The rising cost of cancer treatment in Nigerian hospitals is pushing patients to seek alternative help outside the medical field. Jumoke Olasunkanmi shares the account of Ebuka, who spoke with African Health Report on his family’s cancer treatment experience.
‘My mother sold her business to pay for her sister’s cancer treatment, and it wasn’t enough” – Ebuka
In a nation of over 200 million, the battle against cancer in Nigeria is marked by despair, with over 78,000 lives lost annually, according to the Association of Radiation and Clinical Oncologists of Nigeria (ARCON). The situation with diagnosis and treatment is far from inspiring hope.
Add that to the lack of adequate facilities and personnel for radiotherapy, which exacerbates the situation. There are only nine scattered across the country. This scarcity forces patients to travel extensively, creating financial burdens often leading to a “debt-trap.”
This high cost of treatment also ensures that not many can aspire to be cured of their ailment in medical facilities.
Ebuka Anthony’s experience highlights the dire situation cancer patients and their families find themselves in Nigeria. He recounted the financial struggles his family faced during his aunt’s breast cancer treatment, saying it drained their collective resources without commensurate results.
In an interview with the African Health Report (AHR), he said his aunt, Mrs. Dorathy Udie, was diagnosed with breast cancer in 2013. After undergoing two surgeries and six rounds of chemotherapy, her health was far from improving, eventually leading to the sale of properties to continue treatment.
“She was diagnosed in 2013 and started treatment immediately… At first it wasn’t so expensive because the family was financially stable but as time went on it got really expensive that my mom had to sell her business,” Anthony recounts.
Mrs Udie was seeing doctors at the Nigerian Navy Reference Hospital, Ojo, in Lagos State, he disclosed, but luckily, she lived in the same state but still had to travel around 45 kilometres from her house to the hospital, a trip made worse with the heavy traffic in the state.
Anthony recalled that Mrs Udie experienced a recurrence after two surgeries and six rounds of chemotherapy.
Desperate, the family sought alternative treatment in the form of a diet consisting of natural fruits alone. When this prooved abortive, she went on to have another surgery and two rounds of chemotherapy, but unfortunately, she passed away after three years of fighting cancer.
“After the first 2 surgeries and 6 chemotherapy she became fine and her hair grow back. But they found another lump in her armpit 2 years later. She had one more surgery and two rounds of chemotherapy. But she still died within the year,” he recalled.
One radiotherapy unit per 19 million people…
According to a 2020 GLOBOCAN report, Nigeria reported 124,815 cancer cases, with a staggering 78,899 mortalities and a 5-year prevalence of 233,911. In 2018, Globocan data showed that the nation recorded 211,052 cases of breast, prostate, colorectal, cervical, and Non-Hodgkin lymphoma cancers.
Early diagnosis and swift treatment are crucial in the management of cancer, with radiotherapy (RT) being a cost-effective option in modern cancer care. Shockingly, an estimated 50 to 69 percent of cancer cases require radiotherapy at some point during treatment. However, the country is severely lacking in facilities with radiotherapy equipment and qualified personnel. Nigeria has less than one radiotherapy unit per 19 million people, compared to 1 unit per 250,000 in high-income countries.
As of 2021, the entire nation had only nine radiotherapy facilities scattered across all six geopolitical zones. A research study published in the National Library of Medicine (NLM) revealed that only four out of these nine RT centres ad at least one functional piece of equipment, with the highest number of required health workers, nine, instead of the recommended 14, found at the University College Hospital. This shortage of equipment and personnel hampers the optimal functioning of RT centers, significantly impacting the quality and accessibility of cancer treatment.
The consequences are dire. Patients are often forced to travel out of their states for tests and consultations, incurring additional expenses and hardship. The financial burden of cancer treatment is monumental, with all expenses falling squarely on the shoulders of patients and their families. Even middle-class families find themselves in a “debt-trap” just to afford treatment.
The cost of treatment varies based on the treatment type but they are still very expensive and out of reach for an average Nigerian.
N30,000 Minumum Wage, N2.4m Treatment Cost
According to a 2022 report by Dataphyte, chemotherapy, a required treatment for cancer, especially at advanced stages, costs between N600,000 to N1.5 million per session, depending on the type of cancer. It stated that breast and cervical cancer are some of the most expensive to treat and both cancers are most prevalent in Nigeria.
Radiotherapy, sometimes combined with chemotherapy for cancer treatment, costs about N600,000 for all sessions. Again, this is subject to the type of cancer being treated. Aside from these therapies, cancer drugs are also expensive costing as much as N300,000 per month.
In a country where minimum wage is N30,000 and health insurance barely captures 3% of the populace, on the average, a cancer patient in Nigeria will most likely need at least N2.4 million to receive comprehensive care, which is often continuous.
Sadly, even the 3% of Nigerians covered by insurance, can still not afford cancer treatment. Health insurance providers in Nigeria don’t provide comprehensive care for cancer patients. Dataphyte noted that although most Health Management Organisations (HMOs) list cancer care as part of the benefits of their insurance cover, this cover is limited across all tiers of insurance coverage from the least to the highest.
Coping With Cancer
Inadequate government-owned facilities have led to the emergence of several non-governmental organizations (NGOs) that provide financial and emotional support to cancer patients in Nigeria. One such organisations is the Care, Organisation, Public Enlightenment (C.O.P.E), a Lagos-based NGO that offers free breast screening, counseling, referrals, education, and support to breast cancer patients.
According to the CEO of C.O.P.E, Ebunoluwa Anozie, the high number of breast cancer diagnoses and equally high mortality rates among Nigerian women, many of whom lack access to affordable healthcare, motivated the organisation to provide crucial services. C.O.P.E also runs support groups for recently diagnosed patients, those undergoing treatment, survivors, and caregivers, aiming to provide them with a sense of community and empowerment.
“We run a support group for breast cancer survivors that meet on the 3rd Thursday of every month excluding January and December to discuss their progress, listen to lectures from health experts and gain new skills,” she explained.
She added that the organisation also educate the public to prevent cancer by encouraging good eating habits, physical exercise and regular screening.
In a nation where the fight against cancer is overshadowed by limited resources and overwhelming financial constraints, organizations like C.O.P.E offer a glimmer of hope, illustrating the resilience and determination of the Nigerian people to overcome this harrowing health crisis.
Limited government-owned facilities birthed NGOs like C.O.P.E, providing vital support and education. CEO, Ebunoluwa Anozie emphasizes the organization’s commitment to empowering survivors through support groups and preventive measures like good eating habits and regular screenings.
In the face of adversity, these NGOs offer a beacon of hope, showcasing the resilience of the Nigerian people in confronting this health crisis. However, the government needs to provide affordable healthcare treatment for the citizens who are battling cancer and other ailments. This is in line with its constitutional mandate to protect the lives, properties and wellbeing of the Nigerian people.
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