Over the last fifteen to twenty years, Nigeria has built a roster of impressive hospitals, general and specialist alike. More join the ranks every day. Cardiology, oncology, and other high-acuity services are no longer out of reach. Some facilities even report patients flying back from the UK, the US, and elsewhere, which says something about the caliber of care now available at home. In quiet conversations, clinicians and patients admit what many suspect: a number of local providers now match and sometimes exceed the “ordinary” standard abroad.
And yet the pilgrimage, especially among public officials, continues. The ensuing conversation, also continues: “my doctors in London,” “my annuals in the States.” At some point it dawned on me that this cannot be only about clinical quality or reliability; or, even purely, about treatment. No! They are theatre signals of power and position. Consider for example the fact that the budgets run for official residencies, and even some private residences, including provision for sophisticated power supply back-ups and accompanying trappings, are in the billions. These are funds that could just as easily underwrite world-class medical complexes staffed by the best minds.
At this point, I recalled a family friend, many years ago, half-joking about his life goals, namely: to marry, to raise children, to see them educated, married, and settled and, ultimately, “to die in a London hospital after a brief illness.” It sounded flippant then. In reality it expressed, especially in that last line, a cultural aspiration. Many in the moneyed class (and, alas, as many who are not) lean into the announcement effect: the press release of going abroad for medical treatment. It is not about healthcare; it is a status narrative.
The same script is played at funerals and tributes to the departed: “survived by a US-based doctor,” “a London-based engineer.” The implication is clear: global is not merely better; it is proof of arrival. It goes beyond the supply-side; it underlies prestige. For the political class, it doubles as entitlement an effortless way to mark distance from the “masses.”
The motif is rapidly spilling into education. Why the reflex to import foreign curricula wholesale, precisely when other nations are fighting to revive, preserve and advance their own languages and intellectual heritage? It must be because these foreign curriculum institutions confer more than knowledge; they confer cachet. They elevate the standing of these families and their children. Enrollment of children in those institutions signals the wealth, prestige, and high social status of the parents, the children, and the family. They are not just buying content; they are buying reputation and endorsement.
To be clear, there are legitimate cases for overseas medical care and study. Complex procedures, rare therapies, or specialist training sometimes require it. However, we should be bold to name the rest for what it is: optics management. And until we disentangle genuine need from status choreography, we will continue exporting the money, attention, and confidence that our own systems urgently need. This is an unaffordable price to pay, simply to reinforce entitlement or offer a taste of distinction, for the aspiring middle class. And it is quietly draining both resources and confidence from systems that desperately need them.
We must be honest with ourselves: in many cases, the postcode has become the prescription. Until we confront that, we will keep exporting billions not just in foreign exchange, but in trust. The real prestige should lie in outcomes, not in airline codes. The real signal of status should be excellence at home, not entitlement abroad. And the real leadership test is whether we can build institutions so strong that choosing local is as aspirational as it is convenient; and prestige becomes the by-product of excellence not the business case for it.
It is time to rethink the script. The critical question is:
“Are these medical trips really about healthcare, and is the choice of foreign curriculum about quality, or are they about headlines? Billions have been spent abroad on medical pilgrimages. Meanwhile, some of our hospitals are good enough that patients return from the UK and US for treatment. So why does the exodus continue? Is the challenge really infrastructure or is it mindset?”
mediatoryemi 