By Dozie Akwarandu
In many Nigerian communities, there is limited awareness of the menace of cancer, with no available health services and access to specialized diagnostic facilities, medical technology, cancer medications, and, mostly, scarce human resources for health.
Cancer has emerged as a leading cause of death in Nigeria, with an estimated 127,763 new cases and approximately 80,000 related deaths in 2022 (GLOBOCAN). This presents a significant challenge to our healthcare system and an often-inadequate response from the medical infrastructure.
With a population of approximately 216 million, most states lack screening modalities or facilities. Nigeria has only about eight radiotherapy centers, with no more than three functioning optimally. There are also no structured oncology centers.
The challenges here are multifaceted, including inadequate equipment maintenance and replacement, prolonged waiting times, and delays due to a limited number of healthcare workers and professionals.
Moreso, Nigeria lacks health care specialists at the primary and secondary levels with basic knowledge of cancer. Hence, there are always delays in the diagnosis and referral stages.
Unfortunately, there appears to be little to address these challenges. Hospitals are on strike most of the time over welfare, infrastructure, and personnel security concerns, among other factors, leaving patients stranded despite largely paying out of pocket.
As a patient advocate, I have witnessed firsthand the struggles faced by individuals and families grappling with cancer. These challenges go beyond the physical toll of the disease; they encompass emotional, financial, spiritual, and social burdens that significantly impact quality of life.
For instance, the average person living with cancer spends over a million naira every month on drugs, with the attendant economic challenges in the country. Consider a household of four persons with a total income of N150,000 per month and two children in school. They would face considerable challenges of affordability and quality assurance. Life gets harder.
Again, most of the hospitals do not have these drugs in their pharmacy stores, thereby worsening access to oncology drugs by patients, leading to accessing fake and substandard drugs.
That is why the likes of Dr. Zainab Shinkafi-Bagudu, the President-elect of Union for International Cancer Control (UICC) and founder of the Medicaid Cancer Foundation has consistently emphasized the importance placing people at the center of care and exploring new ways of making a difference and highlighting that every experience with cancer is unique, and that it takes all of us, united to create a world where we look beyond the disease.
In navigating this complex terrain, advocacy becomes a vital tool for empowering people who have experienced cancer, as their voices can drive home the gaps in care, how policies can be improved, and ultimately transform cancer care in Nigeria.
Moreso, many Nigerians still believe that cancer is a punishment or spiritually induced. They remain unaware of the risk factors for cancer or signs and symptoms, or of the importance of detecting cancer in the early stages of the disease, when it is easier to treat successfully, less invasively, and less financially challenging.
Advocacy through community outreaches can educate people about preventive measures and encourage routine screenings. Such awareness campaigns must be culturally sensitive and accessible, utilizing local languages and formats that resonate with diverse populations. It should not challenge their culture while emphasizing the need for, and the justification of, vaccination and integrative care.
By deepening our understanding of cancer, we can foster a proactive approach to health, enabling individuals to take greater control of their well-being.
For those who have been diagnosed with cancer, the journey through treatment can be isolating and overwhelming. Patient advocates can play a crucial role in establishing support networks that offer emotional and practical assistance, not only to people living with cancer but also to their families.
These networks provide a platform for them to share their experiences, access resources, and find solace in the company of others who understand their struggle. Such collective strength not only fosters resilience but also amplifies patients’ voices in advocacy efforts, ensuring their needs and concerns are addressed.
By presenting the realities faced by patients and families, we can help shape a healthcare landscape that recognizes cancer as a critical public health issue deserving of attention and resources.
To strengthen advocacy efforts, it is essential to empower patients and their families through training and education. This will not only enhance their individual experiences but also foster a larger movement for change.
Workshops focused on communication, negotiation, and understanding of healthcare policies can equip patient advocates to engage effectively with healthcare providers, institutions, and government officials.
Every voice matters. The insights and experiences of people with lived experience should be at the forefront of discussions that shape healthcare policies and practices. A decision taken in isolation might not capture the values, needs, and goals of these individuals.
For this reason, effective advocacy must extend into the realm of policy. Patient advocates have a responsibility to engage with policymakers and urge them to prioritize cancer care in national health agendas.
This includes advocating for increased funding for cancer research, integrating research into clinical services, improving access to affordable treatments and routine screening programmes for everyone, and establishing more comprehensive cancer care facilities across Nigeria.
We therefore need to push for comprehensive cancer care coverage by the National Health Insurance Agency (NHIA) to increase financial protection for those affected and to expand and improve the management, accessibility, and use of the Cancer Health Fund (CHF).
There should also be mandatory communication skills training for cancer professionals to ensure empathetic care, address personnel shortages and welfare needs, and allow more time with each patient. Best practices and resources should be shared between advocacy groups, policymakers, healthcare facilities, international organizations, and industries.
By standing together, amplifying our voices, pushing for essential changes, and having the will to make these changes, we can ensure that no one faces cancer alone and that every Nigerian has access to the care and support they deserve.
Let World Cancer Day, organized on 4 February by the UICC, of which Nest of Hope is a proud member, be the opportunity to drive personal, collective, and government action and transform the narrative around cancer in Nigeria.
Having these individuals affected by cancer supported and protected is not just an investment to the country, but it’s a dividend for the future.
Get involved in any way you can, because together we can create change. Together, we are UnitedByUnique.
Akwarandu (COREN) is a registered Civil Engineer, Survived Stage 3 Colon CA, and the President and Lead Advocate, Nest Of Hope Advocacy & Support Community. He can be reached at dozie@nestofhopesupport.com
