Comfort Daniel, a breast cancer patient, has been having problems with her radiotherapy treatment in Nigeria.
A linear accelerator is needed to conduct the treatment. There are only eight of such machines in the country; and often, most of them are not working.
So, cancer patients like Ms. Daniel in Nigeria have to wait for days or months for radiotherapy sessions, often leading to complications in their conditions.
Ms. Daniel was diagnosed with an aggressive form of breast cancer (HER 2- Positive) for which she had surgery. Because the cancer had spread to her head and lungs, she needed urgent radiotherapy sessions after the surgery.
But she could not get the service in any of the federal teaching hospitals which have seven of the linear accelerator machines in the country. All the machines there had packed up.
“It was a very sad experience for me,” she told this newspaper this month in Abuja.
“The operation to remove the breast was not the main thing; getting radiotherapy treatment as soon as possible and not breaking it was the problem.
“I had no problem with the surgery as I had already made up my mind that it (her breast) should be removed and I had started my chemotherapy treatment as well.
“But I need radiotherapy to attack the spread of the cancer cells and that has been one of my major challenges, because even if you are holding money, you are still not able to get it done because most of the machines have broken down.
“I had to leave National Hospital, Abuja to Usmanu Danfodiyo University Teaching Hospital, Sokoto thinking I would be able to get the radiotherapy done.
“I had called the hospital a day before and was told the machine was working. But when I got to Sokoto, I was told the machine had packed up the previous day and that it might take them weeks to get the spare parts to fix it.
“I could not wait. My case was urgent. The cancer has gotten to my head and we need to stop it from getting to the brain. So, I had to proceed to Lagos, to Eko Hospital, the only private hospital with a machine working in the country,” she explained.
Investigations by PREMIUM TIMES confirmed that there are only eight radiotherapy machines in the whole of Nigeria. Seven of them are in different teaching hospitals across the country, the eighth being the one at Eko Hospital in Lagos.
The number of cancer patients in the country requiring radiotherapy at any time will stretch the facilities even if all the eight machines are working. But at no point ever have all the eight been fully functional. Patients thus have to book and await their turns for the procedure. For some, their turns never come before they succumb to the killer disease.
Radiotherapy is one of the key regimens in the painful fight against cancer. A cancer patient often needs the treatment at one point or the other. And experts say it is often better not to start it than to have a break in the sessions.
Gloria Orji has been a breast cancer survivor for six years. She has a rare lucky case with radiotherapy treatment in Nigeria. She believes it was this luck that helped her to win her battle against the disease.
“I was diagnosed early at Stage One. But I still needed to do radiotherapy treatment. I had 25 sessions of radiotherapy and I am glad to say I am one of those who got treatment in Nigeria and had no break in sessions,” Ms. Orji said.
Experts understandably attribute the constant breakdown of the few linear accelerators in the country to overuse and old age.
A NEW NOT YET OPERATIONAL MACHINE
PREMIUM TIMES discovered that the National Hospital, Abuja has a “new” cancer machine bought in 2013. But it is yet to be functional as it is still undergoing installation and calibration.
A source at the hospital said no one is sure when the process will be concluded. The calibration “will take some time,” the source said.
“The log output from the machine is being taken to South Africa for confirmation and this is taking years to finish.
“It is necessary to do the calibration so as to be able to set the machine to get the right measure of radiation for treatment of patients.
“We are not only spending money and wasting time on trying to get the machine functional, we are losing patients as well every day.
“And the longer the machine stays before installation, the older the model becomes as well,” he said.
The Head of Department, management Information services, National Hospital, Tayo Haastrup, admitted that both radiotherapy machines in the institution are not working, one because it is old and got spoilt and the other which is new is under installation.
He however assured that the government is doing everything in it power to rectify the problems.
“We know the radiotherapy machines is done and we hope that there will be funding for the repair, however we have a new machine that is on ground and we have a new cancer centre and it is 80 per cent completed.
“The machine is there and we are just expecting a few things to do to make sure that it starts running. And we have the support of the minister to see it through and he is also rallying round to raise funds to complete it so that the new one can be running perfectly and we can put it to use.”
Mr. Haastrup also spoke on how the faulty machines affect the patients’ treatment.
“We will be able to solve lots of cancer problems if we can get both machines up and going. It is not that we have not being treating them, clinical have been ongoing,” he said.
“It is only the radiotherapy that has not been available as we have all the experts on ground. We have been sending some of our patients to Zaria and some of our patients on their own have been going to Eko hospital, in Lagos,” he added.
Rose Agbi, another breast cancer survivor urged the government to speed up intervention on radiotherapy machines. She said life has not been easy for most cancer patients who need radiotherapy but cannot get it.
“Not being able to have radiotherapy is an additional stress to the cancer patient who is already psychologically traumatised and in pain.
“The government should make radiotherapy available in every government hospital so that patients will not be left at the mercy of the private which is too expensive.”
Ms. Agbi said the machines that broke down could not be trusted to be efficient.
“We cannot even ascertain if they are still working properly and killing the cancer cells or just causing more harm,” she said.
In March last year, the Director General of the International Atomic Energy Agency, IAEA, Yinka Amano, said the installation of the new machine at the National Hospital would be completed the following month.
Seventeen months after he said this, the machine is yet to be made operational for use.
The Minister of Health, Isaac Adewole, while receiving the IAEA director, had said Nigeria needs about 200 radiotherapy centres to cope with the rising number of cases of the disease in the country.
He had lamented that Nigerians are getting less than 10 per cent of the radiotherapy services they need.
MINISTER ASSURES PATIENTS
In an effort to know what the government is doing to ease the plight of cancer patients; PREMIUM TIMES spoke with the health minister who assured that the government has not abandoned the patients.
Mr. Adewole said the government has made provision for radiotherapy machines for some health tertiary institutions in the 2017 budget.
“We have budgeted for radiotherapy machines in the 2017 budget, it was budgeted under strategic intervention for tertiary hospitals and we budgeted nine billion,” he said.
“We know that is not enough, that is why we are partnering with Nigeria Sovereign Investment Authority who will also put money, about two billion, into the project. We will also be looking elsewhere to generate more funds for radiotherapy,” he said.
A review of the budgetary provision shows that the N9 billion (N 9,000,302,402) was indeed in the budget as ‘strategic joint venture investments in tertiary institutions with Nigeria sovereign investment authority.’
The eight benefitting tertiary hospitals will be the UNTH in Enugu, UBTH in Benin, UCH in Ibadan, ABUTH in Zaria, UNIMTH in Maiduguri, OAUTH in Ife, National Hospital in Abuja, and LUTH in Lagos.
A configured linear accelerator costs about $4,000,000, (N 1.4 billion at N 350 per dollar), while prices for fairly used ones range from $750,000 to $1,500,000, depending on the year of manufacture, types of gadgets sold along with the machine, and location of the machine. This implies that the money budgeted could buy about six linear accelerators.
Aside from the N 9 billion, another N117,000,000 was also budgeted for cancer related issues in the 2017 budget of the Federal Ministry of Health.
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