Closing The Care Gap In The Nigerian Cancer Space – Where Cancer Treatment Can Be Accessed – By Dr. Popoola Margaret Owoloyi MBBS, MPH.

 

“To achieve this in Nigeria, we need to know the facilities in Nigeria and the level of care each facility is capable of offering”

PEGASUS REPORTERS, LAGOS | FEBRUARY 25, 2022

Abeje, once strong, bold, beautiful and the pride of her husband and children is now a miserable shadow of herself. She’s been ill for some years. At the onset, she self-medicated without a clear diagnosis for what ailed her. Getting no respite from self-medication and faced with worsening health, she made a half-hearted attempt at getting help from the nearest government hospital close to her home. It was there 5years ago she was first diagnosed with cancer of the cervix.

Typical of most people, she rejected the diagnosis and went in search of traditional herbal medications instead. For the period she stayed in denial, the disease festered and spread to other parts of her body thereby forcing her to reappraise her situation and accept the diagnosis.

Returning to the hospital where her condition was first diagnosed, she indicated her interest in receiving treatment for her condition, however, she was told she had to be referred to a higher level of care since her disease was now more advanced than when she first presented to the hospital and it was at that point that a new kind of trauma started in Abeje’s life.

She was first referred to another hospital in the same town where she lived, from where she was referred to another in a different town, then to a different state and finally to another region of the country for the seemingly elusive cancer treatment.

She eventually got treatment after a long waiting list however, she learnt a few things during the course of her ordeal.

First, she realised she contributed significantly to the advanced nature of her disease by refusing to present early to the hospital and by rejecting her diagnosis and the treatment plan that would have been beneficial to her at that early stage.

Secondly, she realised with benefit of hindsight, she suffered before getting to the facility that treated her eventually because there was no standard Patient Navigation Protocol that would have guided the physicians that first saw her refer her appropriately.

Thirdly, she realised that, though there are facilities in Nigeria offering varying degrees of Cancer Care, most of them were not well documented and as such were not known to the average Nigerian.

Thoroughly exhausted, and almost impoverished from chasing after cancer treatment in Nigeria, Abeje’s desire is to CLOSE THE CARE GAP IN THE NIGERIAN CANCER SPACE by making patient Navigation easy.

WHAT IS PATIENT NAVIGATION?
Patient Navigation in this context is the process of getting a patient seamlessly through initial consultation, diagnosis, treatment and rehabilitation without unnecessary detours or long waiting times that hamper treatment. Patient navigation are usually easier in places where there are established treatment protocols to follow once a diagnosis is made.
It also becomes even easier when the facilities that offer Cancer Care are known and the exact kind of treatment they are able to offer are also known and documented. That way the primary care physicians, the surgeons, the oncologists and the various health facilities are able to act promptly and synergistically in a way that will benefit the patient.

To achieve this in Nigeria, we need to know the facilities in Nigeria and the level of care each facility is capable of offering.

WHERE TO ACCESS CANCER CARE IN NIGERIA

SCREENING:
Presently, screening is not standardised as many facilities are into screening for various cancers particularly Non-Governmental Organisations (NGOs). However, all teaching hospitals, all FMC’s should be able to do that. There should be a protocol guiding screenings such that appropriate data are collected during the screening plus good documentation. Lakeshore Cancer Centre in Lagos, a private hospital is also big on cancer screening.

DIAGNOSIS
The first step will be a diagnosis backed by histology. Most Federal Medical Centres and all the teaching hospitals have the capacity to make a histological diagnosis.

INVESTIGATIONS
Most basic investigations can be carried out by most government hospitals, however, most specialised tests are best accessed at the level of the teaching hospitals. Radiologically, apart from the teaching hospitals, some ancillary centers also do a great job in the provision of tests like the Computerised Tomography (CT) Scans, Magnetic Resonance Imaging (MRI) etc like the Military hospitals, Air Force hospitals, etc.  Some private centres also do well in this regard eg Asi Ukpo Diagnostics and Medical Centre, Calabar, Cross River State, Echo Scan and most recently, MeCure just acquired a Pet Scan for use in its Oncology centre in Lagos.  Other specialised tests may be available at the National hospital, Abuja.

TREATMENT.
The federal government has tried to designate centres of excellence in cancer treatment in the six geopolitical regions (see my previous article; A brief Introduction to Cancer, for their names) however, it is not all the time that they will have the capacity to offer the full complement of cancer treatment.
Sometimes, machine breakdown and other faults might make treatment unavoidably absent at some of these centres.

Presently, as at the time of press, the following treatment components can be accessed at the under-listed facilities.

Chemotherapy:
All hospitals where there are oncologists, either as substantial physicians or as visiting physicians, can administer prescribed chemotherapy.
Most teaching hospitals and Federal Medical Centres have Chemo rooms for chemotherapy administration.
FMC Jabi, Abuja recently commissioned theirs.

Radiotherapy:
1. Lagos University Teaching Hospital (LUTH)
2. National Hospital, ABUJA
3. MARCELLE-RUTH(LAGOS)
4. University of Benin Teaching Hospital (UBTH) BENIN
5. University of Nigeria Teaching Hospital (UNTH).

Brachytherapy
1. Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State.
2. Federal Teaching Hospital ( FTH), Gombe, 3. National Hospital, Abuja.
4. University of Benin Teaching Hospital (UBTH), Benin.
5. University College Hospital (UCH), Ibadan.

Centres to watch out for to be added to this category in the nearest future would be FMC, Jabi, Abuja because of its antecedent of improving the facilities in the centre across the board in all the specialities.

Teletherapy
Eko hospital, Lagos.

Others.
A number of private hospitals have distinguished themselves in the cancer space and they are:
1. St. Nicholas Hospital, Lagos.
2. Eko Hospital, Lagos
3. Lagoon Hospital, Lagos.
4. First Consultant Medical Centre, Lagos
5. Primus Super Specialty Hospital, Karu, Abuja.

Special Mention.
Worthy of special mention would be the new centre borne from Public-Private Partnership effort between the Nigerian Sovereign Investment Authority and Lagos University Teaching Hospital, known as NSIA – LUTH Cancer Center located in LUTH, Lagos.
This centre boasts of the full complement of cancer treatment beginning from screening, chemotherapy, brachytherapy and radiotherapy.

Cancer Treatment Support.
A number of non-profits provide cancer treatment support ranging from enlightenment campaigns, screening, patient navigation, to cancer treatment funding and drug & research.
Some of the Non – Governmental Organisations operating in this space effectively, to mention but a few are:

1. Medicaid Cancer Foundation

2. Project Pink Blue

3. Centre for Health Education and Life Promotion (C-HELP)

4. Pink Oak etc.

Conclusion:
Good synergy amongst the specialists, the facilities, with a good patient navigation protocol will go a long way in closing the care gap and providing better care for the average cancer patient in Nigeria.
#TogetherWeCanHealTheWorld.

Dr. Popoola Margaret Owoloyi MBBS, MPH also known as Dr Meg, is an Orthopedic Surgeon in training at the Ahmadu Bello University Teaching Hospital, Zaria. She’s a Reverse Medical Tourism advocate and a champion of the call for a better health system for Nigeria and Nigerians. She is the ED, C-HELP Nigeria, Coordinator, Irawo Book club and the Chief Navigator at WOW Consult, a Patient Navigation outfit that seeks to connect patients to the appropriate health facility for their medical condition locally, thereby encouraging Reversal of Medical Tourism. She is the author of the financial bestseller NAIRA BOSS and the amazing medical text, EVERY PREGNANT WOMAN ( with Hausa translation) amongst others.

Dr. Popoola Margaret is the Convener of the C-HELP’s HEALTH SUMMIT and ANNUAL CANCER AWARENESS ROAD WALK. She is also the Convener of the HEROES of HEALTH AWARDS. JMBSR – a medical and basic science journal, is also floated by her organisation, C-HELP. For more information, questions about cancer or other health concerns, you may reach the author Dr. Popoola Margaret Owoloyi via Email: chelpngo@gmail.com or 08067698538 (WhatsApp Only)

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