At 56, Nigeria Still Lacks Functioning Radiotherapy Machines

Prior to October 1, 1960, when a British journalist and novelist, Flora Shaw gave the most populous black nation its name, Nigeria, in preparation to becoming an independent state, everyone was of high spirit that soon the nation would be able to control its enormous resources independently, and that in the next two to three decades, most of the basic needs of the citizens would have been met, including infrastructural development, education, health, among others.

Truly, Nigeria has generally been regarded as a blessed country, even before its name was birthed. But 56 years after, various institutions in the country, including the health and educational sector, as well as financial institutions are still grappling to be at par with those of some other countries that got their independence at about the time Nigeria did. Of these countries, only few could match the natural and human resources found in Nigeria.

Singapore, Malaysia, Cyprus, among others according to some school of thoughts, have long passed Nigeria in terms of healthcare, economic growth, poverty alleviation, infrastructural development and other several parameters that determine the strength and progress of a country.

THISDAY investigations as Nigeria turns 56 on Saturday, showed that the chief sector where the citizens feel the country has not fared relatively well considering the resources at its disposal is the health sector, with majority of the citizens already losing confidence in the country’s healthcare system due to lack of infrastructure and policies targeting the health and wellbeing of Nigerians since the country was birthed.

With several areas of the healthcare system continuously begging for attention, including the primary healthcare system, quality and affordable healthcare, increased maternal and child mortality, as well as high cost of treatment and slow pace in meeting world targeted health goals, a major area of the health sector where stakeholders and the citizens feel the country hasn’t fared well, and could be said to have abysmally performed poorly, was the attitude to cancer treatment.

While most countries have recognised cancer as one of the major killer diseases globally, and are putting concerted efforts in place to tackle it, as well as manage/treat the scourge, Nigeria still lag behind in tackling the global health issue which has killed several Nigerians in recent times.

Every year, thousands of cancer patients die in the country due to the lack of proper treatment plans and awareness by the citizens on prevention and routine medical checkup. Experts believed the scourge was becoming prevalent in Nigeria because the government has not placed a priority in tackling the scourge like it did for Ebola virus disease and other outbreaks which have been successfully controlled or eradicated.

Plainly put, a Professor of Clinical and Radiation Oncologist, Prof. Sunday Adeyemi Adewuyi, in a presentation at the CEAFON cancer summit in Abuja, said the abysmally poor cancer management in the country can be referred to as a death sentence for cancer patients because the country presently lacked the capacity to manage the several thousands of patients needing radiotherapy daily.

He said the recommended number of cancer machines, according to the International Atomic Energy Agency (IAEA), is one machine to 250,000 population, or one machine to 350 to 450 cancer patients, but that Nigeria currently has seven radiotherapy machines which means there was one cancer machine to over 30 million people.

Checks by THISDAY have however shown that all seven cancer machines have in recent years never worked at the same time. Only one or two work at a given time, records show.

In a more gloomier development, weeks ago, all cancer machines in the country were down, leaving the two million cancer patients and the over 180 million Nigerians at the mercy of the disease. As at the time of going to press, this newspaper could not ascertain if any of the machines has been fixed.

According to Adewusi, Nigeria was expected to have 840 cancer machines to match the recommended numbers per the population. “South Africa, has 18 radiotherapy machines, which means one machine to 1.3 million citizens, while another fellow African country, Egypt, has 35 cancer machines, that is one machine to 1.2 million citizens. Japan has 611 cancer machines, with one machine to 150,000 citizens, while China has 453 machines, with one machine to 1.8 million people,” Adewusi said.

According to the World Health Organisation, radiotherapy machine is the device commonly used for external beam radiation treatment for patients with cancer, adding that it was better for an oncology patient not to get radiation treatment than to get half dose or incomplete dosage.

One of the cancer patients who was turned back from Lagos University Teaching Hospital, LUTH, weeks ago due to the breakdown of the radiotherapy machine in the hospital, Mrs. Omawunmi Olajide, said she was on radiotherapy session in the National Hospital Abuja, but was referred to LUTH when that of Abuja broke down, adding that she was also unable to access the therapy session in LUTH due to the same situation.

She said when the Uthman Dan Fodio Teaching Hospital was contacted, they also told her the same story of a non functioning radiotherapy machine. Hence she was leaving at the mercy of the hospitals and the government, which she said she hoped would put the machines in place soon for her to continue her treatment.

Experts say when a cancer patient undergoing radiotherapy stops the treatment process, the cancer cells tends to build up immunity and bounce back, taking the patient back to square zero.

Asked what she would wish the country do as it turns 56 this week, Olajide said government should provide cancer treatment machines, as well as subsidise the cost of treatment, adding that getting the needed funds for treatment was also as important as getting a functioning radiotherapy machine for treatment.

Olajide is not the only one going through the pain of cancer and the inability to access treatment in the country. Earlier reports have shown that daily, cancer patients throng hospitals where there were supposedly radiotherapy machines, but that the continuous breakdown of the machines has hampered treatment across the country, thereby leading to high mortality rate occasioned by the disease.

Before the machine in National Hospital Abuja broke down, a Consultant, Clinical Oncologist in the hospital, Dr. Bello Abubakar Mohammed, earlier this year, told THISDAY that patients were becoming helpless due to the huge number of people on the waiting list to access the radiotherapy machine in the hospital.

“If a patient comes today and pay all the funds to access radiotherapy treatment, that patient will have to wait for at least six weeks before it can reach his or her turn. Only God knows how many patients will survive that waiting time. That is the situation we find ourselves,” he said.

As though he also envisaged that the over load on the machine might cause a breakdown soon, Mohammed noted that every day the machine was working far beyond the recommended time because there were too many people on the list. “If you rest the machine, people will begin to die. The machine has been working like that for 16 years, whereas its lifespan is seven years. The machine is already over stretched. If this one packed up now, what will be the fate of those waiting to access the machine?” He queried.

A week after he spoke to THISDAY, the machine packed up, and as at the time of publishing this article, there is no information on whether it has been fixed.

“Apart from the dearth of cancer facilities, we are short of oncologists and other personnel. We have less than 60 oncologists in the country, yet we need 3,000 of them. Same with other personnel like medical physicists, oncology nurses, among others,” adding, Mohammed said it takes six years to train a specialist.

Commenting on the total breakdown of radiotherapy machines in the country weeks ago, the Chairman, National Programme on Cancer Management, Professor Francis Abayomi Durosimi-Etti, who spoke to the media said there was palpable fear in the land over the fate of cancer patients, with the complete breakdown of all radiation machines in the country. “It is so sad, it is a pity and it is a shame and I actually feel ashamed because all over the world we have so many machines even in one hospital compared to all the faulty ones we have all over the country,” he added.

Durosimi-Etti, who stressed the need to urgently fix the machines, added that they should be upgraded.  “To the best of my knowledge, action is being taken in this direction. I must admit that it is very sad. The problem is that those machines were old and then we have this erratic power supply and third, the humidity and dust are not helping.

 ‘’This is because they require certain conditions to get them operate optimally. The Linear Accelerator needs cooling system and this is something I believe can be fixed. I can tell you definitively from my knowledge, being a key player here that our government is doing a lot to get round the problem.’”

Adding, Durosimi-Etti recommended that government set up a task force to look into the solution.

He said: “The situation whereby when a patient with tumour approaches a cancer centre and commences treatment would have to suspend treatment because the machines break down and cannot continue elsewhere because the guidelines for operations is not the same as the centre where he or she was receiving treatment is not good at all,” adding that it would take about $2 million to get a brand new radiotherapy machine.