Ask the person standing next to you if she or he would prefer to be treated at home or flown abroad for treatment, heavens forbid, in case of serious illness. What answer do you get?

In almost all African countries, if one asks the number one citizen the same question the response is obvious. Take me overseas immediately, the President or Prime Minister says. And do not tell anyone where I am or why I am there.

African leaders do not trust their own medicines. They wont take their own medicines. They do not trust their own healers. It is the only sensible conclusion that one draws from the “going overseas for treatment” syndrome by leaders – political, civil servants, business people. Obviously the political leaders attract most attention and is the subject of this article. Most especially, Presidents in Africa are afraid to be treated at home when they fall seriously ill.

But more than 99 per cent of the citizens are forced to take their own medicines, given by their own healers. They cannot afford to go overseas for medical care. All development reports on Africa rank ill health as one of the top characteristics of the continent. Populations in many countries have high mortality rate, maternal mortality rate, infant mortality rate, TB and HIV infection, compared to other regions. Lately Ebola has turned up the hollow belly of the health facilities and infrastructures of the three heavily burdened countries – Guinea, Liberia and Sierra Leone.

In March 1984, President Ahmed Sekou Toure of Guinea at age 62 passed away after 26 years as President. He was undergoing cardiac treatment in the USA where he had been rushed after being stricken in Saudi Arabia the previous day.

In February 2005, after 38 years in office, President Gnassingbe Eyadema died on board the aircraft that was evacuating him for emergency treatment abroad. Some information said that he was already dead by the time he was put on the plane. At the time of his death he was the longest-serving head of state in Africa.

In August 2008, President Levy Mwanawasa of Zambia died in office. Aged 59, he passed away in France where he was evacuated after he collapsed at a meeting in Egypt. He had been in office for six years.

In the same year in December, Guinea’s President Lansana Conté ,74,  died in Conakry.  He had been receiving treatment overseas, including in Switzerland and Morocco, for many years. He was President for 24 years.

In June 2009 it was Gabon’s President Omar Bongo Ondimba who passed on at age 73 in Spain.  He had ruled for 38 years.

In May 2010 Nigeria’s President Umaru Musa Yar’Adua died at age 58 in Abuja. He had returned from Saudi Arabia two months earlier where he had been receiving treatment. He spent three months overseas receiving treatment on his last trip abroad.

In July 2012, Ghana’s President John Atta Mills died in Accra at age 68. He had been in office for almost three years. Rumours of his ill health circulated for several months before his death, including when he went to the USA for treatment. He and his ministers denied that he was in poor health.

In April 2012, Malawi’s President Bingu wa Mutharikia  died at age 78 in Lusaka. Several reports said that he died in South Africa where he was flown to receive treatment. He was in office for eight years.

In August 2012 Ethiopian leader Meles Zenawi died at 57 in Belgium where had been receiving treatment for some time. The Prime Minister and head of government had ruled the country for 17 years.

In November 2012, Guinea Bissau’s President Bacai Sanha , 64, passed away in a hospital in Paris. He had ruled for only three years.

Most recently in October 2014, President Michael Sata of Zambia died in London. He was 77 years old and had been in office for three years. Whilst opposition leader, he had accused his predecessor President Mwanawasa of hiding his ill health, saying that a medical board should be constituted to determine Mwanawasa’s health status. In a twist of fate, President Sata was taken in hiding to South Africa, India, United Kingdom and Israel for treatment before he died.

Quite a long list. The main characteristics are: overseas treatment; claims of no ill health by the leaders and their administrations even when the poor health is obvious; unexplained long and short trips abroad; denials of death for several days or weeks before official announcement; unclear explanations of cause of death.

Ten African leaders died in office between 2008 and 2012 compared to only three in the rest of the world. Of the 12, two only – Guinea Bissau’s Joao Bernado Vieira and Libya’s Muammar Gaddaffi – died in violent circumstances. The rest died of natural causes.

All of them had received treatment overseas during the course of their illness, and most of them passed away whilst undergoing treatment abroad. Could availability of first class medical facilities at home have helped, or even prolonged their lives?

Despite his failing health, President Nelson Mandela was not flown overseas for treatment. He was treated and provided care until he passed away in South Africa.  It is testimony to the health care facilities that the country provides.

More often than not causes of deaths of African leaders are more street talk and speculations than facts. Official reasons for the illness of Presidents are difficult to accept. In almost all cases, official communication about health of officials are rare or deceptive.

When Presidents travelled overseas even after collapsing at meetings or appearing frail at meetings, their communication officers or spokespersons said that the Presidents were in “robust health”. When Presidents travelled frequently overseas for treatment, their trips were merely for “routine check- ups” or “official reasons”.

African leaders frantically seek to combine traditional medicines that get them into powerful offices with western medicines during their last days. Or so it seems. There are other explanations. African leaders are on average older, and some of them are really elderly when they assume office. The continent has short life expectancy comparatively. Many of the leaders are long-term autocrats, having ruled for many years – weight of the office collapses on them, literally. Even those who have overtly or covertly become Presidents for Life sag under the weight of nature.

Unstable governments have unclear succession system and death of leaders is a make or break time. The cultural milieu in most of the continent does not favour divulging information of ill health, particularly the health of leaders. Official medical treatment abroad also encourages stealing and mis-allocation of funds, ostensibly for purported uses in orchestrated emergencies around death of leaders.

The poor health situation can be fixed. It should be.

As you make your bed so you shall lie on it, says an age-long adage. It was time that African political leaders made a worthwhile health and medical “bed” for themselves to lie on. Then their families, friends, and citizens of their countries will have adequate care facilities at home. It is good for the economy, it will create employment, generate related businesses, show maturity of systems and services, and assure political stability.

Makinwa is a communication for leadership entrepreneur based in South Africa and Nigeria. Twitter: @bunmimakinwa

The article was published on November 12, 2014 by Sahara Reporters