Last month, the first cases of Ebola infection were reported in Nigeria. This has rightly precipitated a series of remedial actions and reactions at all levels of society. Thanks to the sustained media advocacy!
At the other extreme, rumors on folk remedies abound, spread through the social media and text messages. Alas, Nigerians, stricken with the fear of contracting the Ebola virus, are willing to experiment with any remedy, no matter how far-fetched. Even those supposedly enlightened have believed and acted on these myths. So far, one Nigerian is on record to have died from Ebola since the late Liberian- American brought the virus to Lagos on July 20, 2014. However, media reports have it that four Nigerians have died from the excessive intake of salt, which is one of the false but widely publicized preventive measures. This is a tragic illustration of the truth of the saying that ignorance is itself a disease.
In the light of this, it is important to try to put things in the right perspective; to make perception truer to reality.
In doing so, we do well to pay attention to James Ball who in a recent article in the UK Guardian says, “Ebola is a horrific disease that kills more than half of people infected by it. It’s unsurprising that the prospect of catching it is a scary one. Even in the midst of the current outbreak – the worst ever – the spread of the disease has not been rapid…. In West Africa: around 400 new cases were reported in June, and a further 500 or so in July. The 800-plus deaths from Ebola in Africa so far this year are indisputably tragic, but it is important to keep a sense of proportion – other infectious diseases are far, far deadlier. Since the Ebola outbreak began in February, around 300,000 people have died from malaria while tuberculosis has likely claimed over 600,000 lives. Ebola might have our attention, but it’s not even close to being the biggest problem in Africa right now. ”
We must do everything RIGHT and BENEFICIAL to check the spread of Ebola. However, the fight against Ebola should not remove our attention from much bigger and much deadlier public health problems, especially the fight against cancer and diseases which are risk factors for cancer, including human papilloma virus (HPV), HIV/AIDs, hepatitis virus, malaria, kidney disease, diabetes and others.
Cancer is in fact a bigger problem in Nigeria than other better publicized problems like Ebola, militancy, kidnapping, air traffic accident among others. For example, since the onset of the recent Ebola epidemic, 1711 Ebola cases have been reported, out of whom 932 have died (WHO: Aug 6, 2014). In sharp contrast, during the same period, 3.4 million people have died from cancer globally; 36,000 of them in Nigeria alone!
The Human Papilloma Virus (HPV) causes more death from cancer in one single day, than Ebola has caused in the 38 years since it (Ebola) was first identified in 1976.
Cancer remains the No. 1 KILLER of mankind, now being diagnosed in one out of every three persons alive. Over 100,000 new cases of cancer are diagnosed annually in Nigeria out of which about 80,000 die. This means that cancer kills over 10 Nigerians every hour and 240 every day with a death ratio of 4:5 (80% mortality)!
Ebola is known to kill between 50% and 90% of those infected with the virus (66% overall, and 54% since 2006). The overall mortality rate of Ebola since the onset of the recent epidemic is 54%. Between the 2nd and 4th of August, about 108 cases of Ebola and 45 deaths occurred in the 4 West African countries (Guinea, Sierra Leone, Liberia, and Nigeria) with the current epidemic. This gives a mortality rate of 42% for Ebola; meanwhile cancer has a mortality rate of 80% in Nigeria.
Furthermore unlike Ebola which causes relatively rapid death, death from cancer is preceded by untold suffering which the cancer victims endure for months or even years, before finally succumbing to the disease. Cancer, which is mankind’s most expensive disease, leads to a significant financial drain on the family of the victim and by extension, on the nation.
Even more worrisome is the recent report by World Health Organization (WHO) which showed an increasing number of cancer deaths in Nigeria whilst cancer survivorship of other countries is improving. In four short years, death from the commonest cancers in men and women (Prostate and Breast Cancer, respectively) has increased significantly in Nigeria. Recent data shows that breast cancer now kills 40 Nigerian women every day whilst prostate cancer now kills 26 Nigerian men every day. This represents almost 50 per cent increase in the number of deaths for breast cancer, and 100 per cent increase for prostate cancer, within four years.
We must intensify the BIG WAR against cancer, because most cancer deaths are preventable. According to the WHO, one-third of cancers are preventable, another one-third is curable and the last third can have good quality of life with appropriate care. Meanwhile, four out of every five Nigerian cancer cases die. Indeed, there is nothing as sad as having people suffer and die from an avoidable cause. In the United States of America, cancer used to be a death sentence just like it is in today’s Nigeria. However, with better care, the survival rate of cancer in the USA has now improved to two (2) in three (3). Moreover, the stated target of the American Cancer Society is to improve cancer survival rate to 100%, thus making this the last century for cancer in the USA.
This success story of the USA is not surprising, given their enormous investment on public health care and infrastructure. Apart from the National Cancer Institute (NCI), there are currently over 1500 Comprehensive Cancer Centres (CCC) and over 2000 mobile health units in the USA.
A Comprehensive Cancer Centres (CCC) is a tertiary health institution focused exclusively on cancer care. Even developing countries like India, Egypt, Zambia, Mauritania, Pakistan, South Africa, Kenya, Tanzania, among others, have CCC. For example, India has over 120 CCC as well as mobile units, mostly established with the support of the private sector. Egypt has a world-class NCI, several CCC as well as mobile cancer units. Egypt also has the largest children cancer centre in the world, built and still being sustained solely by donations. At present, Nigeria has no single CCC, nor a full-fledged Mobile Cancer Centres (MCC).
It is therefore expedient to provide public health infrastructure to adequately tackle the contemporary cancer scourge in Nigeria. In fact, a robust health infrastructure is also the requisite for tackling the Ebola epidemic. US President Barak Obama alluded to this when he stated that it is too soon to send experimental drugs for Ebola treatment to Africa; affected countries should instead focus on building a “strong public infrastructure”.
There is no denying the fact that there is an urgent need to provide adequate basic public health infrastructure in our country. We cannot keep running after the first- class facilities in other countries whilst neglecting our motherland. Just before his death from throat cancer, the late Archbishop Obiefuna – past President of the Catholic Bishop Conference of Nigeria, said “a country that does not give priority to the health care of the citizens is not worth the name country”.
According to the World Health Organization, “We cannot treat our way out of the cancer problem. More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally.”
A good starting point would be the deployment of Mobile Cancer Centres (MCC) to take holistic health promotion to the grassroots of Nigeria. The campaign to actualize this is the present focus of the Committee Encouraging Corporate Philanthropy (CECP-Nigeria). An MCC is NOT the same as a Mobile Mammogram. Rather, it is a clinic on wheels, in which screening, follow-up and treatment (including surgeries), can take place. It includes facilities for mammography, sonology, colonoscopy, colposcopy and cryotherapy, as well as a surgical theatre. It is also equipped with a laboratory for screening against certain cancers like prostate, colon and bladder cancer and other common diseases which are known to increase the risk of cancer. These include malaria, diabetes, hepatitis, kidney disease, hypertension and HIV/AIDS. Thus the MCC would tackle the double burden of disease i.e. Communicable & Non-Communicable. Each MCC costs $600,000.
It is important to note that the MCC could also be therapeutic with regards to many of the social problems that Nigeria is facing today, because the mobile centres would be a symbol of hope for the millions of poor Nigerian masses who believe that the country does not care for them.
Ebola itself is spread through direct contact with the bodily fluids of an infected person. The key measures for Ebola prevention are better hygiene and prompt isolation of infected persons. Both measures will only be imbibed through public health education; the MCC would be a great means of getting life-saving health education to the grassroots.
We cannot achieve the vision of stemming the contemporary cancer scourge without the support of everyone.
Dr. Paul Kleihues, Director of the International Agency for Research on Cancer (IARC) and co-editor of the World Cancer Report 2012 said “We can make a difference by taking action today. We have the opportunity to stem this increase. This report calls on Governments, health practitioners and the general public to take urgent action. Action now can prevent one third of cancers, cure another third, and provide good, palliative care to the remaining third who need it.”
The last word goes to Bill Gates; he said “you do not need to be the chair of a large foundation to have an impact on the world. Risk takers need backers. Good ideas need evangelists. Forgotten communities need advocates. And whether your chief resource is volunteer time or hard-earned dollars, for a relatively small investment catalytic philanthropy can make a big impact”.
© 2014 Committee Encouraging Corporate Philanthropy (CECP- Nigeria)