Take a look at the table below. It’s a simple five-cell affair with the names of twenty-five recently deceased Nigerians drawn randomly from various walks of life, including ages at time of passing, countries where each death took place, the causes of death (where available), and the year of transition.

The names are presented in a simple alphabetical order, with no distinction between those who lived or had a home abroad, and those who traveled expressly to secure medical care. However, as far as I can tell, only two, possibly three, of the 25 people on my list belonged in the former category.

What is at issue for me – and something I propose to think with in this brief piece – is the information in the third cell: where the deceased were at the time of death. The most interesting observation is that none of the 25 individuals listed here died in Nigeria or in a Nigerian hospital. Eleven died in the United States; 10 in the United Kingdom; 2 in India, and 1 each in Spain and South Africa. What is the import of this pattern, and what does it tell us about life as it is lived in contemporary Nigeria?

What, precisely, is the sociological narrative here, and what are the socio-economic, cultural and political forces driving the trend?

Let’s start with the most obvious take-away, which is that the two countries at the top of the list- the United States and the United Kingdom respectively- are also the same two countries that many young Nigerians are, literally, dying to enter in order to remake their lives.

As Yemisi Ogbe notes in a recent essay, “Birthing the American,” about a related phenomenon, for majority of the younger generation, “American was the most desirable thing to be, British was second best, and Nigerian completely unpalatable.” This is the underlying explanation for the craze among the Nigerian family of means for dispatching their pregnant women to clinics and hospitals in those favored countries at the first signs of labor. Made in Nigeria. Hatched in Arkansas. Those who cannot afford the cost of travel and associated logistics to their preferred choices ‘make do’ with South Africa (whose presence in the table is more than symbolic) and, increasingly, India.

The result of this unfettered appetite for all things ‘Abroad’ by the rump of the Nigerian middle class is an active apathy towards, and continued social disinvestment in public health in particular, and public welfare in general.

The totally predictable outcome of this- hospitals that, to varying degrees, lack the capacity to diagnose simple ailments, regularly misdiagnose, lack qualified medical personnel, and are poorly funded and riddled by corruption – is the fundamental reason why, and as attested to by the table – it has become rare for any Nigerian of some means to either seek medical attention in, or die in Nigeria, let alone a Nigerian hospital.

Unless of course such people happened to be involved in a fatal air or road crash or fell to the bullets of hired assassins. This fact is even more astonishing when we realize that the list does not include the hundreds of individuals who, in quiet desperation, seek medical help outside the country, only to be sent back home to die; either because they could not afford the cost of continuous treatment in foreign hospitals, or because their diagnoses came too late in the day to make any impact on their ailments.

Nor does it include the members of what I call the Sunset Class (mainly retirees and others) who greatly desire to return to the country, but are forced to stay because separation from some vital prescription or recurrent treatment is certain death. If you are a Nigerian reading this, you are bound to recall someone from your immediate social proximity- a relative, an uncle, a sibling, a parent- who belongs to either category.

An additional observation here is the prevalence of various forms of cancer (11 out of the 25 cases here) as the proximate cause of death. This brings up some critical questions: do our hospitals have the necessary equipment for early detection of cancer? Do they have the capacity to treat it? How many of the 11 cancer-related deaths here could have been avoided if our hospitals had the necessary capacity? I admit cancer may not be the best example.

After all, nearly half of total American deaths are caused by cancer, and many do not approach the ages of some of the people on my list. Yet, although cancer is still, relatively speaking, a medical black box, the prognosis for cancer patients is much better in the West. By contrast, thousands of Nigerians die of completely curable conditions, most dying too young to ever achieve the kind of fame or notoriety to which all the individuals on my list had a decent claim.

In all of this, one thing at least is clear: what we are witnessing is the tragic manifestation of decades of neglect of our health sector; and given that there is as yet scanty evidence that those currently in the saddle recognize the severity of the crisis, the reality is that things will only get worse in the foreseeable future.

 Professor Obadare teaches sociology at the University of Kansas, in the United States.