Hundreds of doctors are on strike in Zimbabwe this week, demanding an increase in their pitiful salaries of $282 (U.S.) per month. It's just the latest blow to the country's crumbling health sector, plagued by chronic shortages of medicine and hospital staff, and heavily dependent on funding from foreign donors.
But don't expect Robert Mugabe to pay much attention to the strike. The 90-year-old autocrat, who has ruled the country for more than three decades, rarely bothers to get his medical care in Zimbabwe. Instead he flies to Singapore to receive his care at an exclusive private hospital that reportedly charges $4,000 to $8,000 per visit.
Mr. Mugabe has been getting his medical treatments in Singapore since 2011, usually several times a year. The government pays the cost. Officially he is treated for cataracts, but most reports say he is getting much more serious treatment in Singapore, perhaps for cancer.
Flying abroad for medical care is a popular fashion for many African leaders. Instead of subjecting themselves to the health systems of their own countries, they routinely go overseas to expensive foreign hospitals. It leaves them indifferent to the poor conditions of their own health systems, and it contributes to the neglect and disrepair of African public health care.
This is not only an injustice to ordinary Africans, who cannot afford to fly abroad for health care. It's also a threat to global health, as the Ebola epidemic has shown. Without strong health care in Africa's poorest countries, diseases such as Ebola can rage out of control and cross borders to endanger the world.
But the African elite still prefer to fly abroad for treatment. Last week, Zambian President Michael Sata died in a London hospital, where he had quietly travelled to seek treatment. Earlier this year, Mr. Sata had flown to Israel for medical treatment.
Of the 11 African leaders who have died in office since 2008, almost all have died in an overseas hospital, or shortly after returning from foreign medical treatment. In many cases, the treatment was done in secrecy. Their officials denied the overseas hospital visits, preferring to protect the leader's pride and power by keeping the truth hidden from their own people.
Among the African leaders who flew abroad for medical treatment were Ethiopian Prime Minister Meles Zenawi, who died in a hospital in Belgium in 2012; Nigerian President Umara Yar'Adua, who received months of heart treatment in Saudi Arabia shortly before returning home to die in 2010; Gabonese dictator Omar Bongo, who flew to Barcelona for medical treatment and died in a hospital there in 2009 after 41 years in power; Ghanaian President John Atta Mills, who received medical treatment in the United States shortly before dying in Ghana in 2012; Zambian President Levy Mwanawasa, who died in a military hospital near Paris in 2008 after two months of treatment; Chadian Prime Minister Pascal Yoadimnadji, who died in a Paris hospital in 2007 after a heart attack; Togolese President Gnassingbé Eydéma, who died in Tunisia in 2005 while on his way abroad for medical treatment after 38 years in power; and many others.
In one of the most extreme examples, Malawian President Bingu wa Mutharika died of a massive heart attack in 2012 in the Malawian capital – and yet his supporters kept his death secret and flew his body by air ambulance to South Africa, claiming that he was getting medical treatment abroad, while they schemed to keep power.
While the preference for foreign medical treatment has continued for decades without much opposition, Africans today are increasingly questioning this tradition. The death of Mr. Sata in a London hospital last week provoked a flurry of negative reaction in the African media from commentators who criticized the trend.
"By choosing treatment abroad, they are communicating that they have no confidence in the services that they themselves provide," wrote Redi Tlhabi, a prominent South African radio host and columnist.
"The absence of a hospital worthy of a president in their countries is a sad and tragic indictment of their leadership," she said. "The irony is jaw-dropping. They stand on podiums and preach 'African solutions for African problems' and lambaste the West … yet they are so in awe of the comforts that the West has to offer."
The Observer, a newspaper in Uganda, added: "It's a shame that a leader can be in charge of a country for 20 years and still fail to create conditions that would enable him or her to get medical attention at home. Perhaps it's because their own health is never really at stake as they have taxpayers' money at their disposal in case they need even the simplest treatment abroad, while their poor citizens are left to their own devices."