I resigned as staff neurosurgeon with the National Hospital, Abuja seven years ago. It was a mutual divorce and like lancing a boil for me. The release was instantaneous and cathartic. So many issues had built up to the point but the inability to deliver quality care was the most important.
You see, the problems started right at the job interview.
Gamma Knife
One of the interviewers asked me, ‘Dr Ogungbo, would you be asking us to buy a Gamma Knife machine for you’? By the way, the Gamma Knife is an advanced radiation treatment for adults and children with small to medium brain tumours, abnormal blood vessel formations called arteriovenous malformations, epilepsy, trigeminal neuralgia, a nerve condition that causes chronic pain, and other neurological conditions.
‘Not really’, I said. Further, ‘If I asked for a Gamma Knife, it would be because there is a huge demand for it and it would make sound business sense’. ‘However, I would actually be asking for the basic ‘bread and butter’ stuff for practising neurosurgery’. ‘We would need to get the basics right first before moving on to the fancy stuff’. Well, I never did ask for the Gamma Knife. Anyone who truly needs the knife in Nigeria (patients with small brain tumours) has to go to countries such as India, Germany or the USA for treatment. But, I also never got the basic instruments for proper neurosurgical practice. In the years intervening till now, the care of patients with brain cancer specifically remains appalling.
In truth, there has not been any improvements in cancer care nationally.
National Cancer Centre
Cancer is scary and demands proper attention. We often pay lip service to cancer. For example, huge sums of money were allocated in the budget for the establishment of a National Cancer Centre. Grand plans and expensive groundbreaking ceremony of a scam. The ugly, miserable-looking brown building can be seen along the Airport road. The money long gone; spent by the scammers in President Umaru Yar’Adua’s government at the time.
Poor quality of care
Secondly, the bread and butter stuff for investigating the cancer-like state of the art MRI scanners, PET scans, Bone scans and even high-quality CT scanners are not available in many of our tertiary institutions. So, even the quality of diagnosis is usually suspect: from poor radiological reporting to suspect the histological diagnosis.
If you have used poor quality machines to image the patient, the result is likely to be poor as well. If you do not have the right reagents for histology, you will give an unbalanced report. As they say, garbage in, garbage out!
The bottom line is that cancer patients are poorly looked after in Nigeria. Cancer patients have to travel from one obsolete machine at the National Hospital, to a defunct machine in Maiduguri and thereafter to another worthless machine in either Benin or Ibadan. The basic radiotherapy machines are not available and cancer queues are longer than the Airport road. So, even though we might need fancy stuff for some people, we lack the basic stuff for the majority.
The drugs for cancer treatment are definitely not manufactured in Nigeria and therefore difficult to come by. Therefore, if you cannot afford to travel out to another country, your remaining time on earth will be awful, painful and downright miserable.
Look, there is not even one single centre for palliative care in Nigeria. Not one place where patients can die in peace, pain-free enough to have a comfortable exit from this world. Cancer is not funny and a lot of compassion is required in the management of patients. The little we can do is show a little empathy and make life just a little more pleasant.
Unfortunately, we are all exposed to the risks of cancer ranging from mobile phones that can cause brain cancer, to cigarettes causing lung cancer, toxins and poisons in food and the recent upsurge in both breast and cervical cancer. Of course, blood cancers like multiple myeloma, leukaemia and even prostate cancer are making their mark, decimating Nigerians in their hundreds daily.
Sadly, that may even include you and me!
The President is out of the country right now for whatever reason. If it is cancer care, one hopes that at some point in the near future, the government will see this as a real need in the country. One hopes that they will set up a unit to deliver real cancer care so the next person will not go out to suffer. You see, we are the cash cows and money trees for other countries, who have no stake in the health of Nigeria.
Ok, on a final note, brain cancer is real and on the increase. We think that mobile phones are a serious risk factor. Please get earphones and keep the mobile phone off your brain. So, prevention is better than cure and your prayers should be, ‘God, please no, not cancer!
Because, if you do get cancer, we will not be able to help you.
Dr Biodun Ogungbo, MBBS, FRCS, FRCSEd, MSc