"The World Health Organisation (WHO) estimates that 10 million people die of cancer annually worldwide and that 70 per cent of these deaths occur in low-to-middle income countries including Nigeria".
When Rosemary Nnamdi, 33, was diagnosed with breast cancer in 2019, she repeatedly murmured to herself that her life has finally come to an end.
Rosemary, a makeup artist and resident of Tungamaje, a suburb in Nigeria's capital city, Abuja, first visited a private hospital in late 2017 after experiencing some discomfort in her left breast. At the hospital, the doctor confirmed the presence of a lump in the breast but said it was not a threat.
The doctor, however, advised her to visit the hospital within six months for further check.
"Since the doctor said the lump is not a threat, I didn't bother much about it and was living fine until mid-2019," Ms Nnamdi said.
The discomfort on the left breast, which she thought she already overcame, soon resurfaced again. This time, she could feel the lump in her breast.
"This time I was so scared that my worst nightmare may become a reality," she said.
Instead of going to the health facility for a follow-up, she stayed back home for some months due to fear of getting diagnosed with cancer, a disease known for its killing nature.
"I eventually visited the hospital and after lots of medical procedures, I was diagnosed with breast cancer. At this point, I almost ended my life," she said.
Ms Nnamdi eventually had a single mastectomy, a surgical procedure that involves removing the entire breast. After such a procedure, the patient is expected to commence radiotherapy and chemotherapy, which Ms Nnamdi said she could not afford.
"I started soliciting funds to cover chemotherapy and radiotherapy sessions but it was never enough. I sold every single property but it could not cover the sessions recommended by the doctor," she said.
Cancer - The killer disease
Cancer is generally described as a disease that occurs when changes happen in a group of normal cells within the body leading to uncontrolled, abnormal growth and forming a lump called a tumour. The World Health Organisation (WHO) estimates that 10 million people die of cancer annually worldwide and that 70 per cent of these deaths occur in low-to-middle-income countries including Nigeria.
Breast cancer, which is characterised by the abnormal growth of cells in the breast, is the most common malignant disorder affecting women and the leading cause of death among them. Although breast cancer can occur in both men and women, it is far more common in women.
Unlike some cancers that have infection-related causes like Human Papilloma Virus (HPV) and cervical cancer, there are no known viral or bacterial infections linked to the development of breast cancer.
Breast cancer is currently the most common type of cancer worldwide, with 2.3 million cases recorded in 2020 and 685,000 deaths globally, according to the WHO.
In 2020 alone, 78,899 cancer-related deaths were recorded in Nigeria, according to Globocan statistics. Women often bear the brunt -- breast and cervical cancers are responsible for more deaths than any others in the country.
While 34,200 men died from cancer in 2020, 44,699 women died from the disease, according to Globocan data.
Although there are no specific data on cases of breast cancer in Nigeria, it is said to represent about 23 per cent of new cancer cases and about 18 per cent of deaths are attributed to it.
Costly treatment
Like Ms Nnamdi, a stage three breast cancer survivor who identified simply as Rashidat, said surviving cancer is the most difficult journey she has ever embarked on. She narrated her ordeal to PREMIUM TIMES, from diagnosis through mastectomy, chemotherapy, and radiotherapy.
"The cost of treating cancer drained me completely and I can never forget how I struggled to complete the recommended treatment sessions," she said.
"I can tell you as a matter of fact that I spent over N5 million on cancer treatment."
Festus Damilola, a civil servant battling colon cancer, said the cost of treatment is unbearable for an average Nigerian. Mr Damilola said since his diagnosis in early 2022, he has spent millions of naira on treatment.
He said he only wished and hoped the country's health insurance scheme can cover his treatment costs, instead of putting his family in debt.
"My treatment is already costing millions of Naira and I'm not even done yet," he said.
The ordeal of Ms Nnamdi, Ms Khadijah, and Mr Damilola explains the financial burden many cancer patients in Nigeria contend with in the absence of government support and investment in cancer treatment.
The high cost of treating cancer in Nigeria and its non-inclusion in the country's health insurance scheme has left many cancer patients stranded. Due to the cost of treatment, some patients end up staying at home and waiting for death.
Failed insurance scheme?
Findings by this newspaper show that a cancer patient requires a minimum of N1,000,000 to go through the complete sessions of radiotherapy in Nigeria. Health experts said the cost of treating cancer can be slashed if it is well covered by the National Health Insurance Act (NHIA).
However, the repealed National Health Insurance Scheme (NHIS), which was supposedly created to reduce the huge out-of-pocket spending for health services, failed to cover major diseases like cancer.
Although President Muhammadu Buhari said the new NHIA will make health insurance compulsory for all Nigerians, there are no specific details on its coverage of cancer and other killer ailments.
An oncologist, Abdulrasheed Abdullahi, said a lot of people cannot afford cancer treatments due to the high cost, hence the need for NGOs and other well-meaning individuals to support cancer patients to reduce treatment costs.
Mr Abdullahi said if the NHIA covers a major aspect of cancer treatment, more lives will be saved and people will be willing to present early to the health facility.
Government's initiative
Meanwhile, to reduce the burden of cancer care in the country, the Nigerian government in 2019 announced plans to roll out a cancer treatment fund with the aim to support people battling the killer disease.
Although the implementation has commenced, the cancer patients' community said they are yet to fully access the fund.
Speaking during a walk against cancer in February, Gloria Orji, the President of the Network of People Impacted by Cancer in Nigeria (NEPICIN), said cancer is a costly disease that many Nigerians cannot afford to treat hence the cancer treatment fund will save lots of lives if well implemented.
Ms Orji said only about 400 patients have so far benefited from the treatment fund according to the information she received.
"The last time I received information about the fund, I was told about 400 patients have benefited which is still a drop in the ocean. We have about N1 billion yet to be accessed.
"We plead for this fund to be released to support cancer patients and help them survive the killer disease," she said
Providing solace
Due to her inability to continue treatment after the surgical procedure, Rosemary decided to opt for herbal treatment which according to her is cheaper and far more accessible.
Her situation, however, worsened barely five months after she commenced the use of some herbal drinks recommended by her neighbours.
"At this point, I started looking for ways to fund the chemotherapy and radiotherapy sessions. I went to the bank for a loan but my request was rejected, I called everyone I know that could help me. But the money I gathered was too little to cover my treatment," she said.
It was at this point in Rosemary's life she had a life-changing encounter with Project Pink Blue, a Non-Governmental Organisation (NGO) providing aid to cancer patients in Nigeria.
The Abuja-based organisation contributes financially and psychologically to the survival of cancer patients in the country. Through various crowdfunding campaigns and donor funding, the organisation provides solace for patients.
"One of the persons I ran to for help referred me to Project Pink Blue and they supported my radiotherapy session with over N600,000," she said.
Another breast cancer survivor, identified simply as Catherine, said Project Pink Blue made her recovery from cancer stress-free.
"The moment I was diagnosed with cancer, I knew there was no way I would be able to afford the treatment due to various stories I have heard. I immediately started going around soliciting for funds until I met with this great organisation changing lives positively," she said.
Ms Catherine said the organisation sponsored over half of her cancer treatment and kept following up until she was completely free of the disease.
Saving lives
The founder of Project Pink Blue, Runcie Chidebe, said the organisation was founded with the aim of making a significant change in the country while also affecting lives positively.
Mr Chidebe said the high number of people especially women soliciting funds on the streets of Abuja was one of the major factors that inspired him to start the organisation.
"Another factor is my zeal to contribute to the development of the nation. During my National Youth Service Corp (NYSC), I decided to do community service on breast and cervical cancer and 28 September 2013 was the first time I hosted an awareness and screening event in Kabusa, Abuja.
"The event was well attended and many people were screened and had one on one with health practitioners. The turnout and appreciation inspired me to keep going," he said.
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He said cancer has continued to claim millions of lives due largely to the high cost of treatment. He lamented that the cost of treatment discourages people from even visiting the hospital for a proper diagnosis.
Mr Chidebe said his organisation has supported over 5,000 cancer patients financially since its establishment in 2013, including Ms Nnamdi and Ms Catherine.
"So far, we have reached about 20 million people indirectly through various awareness walks and advocacy programmes. Directly, the organisation has supported 5,000 people through patient fundraising, cancer, hypertension, and hepatitis screening.
"This direct impact of the organisation also includes the 44 cancer doctors trained in 2018 and 44 oncology pharmacists trained in 2021 sponsored by this organisation," he said.
He said the organisation sometimes uses the picture of a cancer patient to solicit funds from the general public and puts the money into an account of both parties; the organisation and one that the patient has access to.
Challenges
The Project Pink Blue founder said despite successes recorded in the past years, the lack of adequate donations has been frustrating the efforts of the organisation.
He said the organisation lacks sufficient funds to meet the demands of the number of people battling cancer.
"The number of people seeking help is far higher than those willing to donate. People are not donating so we are incapable of meeting the demands of everyone," he said.
Mr Chidebe said another challenge is that the Nigeria health system is making it difficult for patients to get early treatment. He said many people abandon the hospital once they are diagnosed with cancer due to the inability to afford the treatment fees.
"The healthcare system is responsible for late detection. If we want to find cancer early and ensure women present early for treatment, the system must be built in a way that we will stop blaming patients," he said.
This story was produced in partnership with Nigeria Health Watch through the Solution Journalism Network, a nonprofit organisation dedicated to rigorous and compelling reporting about responses to social problems.
