospital.” Many Nigerians have described it as a disgrace. Well, it is nothing more than that.
The hospital presented the footage as proof of the world’s growing trust in Indian healthcare, no doubt, but Nigerians watching their former ruler become the face of a foreign hospital’s sales pitch felt shame. The shame was earned.
Don’t misread this: Any man’s choice of surgeon or hospital is a private matter, and General Abubakar, as a private citizen, is entitled to his choice. However, what makes his case different is that he once ruled over Nigeria, though he was not elected. Despite that, Nigeria oversees his personal welfare as a former Head of State and member of the Council of State. Perhaps that is why the image of Vice President Kashim Shettima was captured in the hospital advert. I also guess that is why Nigerians feel a sense of shame seeing that advertorial with their former Head of State as a model.
Nigerian are entitled to read meanings into that public spectacle that has classically rubbished Nigeria’s leadership since 1999. That video says one thing: that the Indian hospital is excitedly telling the world that Nigeria’s leaders do not trust hospitals in the country they led and still lead. That is a mockery of Nigeria and its leadership. So, the video was not about one man’s knee, but a shameful verdict on the 27 years of civilian rule in a country where political leaders celebrate optics rather than substance.
More painful is the fact that Abubakar, as Head of State, commissioned the National Hospital in Abuja in 1999. 27 years later, the man who commissioned it preferred to undergo knee surgery in Gujarat, India. Do not forget that since the commissioning of the hospital, Nigerians have elected five presidents: Olusegun Obasanjo, Umaru Musa Yar’Adua, Goodluck Jonathan, Muhammadu Buhari and Bola Tinubu. They have elected governors in the 36 states, and hundreds of senators, representatives and state legislators. Each of these swore an oath to protect the welfare of citizens. Each campaigned to improve healthcare delivery. Yet, not one of them can point to a public hospital system that he would stake his own life on.
Recall that in April 2001, African heads of state gathered in Abuja, hosted by Nigeria’s own president. On that occasion, they pledged to devote at least 15% of their national budgets to health. Nigeria is yet to honour that pledge. The National Health Act of 2014 promised a Basic Health Care Provision Fund, drawn from at least one per cent of the Consolidated Revenue Fund, so that primary care might finally reach the poorest. Its rollout was delayed for years and remains uneven. A law passed with applause became, like so many others, a ceremony without a result.
The consequences sit in every Nigerian ward. Most health spending in the country comes directly from patients’ own pockets. This means that illness is settled at the bedside in cash. Families sell land and plead with strangers on social media to pay bills for dialysis or cancer care. Primary health centres in many communities are stripped of even syringes and OTC drugs. Women die in childbirth at rates among the highest in the world. Trained doctors and nurses escape to Britain, Canada, and the Gulf because the system that trained them offers no equipment, no decent salary, and no safety. Resident doctors go on strike with a regularity that rivals changing diapers. Every strike is a reminder that the people who heal the nation are begging for the minimum while those who govern it are lounging in hospitals abroad even for an ear infection.
Nigeria has always run two health systems. One is for the citizen, and it includes the general hospital without oxygen, the clinic without power, the queue that outlasts the illness. The unexplained reality is that the 2024 capital budget for six tertiary medical institutions in the country, put together, is less than the budget for the National Assembly clinic. While NASS Clinic got about N15 billion in the 2024 budget, Nigeria’s premier teaching hospitals received a total of N13.8 billion. (University College Hospital, Ibadan N2,668,110,394; Ahmadu Bello University Teaching Hospital N2,460,670,299; University of Nigeria Teaching Hospital, Nsukka N2,804,614,476; University of Benin Teaching Hospital N2,384,604,252; University of Ilorin Teaching Hospital N1,162,681,670; and University of Maiduguri Teaching Hospital N2,370,252,076.) The other health system is for the ruling class, and it begins at the airport.
And 27 years after civilian rule was restored, Nigeria cannot boast of a public health institution that can cater for the needs of its ruling elite. President Yar’Adua spent months being treated in Saudi Arabia while the country was told little, and he died in office in 2010. President Buhari spent months in London in 2017 for ailments that were never disclosed. He governed largely by absence, and died in a London hospital in July 2025. General Abubakar was quoted as saying that he was in that same London facility at the time. Governors, ministers, senators and their families have long followed the same road to London, Dubai, Cairo and India, though the Presidential Villa keeps a clinic which got N1.33 billion in the 2024 budget.
For the political elite, overseas treatment is the only option. But they forget that when a leader who signs the budget has never sat in the waiting room of a public hospital, the broken lift, the empty pharmacy and the unpaid nurse will never be his emergencies. He also forgets that every foreign flight for routine treatment is a vote of no confidence in the hospitals he was elected to fix.
Kudos to India for doing what Nigeria’s leadership refused to do since 1999. It decided that healthcare was worth building, and it now exports that decision to the world, including to Nigeria. The advert simply shows the difference. Some Nigerians have called the video a diplomatic insult. The insult is real, but its author is not the hospital. It is Nigeria’s leaders. It is an insult written in budget speeches read on the floor of the National Assembly and 36 state Assemblies over the past 27 years. The shame is seen in constituency projects that favoured boreholes, solar streetlights and ribbon-cuttings over functioning hospital wards. The bigger shame is in presidential and governors’ convoys that are better maintained than any referral hospital in the country. The fact is that every naira and every dollar spent on the political leaders’ treatment abroad is a resource that the Nigerian health system did not receive, and every specialist trained at home and lost to emigration is a gift to the very countries that now advertise to us. We export our doctors and our patients at once, and there can be no greater shame.
That video is also a call on Nigerians to demand that their leaders meet the 15% commitment they themselves hosted, and release the Basic Health Care Provision Fund fully and on time. They should pay, equip and protect the doctors, nurses and pharmacists who remain. They should rebuild primary health centres first, because that is where the poor access healthcare. And they should accept a simple rule of honour that officials who live on the public treasury should receive their healthcare in Nigerian public hospitals, and any foreign treatment should be disclosed, with its cost.
For the electorate, the game is yours. A candidate who asks for your vote at the polling unit and for a visa at the embassy has already told you what he thinks of your hospitals. Though the video will fade and be forgotten with time, what must not fade is what it revealed. The hospital in Ahmedabad is our mirror, and the face looking back at us is the face of a country whose leaders preferred to be treated elsewhere rather than to build the place where the rest of us must be treated at home.
