African elites who once flew abroad now face local health systems

The coronavirus pandemic could reduce a yawning inequality in Africa, where some heads of state and other elites are flying to Europe or Asia for health care unavailable in their countries. Since countries, including their own, impose dramatic travel restrictions, they may have to try their luck at home.

For years, Benin’s leaders in Zimbabwe have received medical care abroad while their own poorly funded health systems are limping from crisis to crisis. Several presidents, including those of Nigeria, Malawi and Zambia, have died abroad.

The practice is so well known that a South African health minister, Aaron Motsoaledi, berated a few years ago, “We are the only continent to have its leaders seeking medical services outside the continent, outside of our territory. We must be ashamed. “

Now, a wave of global travel restrictions threatens to block this option for a group of aging African leaders. More than 30 of Africa’s 57 international airports have closed or severely restricted flights, according to the US Department of State. Sometimes the flight trackers showed that the continent’s sky was almost empty.

“COVID-19 may be an opportunity for our leaders to reconsider their priorities,” said Livingstone Sewanyana of the Foundation for Human Rights Initiative, which has long urged African countries to increase health spending.

But the call did not lead to action, even as the continent is grappling with major crises, including deadly epidemics of Ebola and the scourges of malaria and HIV.

Health spending is half the world average

Health spending in Africa accounts for about 5% of gross domestic product, about half the world average. And this despite the commitment of the members of the African Union in 2001 to spend much more. Money is sometimes diverted to security or simply stolen, and shortages are common.

Ethiopia had only three hospital beds per 10,000 people in 2015, according to data from the World Health Organization, compared to two dozen or more in the United States and Europe. The Central African Republic has only three fans across the country. Doctors in Zimbabwe reported performing bare-handed surgeries due to the lack of gloves.

Health experts warn that many countries will be overwhelmed if the coronavirus spreads, and that it is already uncomfortably close. Several Burkinabe ministers have been infected, as has a senior official in the Nigerian president. An assistant to the Congolese leader has died.

For most people, the new coronavirus causes mild or moderate symptoms. For some, especially the elderly and people with health problems, it can cause more serious illness and death.

“If your test is positive in a country, you should seek medical care in that country,” the head of the African Centers for Disease Control and Prevention, Dr. John Nkengasong, told reporters on Thursday. “It is not a death sentence.”

In Nigeria, some feared that their president would be among the victims. Long worried about President Muhammadu Buhari’s absences from the public, including weeks in London to treat unspecified health problems, they turned to Twitter to ask why he hadn’t addressed the nation when virus cases were increasing.

Buhari’s office dismissed speculation about his fate as an unfounded rumor. When he left on Sunday evening, he announced that all private jet flights had been suspended. International airports were already closed.

While travel restrictions have anchored the wealthy, political analyst Alex Rusero said that a determined African leader could probably still find a way to go abroad for care.

“They are so scared of death that they will do whatever is available to them, even if it is a private jet to a private hospital in a foreign country,” said Rusero, based in Zimbabwe, whose late President Robert Mugabe has often sought Asia.

Nowhere is the situation worse than in Zimbabwe, where the health system collapsed. Even before the pandemic, families of patients were often asked to provide essential items such as gloves and clean water. Last year, doctors reported using bread bags to collect patients’ urine.

Zimbabwe’s vice president Constantino Chiwenga left for independent medical treatment in China last month as the epidemic eased in that country. Zimbabwe closed its borders a few days later after the death of its first virus.

Chiwenga has since returned – to lead the country’s coronavirus task force.

Some in the new generations

But some members of a new generation of African leaders have been keen to show sensitivity to virus prevention measures.

The President of Botswana, Mokgweetsi Masisi, initially challenged his country’s restrictions on the travel of government employees to visit neighboring Namibia for the inauguration of its leader. But he went into quarantine and now reminds the others to stay home, calling it “literally a matter of life and death”.

South African President Cyril Ramaphosa announced that he had tested negative just before a three-week lockout in the most developed country in Africa. Madagascan President Andry Rajoelina too.

Other leaders, including President of Burkina Faso Roch Marc Christian Kabore and Ethiopian Prime Minister Abiy Ahmed, tweeted images of themselves working by videoconference as countries encouraged people to keep their distance.

While African leaders are more attached to their homes than ever, their access to medical care is still much better than that of most of their citizens.

In the capital of Burkina Faso, Ouagadougou, medical student Franck Bienvenu Zida became self-isolated and worried after being in contact with a person who tested positive.

The 26-year-old feared to infect people where he lives, but his efforts to get tested were unsuccessful. Three days after calling an emergency number to request a test, he was unable to pass.