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### Viewing cable 09ABUJA203, NIGERIA: UPDATED HEALTH INFORMATION ON PRESIDENT

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Reference ID | Created | Released | Classification | Origin
--- | --- | --- | --- | ---
09ABUJA203 | 2009-02-04 16:04 | 2011-01-22 21:09 | SECRET//NOFORN | Embassy Abuja
Appears in these articles: www.spiegel.de

`

    VZCZCXRO2938
    OO RUEHPA
    DE RUEHUJA #0203/01 0351633
    ZNY SSSSS ZZH
    O 041633Z FEB 09
    FM AMEMBASSY ABUJA
    TO RUEHC/SECSTATE WASHDC IMMEDIATE 5177
    INFO RUEHZK/ECOWAS COLLECTIVE PRIORITY
    RUEHSA/AMEMBASSY PRETORIA PRIORITY 1640
    RUEHYD/AMEMBASSY YAOUNDE PRIORITY 0614
    RUEHOS/AMCONSUL LAGOS PRIORITY 0750
    RHMFISS/HQ USAFRICOM STUTTGART GE PRIORITY
    RHEBAAA/DEPT OF ENERGY WASHDC PRIORITY
    RHEHNSC/NSC WASHINGTON DC PRIORITY
    RUEAIIA/CIA WASHINGTON DC PRIORITY
    RUEKDIA/DIA WASHDC PRIORITY
    RHMFISS/HQ USEUCOM VAIHINGEN GE PRIORITY
    RUZEJAA/JAC MOLESWORTH RAF MOLESWORTH UK PRIORITY

` `

    S E C R E T SECTION 01 OF 06 ABUJA 000203

    NOFORN
    SIPDIS

    DEPT FOR AF/W, INR/AA
    DOE FOR GEORGE PERSON

    E.O. 12958: DECL: 01/26/2034
    TAGS: PGOV PREL PINR NI
    SUBJECT: NIGERIA: UPDATED HEALTH INFORMATION ON PRESIDENT
    YAR'ADUA (C-AL8-02520)

    REF: A. STATE 6401
    ¶B. 08 ABUJA 2525
    ¶C. 08 ABUJA 2517
    ¶D. 08 ABUJA 2222
    ¶E. 08 ABUJA 2165
    ¶F. 08 ABUJA 2147
    ¶G. 08 ABUJA 2141
    ¶H. 08 ABUJA 2123
    ¶I. 08 ABUJA 2104
    ¶J. 08 ABUJA 2065
    ¶K. 08 ABUJA 1822
    ¶L. 08 ABUJA 1016
    ¶M. 08 ABUJA 962

    Classified By: Ambassador Robin Renee Sanders for reasons 1.4. (b & d).

    ¶1. (S/NF) INTRODUCTION. Ref A requested updated information
    about the health of Nigerian President Umaru Musa Yar'Adua.
    We note that our GON and private contacts continue to state
    that President Yar'Adua is managing his known health issues
    -- chronic kidney problems -- and is not suffering from
    something more serious. The Villa also continues to keep a
    tight hold on any information concerning his health and has
    been cautious about any indications on travel outside of
    Nigeria, to avoid additional concerns. As a result, attempts
    to gain specific and/or verifiable information on his
    condition, prognoses, medication, treatment options are
    limited. The Ambassador's last personal dialogue with him
    (Ref. C), in which she observed him up close, noted that he
    was extremely frail, more soft spoken than usual, his skin
    was extremely drawn, teeth were extremely tarred and his
    involuntary cough had increased. He was, however alert and
    could carry on a sophisticated conversation. We have also
    reported, ref. B, recent extensive critical comments by a
    Villa staff member on the impact of the President's health on
    the country's governance. What is clear is that the
    President's health is a matter of growing concern,
    particularly on the minds of the northern Nigerian elite. We
    have noted a considerable up-tick in what appears to be
    behind-the-scenes machinations and backroom dealing, most
    notably the recent reconciliation meeting between former
    President Obasanjo and former VP Atiku and Atiku's pending
    official return in March to the ruling PDP, former President
    Babangida's sudden return to the political scene with a
    string of public pronouncements, and Kwara Governor Saraki's
    machinations to possibly be a PDP candidate in 2011.

    ¶2. (S/NF) If Yar'Adua were closer to "death's door," we would
    expect more of a political power struggle publicly to break
    out drawing in these traditional "Godfathers" of Nigerian
    politics, as well as newer groupings including Kwara State
    Governor Saraki (and Governors' Forum chairman), some of the
    other Governors (e.g. Niger and Kaduna), and some members of
    the "Katsina clique" who have gathered around Yar'Adua. All
    these groups have a shared interest either in maneuvering VP
    Goodluck Jonathan out of assuming the presidency, or in
    assuring that his power as President was strictly
    circumscribed and that he appointed a strong Northerner as
    his VP. (We note there has been a speculation of a Yar'Adua
    demise in February 2009. Thus, this has not happened and he
    may either not be suffering from a terminal disease or could
    -- as other leaders have done in the past -- hang on longer
    than we anticipate.)

    ¶3. (S/NF) Yar'Adua began a two-week vacation on January 26
    (to date he still remains in Abuja and his vacation is
    scheduled to end on Monday, February 9). However, official
    statements from the Presidential Spokesman indicated that he
    would pass the two weeks in Lagos, Cross River State (at the
    Obudu Cattle Ranch) and at his home state of Katsina. There
    is widespread speculation, however, that the Villa may be
    using the guise of a "vacation" to hide medical treatment.
    On January 27, Kwara State Governor Saraki insisted to
    Ambassador that Yar'Adua will not/not leave Nigeria during
    his vacation; however, we believe that he is most likely
    receiving clandestine medical treatment in Nigeria during
    this period. Ambassador was told by two key contacts, Shell

    Abuja 00000203 002 of 006

    VP for Africa on January 27 and Information Minister Akunyili
    on February 2, that experts from Germany have been brought in
    to oversee the President's treatment. END INTRODUCTION.

    ¶4. (S/NF) Information below on the health of President
    Yar'Adua is keyed to Ref. A questions:

    ¶A. (c) overall health

    A 1. (S/NF) DIAGNOSES: Despite continued statements by the
    Villa spokesperson that the President is not in poor health,
    several individuals xxxxxxxxxxxx and First Lady Turai Yar'Adua) have
    admitted privately to the Ambassador that he suffers from
    acute kidney disease (Refs. C, G, H and others). We continue
    to hear press and blog reports that Yar'Adua suffers from
    lung cancer, although this is generally from sources further
    removed from the Presidency. xxxxxxxxxxxx is the only credible source who confirmed
    that he heard reports of lung cancer. xxxxxxxxxxxx is
    not close to the President and has access to tertiary
    information at best.) On October 27, First Lady Turai
    Yar'Adua told Ambassador that Yar'Adua did not have lung
    cancer, but admitted that he suffered from long-term kidney
    disease and from asthma (Ref. G). On January 27, Kwara State
    Governor Saraki, a medical doctor by training, told
    Ambassador that Yar'Adua is "not at death's door" and that he
    is learning to cope and manage his energy levels better,
    leading to an improvement in his energy and breathing since
    the September 2008 timeframe. xxxxxxxxxxxx a contact xxxxxxxxxxxx at
    the German Julius Berger company said that Yar'Adua is
    steadily weakening and going downhill, noting that although
    he is "not in danger of dying soon," his ailments were
    serious and chronic. Other media outlets, such as the online
    news site "Sahara Reporters" have reported several
    conditions: Churg Strauss Syndrome and/or lung cancer along
    with kidney disease.

    In a follow-up meeting with Information Minister Akunyili on
    February 2, xxxxxxxxxxxx told the Ambassador that Yar'Adua remained
    extremely weak. xxxxxxxxxxxxx noted that when xxxxxxxxxxxx last met with him it
    was at the residence and not the office as he has
    substantially reduced his office hours to conserve his
    energy. xxxxxxxxxxxx said Yar'Adua told xxxxxxxxxxxx that he really
    wanted to go out of Nigeria for "a rest" but given the uproar
    over his September 2008 trip to Saudi, he was compelled to
    stay in Nigeria to avoid more speculation on his health. xxxxxxxxxxxx
    added that Yar'Adua's current strategy is to have meetings
    planned well in advance so he can rest up in order to be able
    to have enough energy to complete the session.

    xxxxxxxxxxxx

    A 2. (C) PAIN: Most of Post's information concerns his lack
    of energy and fatigue; however, information exists in other
    channels regarding pain management.

    A 3. (s/nf) health improved/worsened, changes in appearance:
    We believe that Yar'Adua still remains weak and as physically
    fragile as he was in November-December 2008. Ref. C contains
    Ambassador's observations during her meeting with Yar'Adua on
    the margins of the December 19, 2008 ECOWAS meetings.
    Ambassador noted: he coughed more extensively as he delivered
    his speech on becoming ECOWAS Chair, he appeared to weigh no
    more than 130-140 pounds, his skin was very taunt, his
    handshake was weak, voice was fainter than on previous

    Abuja 00000203 003 of 006

    meetings, his eyes were deep set with dark circles
    underneath, and his teeth were also very badly tarred. Over
    the past several weeks, Yar'Adua has made few public
    appearances. Despite this, he was able to carry on a
    sophisticated conversation. His most recent appearance was
    at his daughter's marriage on January 25, 2008, to Bauchi
    State Governor Yuguda. Although we believe these appearances
    were meant to calm public anxiety, they actually tended to
    renew suspicions about his health. Based on pictures and TV
    coverage of these events he appears pale and weak. He
    continues to lose weight and he coughs and appears at times
    to have difficulty breathing when he talks. U.K. diplomats
    told us January 28 that they have seen reports that Yar'Adua
    wears make-up for public appearances and padding to hide his
    weight loss.

    A 4. (S/NF) RESTRICTIONS TO ACTIVITY/SCHEDULE: Yar'Adua's
    schedule, since assuming office in May 2007, has never
    included long days or late night appointments (Ref. M);
    however, it has clearly been severely restricted since late
    Summer and appears to be more so since late December 2008.
    President Yar'Adua has made few international trips since
    assuming office, including missing the September 2008 UN
    General Assembly meetings. xxxxxxxxxxxx
    contact of the Mission shared his risk-analysis paper with us
    in late 2008 (Ref. B, q.v.), in which he complained that
    Yar'Adua's restricted office hours are "taking a heavy toll
    on governance." He also noted then that the President "works
    for limited hours, often can't keep scheduled appointments,
    and cannot undertake rigorous national tours." On xxxxxxxxxxxx told PolCouns that Yar'Adua's
    health has improved "a bit" since last fall; however, there
    has been no positive impact on his ability to meet the
    demands of the presidency. (This comment dove tails with
    Saraki's, who also indicated that Yar'Adua has had a slight
    improvement.)

    A 5. (s/nf) yar'adua aware of his diagnoses/prognoses:
    Although the spokesman for the Villa continues to maintain
    that Yar'Adua has no serious health problems that hinder his
    ability to carry out his executive functions, the President's
    wife admitted his serious kidney ailment to the Ambassador.
    We do believe that those around him may be jeopardizing his
    well-being for their own political gain. We note that, in
    conversations with other foreign diplomats, the First Lady
    has indicated she is looking forward to Yar'Adua running for
    a second term in 2011.

    A 6. (C) NAMES AND SPECIALTIES OF PHYSICIANS: Adamu Banye
    Barau serves as Chief Physician to the President. Barau
    applied for a U.S. visa in April 2008. xxxxxxxxxxxx Barau planned to travel to the U.S. to
    purchase medical equipment. In addition, we know Hussaini
    Yakasai Munir serves as a Villa medical officer. (NOTE:
    Munir applied for a visa in mid-January to attend medical
    training in North Carolina from February 2-14. Specifically,
    he will attend Advanced Cardiac Life Support, Cardiac Stress
    Testing, Overview of Cardiac Catheterization, Non-Invasive
    Management of Myocardial Infarction, and Advances of
    Echocardiography at Ladan Medical Center, North Carolina
    under Dr. Mohammad Lawal Garba.) We also know from several
    sources that German specialists do come in and out of Nigeria
    as they are, xxxxxxxxxxxx, transported by the
    German Julius Berger company.

    A 7-8. (c) who provides yar'adua with reports on health and
    IS HE FOLLOWING DOCTOR'S ADVICE: We have no specific
    information, but we believe that his wife and other members
    of the "Katsina clique," such as Agriculture Minister Ruma,
    and possibly Kwara Governor Saraki (who is a medical doctor),
    are managing Yar'Adua's health strictly for political
    reasons, which seems to overshadow any advice he may be
    receiving from medical experts.

    ¶B. Procedures and treatments

    B 1. (C) MEDICATIONS AND CHANGES IN MEDICATION: Information

    Abuja 00000203 004 of 006

    exists in other channels that provides suggestions on what
    Yar'Adua may be taking.

    B 2. (s/nf) medical procedures/surgeries in the past year:
    Yar'Adua had a range of medical tests in Saudi Arabia in late
    August 2008, about which there is reporting in other
    channels. According to Leadership newspaper, between August
    20 and August 31, 2008 he was at the King Abdulaziz Hospital
    in Jeddah. We understand that, in 2001 or 2002, while he was
    Governor of Katsina State, Yar'Adua had a kidney transplant.
    The Ambassador was told on November 1, 2008 that Minister of
    Agriculture Ruma was the donor for Yar'Adua's transplant, but
    that the kidney now appeared to be failing. The individuals
    (lunch attendees at a Central Bank luncheon) maintained that
    Ruma's brother had traveled to Germany to determine if he was
    a potential match for a second transplant (Ref. E).

    B 3. (C) ADVISED TO SEEK TREATMENT IN LAST MONTH: We
    understand that travel to Germany was being heavily
    considered by the Villa in December 2008, but given that it
    sparked renewed public concern about Yar'Adua's ability to
    govern, the President remained in Nigeria. This has been
    confirmed by xxxxxxxxxxxx

    B 4. (S/NF) CANCELED OR POSTPONED ANY PLANNED TREATMENT:xxxxxxxxxxxx told Ambassador on
    December 22 that First Lady Turai Yar'Adua confided xxxxxxxxxxxx
    that Yar'Adua would travel to Germany for a second renal
    transplant between December 16 and January 1 (Ref. C).
    Yar'Adua did not take this planned trip given public reaction
    to rumors about travel and concerns about his ability to
    govern. We have no information on whether this trip may be
    rescheduled.

    ¶C. Medical equipment

    C 1. (C) EQUIPMENT ACCESSIBLE IN ABUJA: We understand that
    the Villa maintains a dialysis machine for the President's
    use in Abuja and from a credible source at Shell Oil Company
    that some additional medical equipment for the President
    arrived in December-January 2009. xxxxxxxxxxxx
     was more specific in a xxxxxxxxxxxx meeting with
    Ambassador, saying that Yar'Adua is on dialysis three times a
    week in the afternoons.

    C 2. (s/nf) access to equipment to treat lung cancer: u.s.
    medical personnel operating in Nigeria believe it may be
    possible to bring chemotherapy drugs into Nigeria to receive
    chemotherapy; however, the only hospital which may/may have
    radiation equipment is Lagos Teaching Hospital. In all,
    however, the American physician with whom we spoke on January
    29 noted that both chemo and radiation therapy require a
    large cadre of trained specialists (from oncologists, to
    nurses and equipment technicians). However, Nigeria has
    little to no specialists in these areas. Due to the lack of
    local specialists, our medical source believed it would not
    be possible to receive reasonably adequate treatment in
    Nigeria.

    C 3. (s/nf) access to equipment for surgery related to renal
    FAILURE OR LUNG CANCER: St. Nicholas Hospital in Lagos
    recently began performing minimally invasive transplants
    (including both removal -- important as all donors in Nigeria
    are "living donors" -- and transplantation) using equipment
    from South Africa.

    C 4. (S/NF) NEW MEDICAL EQUIPMENT BROUGHT TO ABUJA: Press
    reports have circulated periodically that new equipment was
    being purchased (dialysis machines mainly) and online news
    site Sahara Reporters reported on January 22 that a contract
    had been awarded previously to one of Yar'Adua's brothers to
    build a 10 billion Naira ($64 million) "State House Clinic"
    at the Villa (advertised in the SUN newspaper on July 5,
    2008). Sahara Reporters maintained that the clinic was never
    completed, but that dialysis equipment and equipment for a
    complete Intensive Care Unit (ICU) was purchased. As noted
    in A6 above, Chief Physician to the President Amadu Barau is

    Abuja 00000203 005 of 006

    believed to have traveled to the U.S. in May 2008 to purchase
    medical equipment. The specific type of equipment is unknown.

    C 5. (s/nf) surgical equipment and specialists in nigeria to
    PERFORM KIDNEY TRANSPLANTS: The St. Nicholas Hospital in
    Lagos has a full transplant team. St. Nicholas has been
    performing renal transplants for approximately ten years,
    performing more than 80 of the 100 or so transplants that
    have been done in Nigeria. To date, there remains no
    capacity in Nigeria to do HLA (human leukocyte antigen)
    tissue matching, although samples can be taken in Nigeria and
    sent abroad for testing.

    ¶D. Mental health

    D 1. (s/nf) does yar'adua seem sad, detached, distracted,
    IRRITABLE OR CONFUSED: xxxxxxxxxxxx both reported to
    Ambassador in December that the President was exhausted, but
    still very intellectually competent, and that the political
    haggling and pressure of putting together a new cabinet drove
    him to push for a vacation outside of Nigeria. The political
    pressures of the cabinet reshuffle reportedly took a further
    toll on his physical wellness. At Ambassador's last meeting
    with him, he did not seem sad, detached, irritable or
    confused.

    D 2. (s/nf) does yar'adua conduct meetings/ is he alert and
    FOCUSED: Yar'Adua has delivered remarks recently at the
    January 12 Armed Forces Remembrance Day and the January 16
    presentation of the 2006 Census to the National Assembly, as
    well as attended the highly visible wedding of his daughter
    to Bauchi Governor Yuguda on January 24. In these public
    appearances, he appeared physically fragile. Ambassador
    noted in her December 19 discussions with Yar'Adua and
    observations of him at ECOWAS that he "remained focused and
    still showed intelligence, understanding and awareness in his
    dialogue." Others, from the Foreign, Petroleum and
    Information Ministers to the Central Bank Governor, have
    confirmed the same.

    D 3. (s/nf) does yar'adua use prepared notes/ do aides prompt
    HIM OR ANSWER FOR HIM: Yar'Adua spoke at the January 12
    Remembrance Day events in Abuja without notes. In his
    December 19 interactions with Ambassador, he spoke without
    notes and without prompting from aides. We believe that he
    is still intellectually fit, even if we don't agree with his
    style of governance. However, his physical weakness adds to
    the inability of his administration to do more on top of his
    slow leadership style. We judge that even if his health were
    not an issue, his governance and leadership style would
    likely remain slow and largely ineffective as a result of his
    personality, his lack of a political network of his own, and
    the fact that he chooses not to dictate decisions to his
    Ministers, even when necessary and/or expected. Although he
    may not be up for days beforehand, he still chairs his weekly
    Cabinet meetings, which we still understand can run 3-4
    hours.

    ¶E. Spread of health information

    E 1. (s/nf) why are yar'adua/family/advisors reluctant to
    DISCLOSE HEALTH INFORMATION: While we have heard the
    argument that Yar'Adua's quiet personality and his northern
    Nigerian culture are the reasons for his unwillingness to
    discuss health information, we believe that those close to
    him are motivated more by a desire to retain power. His wife
    and several special advisors, such as Economic Advisor Tanimu
    Yakubu, we would put high on this list as they only have
    influence so long as he is President.

    E 2.xxxxxxxxxxxx

    Abuja 00000203 006 of 006

    stage is missed. (This is a point the Mission raises
    regularly with GON interlocutors.)

    E 3. (c) reasons or motivations for those close to yar'adua
    TO LIE ABOUT HIS HEALTH: We would characterize the behavior
    of those close to Yar'Adua more as avoidance, secrecy and
    disregard for what is ultimately medically best for the
    Nigerian President. We would add that the closed-mouth
    nature of both Yar'Adua and his wife, plus the influence of
    their religion are also factors. In Yar'Adua's May 15, 2008
    interview with the Financial Times, he admitted he is "a
    normal human being, who can fall sick," hinting at his
    medical condition. His wife admitted his kidney and asthma
    ailments to the Ambassador on October 27, 2008 without
    hesitation. So, his handlers do not directly lie, but just
    go to great lengths to avoid talking about it.

    #. (U) This cable was coordinated with Consulate Lagos.
    SANDERS

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