DR. ZAINABSHIN KAFI BAGUDU

How did Medicaid cancer foundation come to be?

During my practice as a consultant pediatrician, I noticed there were lots of errors made when investigative tests were conducted. This inspired me to open a diagnostic center with the support of my husband, to support highly skilled professionals and raise the standard of diagnosis in Nigeria. After establishing the radio diagnostics center, the need for a cancer foundation arose because of the numerous positive cases of breast and cervical cancer. I myself have had removal of breast benign lumps. I also lost two grandmothers to breast cancer. 250,000 Nigerian women die from Breast Cancer in Nigeria each year. These are grandmothers, aunties, sisters etc. So I didn’t find cancer, cancer found me. The Medicaid Cancer Foundation started to meet a need of people I was serving.

There should be inclusion of cancer care and treatment to universal health coverage through NHIS. Increase cancer awareness to promote early detection and hence decrease the cost of treatment.

How is the foundation funded and managed?

Medicaid Cancer foundation is funded by an annual fundraising event in the month of October. Every year we have a one million-man walk where we sell kits and paraphernalia. We have also held concerts, stage plays, raffle draws, dinners etc. All the profits go to funding indigent patients. We have screened over 13,000 patients in seven years and assisted 600 with treatment. Awareness is more difficult to measure but I know anecdotally that we are wining.

We also reach out to corporate and individual donors and supporters that have been with us since inception. We have successfully applied for some grants. All our accounts are audited each year and currently being run by founder and its board of trustees, Chief Operating Officer and Coordinators. We have lots of volunteers as well. You run a radio diagnostic centre in Nigeria, what are some of the challenges you experience doing this?

As a nation, we have poor credit rating so we cannot secure equipment on lease from international manufacturers. This means to upgrade equipment we have to put down money cash down! Other local issues include lack of a stable power supply. I’m not talking about not having electricity all the time but surges that ruin the sensitive power boards of the machines. The financial investment required to start up a CT machine in Nigeria is twice what required elsewhere. We have to run special cables underground, dedicated transformers, inverters, generator, back up generator, all in a bit to ensure the power that reaches the machine is smooth. The there is the high cost of consumables and equipment as well as maintenance not to mention fluctuations in dollar rates. There is no tax waiver for running such a vital service. Policy makers need to look into this last bit seriously if we want to strengthen our weak health systems. What can be done to make treatment more affordable?

Treatment of cancer is expensive worldwide. Cancer is a complex poorly understood disease. There are very limited numbers of pharmaceutical companies that produce Cytotoxic drugs which makes them have financial control over sales of cancer drugs.

Furthermore, the processes involved in making these drugs are a lot more cumbersome than ordinary drugs.

Here in Nigeria, the availability of radiotherapy treatment is extremely limited. We all know that story of how limited machines are. We have nine linear accelerators in Nigeria. For our population, the WHO recommends 300. Hence a greater number of those that can afford it resort to medical tourism abroad.

To me, enacting our policies to strengthen health care system in Nigeria is now urgent. We have three beneficial policies that are yet to be fully implemented despite being passed into law. Where is the 1% of Nigeria’s consolidated revenue allocated to healthcare? Why won’t the Chairman of Appropriations allocate that amount for the third year in a row? This is not acceptable. We must sort out our primary healthcare centers quickly. And include cancer care or at least screening at that level. Awareness at the grassroots and disabusing the minds of our illiterate population can be at the PHC level. There should be inclusion of cancer care and treatment to universal health coverage through NHIS. Increase cancer awareness to promote early detection and hence decrease the cost of treatment. We might not have the huge resources to establish 300 centers but we can grasp the low landing fruits like awareness, improving the quality of data from, and screenings at primary health care level.

While many may be aware of breast cancer, not many actually take the necessary steps to get screened early. Could you tell us more about the importance of early detection and some telltale signs of breast cancer?

Early detection of any disease is important. Nigerians have a lackadaisical attitude to so many things especially their health. They ignore early signs, and most people adopt the “not my portion syndrome”.

There are so many signs of breast cancer. It ranges from lumps, to nipple discharge, puckering and dimpling of the skin, nipple inversion, pain, skin discoloration, rashes, scales and flakes of breast skin. It is known that the risk of breast cancer increases with age. Which group is most susceptible to breast cancer, and what can they do to prevent it?

Susceptibility of women to breast cancer is due to a permutation of factors. Elderly women aged 50 years and above, are more susceptible to breast cancer as age is the strongest risk factor. Women that have the inherited genes are also more susceptible than those who do not have. Maintaining a healthy lifestyle and having regular screening will greatly reduce the risk. What about lumps detected in the breast? Should we be concerned even if they are benign?

Any lump detected in the breast should be followed up thoroughly to be sure of its nature. Benign lumps should not be of concern per say as lumps could either be benign or cancerous, they do not change from one to another. But it is important to deviate oneself from all factors that could increase the risks of coming down with cancer.