Nigeria: Cancer Treatment Centre Where Patients Pay Through the Nose

10 August 2019

In this report, ODIRI UCHENUNU-IBEH examines the struggles of cancer patients receiving treatments at the Cancer Treatment Centre in the Lagos University Teaching Hospital

We must assist the cancer centre at the Lagos University Teaching Hospital (LUTH) to grow; If we don't let that centre run properly or maintain it, in another year or two, it stops working; N5 billion goes down the drain and nobody can get treatment again.

"We will then go back to square one where people travel abroad for cancer treatment," says the Chief Medical Director, LUTH, Prof. Chris Bode, when our correspondent asked him what he thinks about the exploration of cancer patients at the hospital.

He further explained that, "The cancer centre is a Public Private Partnership (PPP), entirely under a different management. Investment group put about $15 million, equivalent to about N5 billion to establish that cancer centre which currently is one of the best in the whole of Africa and is going to be the best in Africa in the next two years.

"Under that arrangement, we must guarantee that it will run by itself, maintain itself for the next 10 years without stop. That is one of the largest investments from the private sector to provide and bridge the infrastructural gap in the healthcare sector."

Bode reiterated that the new cancer centre is not under LUTH, it is under a private investment management. "I cannot say treat this patient or don't treat this patient here because they are out for business.

"Don't forget that there was a time, when Nigeria has not a single proper cancer machine. Nigerians need to choose: do we want to have an excellent centre or do we want to have a free treatment? What we were getting before which is not always available was free treatment that everybody wanted.

"If you go to India, outside your air fare and the people you will take along, you will pay $8,000 for treatment alone, the same with Ghana. Here at LUTH, a cancer patient pays less than $2,000 to $3,000," he added.

He however advised that whoever wants treatment there should go to their family, church, mosque, senators house of representative members, local government chairmen, governors, and source for the money for the treatment because the centre does not treat people free.

Yes! An investigation by LEADERSHIP points to the direction that cancer treatment is a big business venture in Nigeria, due to the rate at which Nigerians die as a result of the disease.

Sadly, investigation has shown that there are only two working radiotherapy machines in the country. That has led to about 40 per cent of the over $1billion spent on medical tourism attributed to patients seeking treatment for cancer.

With over 41,000 Nigerians dying as a result of cancer in 2018, Head of department of Radiotherapy, LUTH, Dr. M.Y.M. Habeebu, told LEADERSHIP that lack of awareness, poor infrastructure, among others are the reasons we have cases of cancer in the country.

Habeebu said Nigeria has nine radiotherapy facilities, but only about three are functional at the moment, adding that there is need to scale up awareness on the menace, because prevention is better than cure.

By International Atomic Energy Agency standard, which is an arm of the World Health Organisation (WHO), Habeebu said Nigeria needs about 40 cancer centres, adding that the country currently has about 65 clinical oncologists instead of 500.

LUTH New Cancer Centre: Curse Or Blessing?

When the President of the Federal Republic of Nigeria, Muhammadu Buhari, came to Lagos to commission the cancer centre at LUTH, he said he is aware that up to 40 per cent of funds spent by Nigerians on medical tourism is attributable to patients seeking treatment for cancer.

Buhari said, "Despite having an increasing number of citizens suffering from cancer, we until now, had only two working radiotherapy machines in the country."

He reiterated that his administration would continue to focus on greater investment in the health sector and work hard to ensure increased access to quality healthcare.

He said, "We promised to effect policies that would remove debilitating constraints on the sector and create sustainable structures to strengthen our healthcare institutions. We are aware that up to 40 per cent of funds spent by Nigerians on medical tourism is attributable to patients seeking treatment for cancer.

"Indeed I am proud to commission the NSIA-LUTH cancer treatment centre, but we recognised that this modest effort to address the gaps in our tertiary healthcare system alone is insufficient to address all the challenges faced by the sector.

"No one ever prays to be diagnosed with cancer, but if they are, what we have made possible here today is the hope that a true chance of survival and good quality of life becomes part of the story of many Nigerian patients with cancer."

Buhari, while assuring Nigerians that his administration will continue to work to ensure that the gaps in the health sector are bridged, said his administration has created an enabling environment for institutions such as NSIA to help fund high impact projects on time and on budget, thereby delivering immense value for Nigerians.

"Despite having an increasing number of citizens suffering from cancer, we until now, had only two working radiotherapy machines in the country. Indeed, over the coming months, the NSIA will commission two modern medical diagnostic centres to be co-locates in the Aminu Kano Teaching Hospital, Kano state and the Federal Medical Centre Umuahia, Abia state, respectively, bringing additional investment to Nigeria's healthcare Sector," he added.

When cancer patients receiving treatment at LUTH, heard of the commissioning of the new centre, they were so happy. After all, they will be getting almost the same quality of cancer treatment that are applicable oversea, but their joy was short lived.

It was made clear to them by the management of the centre that it would not be business as usual, that the free treatment syndrome is not tolerated at the new cancer centre.

The majority of the cancer patients' treatment there are being sponsored or the patients themselves must be very rich to sponsor their treatments. Those who cannot afford it, have been turned into beggars.

Some cancer patients who spoke with LEADERSHIP recently attested to that. They wish government, international donors and well meaning Nigerians can come to their aids because the financial burden of the disease has forced them into begging.

I must say cancer is not a dead sentence, but it is the money that is killing us, lamented Chioma Uche, who was diagnosed of the disease November, last year. She said, "People now know that early detection is the key, but once we start treatment, money is what makes us to withdraw and resort to dying.

"When I heard that a new cancer centre has been commissioned by the government, I was very excited, after all, this is government facility, it will be affordable, but the reality contradicts my thinking.

"Before now, we used to pay N1050 for consultation fee and then we can either get our drugs at LUTH or get them outside. Also, before the new cancer centre at LUTH, radiotherapy was less than N200,000.

"With the new cancer center, the price has skyrocketed to N800,000 for radiotherapy. Majority of us cannot afford that. Consultation fee that used to be N1050 has been increased to N20,000 for a start and then subsequent visits is N15,000. So any doctor appointment visit is N15,000.

"There was a day that the doctor booked an appointment for me to review my status, I had to pay N15,000 for that. For him to just confirm that I am fine and then take me to the next level, I had to pay N15,000.

"My next stage then was to visit the radiotherapy department, when I asked for the price, the doctor said it is N800,000 for 18 days treatment. So I told the doctor that N800,000 is much that I don't even have the money home and abroad. Even if I sell everything I have, I cannot raise that money.

She said one of the cancer patients she met at LUTH could not continue her treatment because of the money. She said, "Her case is very critical now due to inconsistencies of treatment. Maybe she will go for chemotherapy this month, before she will raise the money for another round of chemotherapy would be four months later. Currently, her case is very critical, she cannot even take chemotherapy right now because her health has deteriorated. They cannot give chemo when one is not fit to take it and her blood count is very low.

Mrs Khadijatu Mohammed who was diagnosed with cancer June 2018 also shared her view. She said the day she was diagnosed with cancer, she spent N150,000 for test alone. She said, "Cancer treatment has turned me into a beggar. Once I don't have the money for treatment and I needed it so badly, there is no way I won't go to people and explained my situation to them. I have to drop my madam and big girl and start begging.

As for Mrs Abiodun Seyi, "When I was diagnosed with cancer, I automatically turned to begging, there is no way I will not go and beg because chemotherapy is every three weeks and some of us are taking chemo of N200,000, others N300,000.

"Let's say I am paying N300,000 for chemotherapy every month, even though I have millions in my account, it will dry up one day. The only way out is to go begging for funds."

Mrs Eunice Kayode said, her cancer drugs cost N1,000. "Calculate N1,000 per day for a month, then I will also have to eat proper diet to make me stay healthy before my chemotherapy. Then we now talk about chemotherapy bills," she said.

I will appeal to the government to prioritize health, because health is wealth, says Kayode. "Anything can happen to anybody; We didn't pray for this. We found ourselves in this situation. Cancer is no respecter of anybody.

"I appeal to government and international donors to help us. The people living with HIV are surviving because of the free treatment. Cancer is not a dead sentence; if we have subsidised treatment, majority of us will survive.

"Because of the huge price at LUTH, I can no longer afford treatment at LUTH. Currently, I am going to the University College Hospital (UCH) in Ibadan . I am paying N150,000 for treatment. When I was taking treatment at LUTH, I paid consultation for N20,000 and then they would prescribe injection that I would take.

"Some people are buying chemo of N300,000 at LUTH. Initially, when I went to LUTH, there was this injection that the doctor prescribed for me, it is called acetyl. It was sold for N375,000, which I was supposed to take every three weeks for a year.

"I had to beg the doctor to prescribe lesser one for me because I don't know any politician to go and beg for the money. If my husband hears of that, I know he would have collapsed. If people that have money is feeling the pain, you can imagine what the poor ones like me are going through.

"I can tell you that cancer is not a dead sentence, but it is the money that is killing us. A lot of people have died because they convinced themselves that cancer is not an ordinary disease, that it is an attack and start going to different churches and native doctors.

"Before they know it, the cancer will spread to different places and by that time, it will be at the last stage, the stage where there is no hope.

"A lot of people will tell you that they know when the cancer started, but because of the money, they concluded in their hearts that this is not ordinary. Imagine you spending N100,000 every three weeks for a whole year, and your salary is less than N50,000, that is not sustainable," she added.

On behalf of cancer patients in Nigeria, Mrs Uche, Mohammed, Seyi, Kayode, however, pleaded with the government, international donors and well meaning Nigerians to come to their aids.

"Subsidise the price. The cancer centre at LUTH is working fine, we are getting the best treatment there, but the money is too much for us," they cried out.

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