Zainab Bagudu, wife of the Kebbi State governor is a consultant paediatrician and the founder of MEDICAID Radio Diagnostic Centre, Abuja. She was present at the just concluded national health dialogue organised by the Premium Times Centre for Investigative Journalism and its partners.
She spoke extensively on wrong medical diagnosis, cancer and the need for the government to provide equipment for the treatment of the disease.
She also granted PREMIUM TIMES an interview.
PT: In the course of an investigation, we realised that most times, medical results are inaccurate. Can you give us reasons for this and what can be done?
ZAINAB: I don’t agree that it is most times but I will agree that we do have wrong diagnosis sometimes. But unfortunately, that ‘sometimes,’ even if it is one out a million lives, it is still a life. This is one of the reasons for setting up MEDICAID diagnostics centre. It is to address the problems that Nigerian doctors have with diagnosis. We have excellent doctors and when they go abroad, they excel. They do very well there but they don’t have the support needed in Nigeria. The doctors come back but they don’t excel as well simply because they don’t have the support they expect like laboratories, pathologists and the equipment they are supposed to have.
In my opinion, after running the MEDICAID centre for so long, the major challenge is not human resources or the skills of the doctors but it is the backup of the equipment and the system. The system includes things like power supply. There is nothing fantastic that the laboratories in the UK are doing, besides touching the buttons on the machine. We do the same thing on the machines in Nigeria but it gives you wrong results. This is because the light has affected one bulb or the other there and it’s not accurate anymore. Sometimes, (inadequate) resources is also an issue.
However, we have been able to stop economising now. People now pay for the right test and they get their money’s worth; but sometimes, you find out some laboratories will over-dilute reagents with water for economic reasons so that they can get more patients in.
With better regulation, the Association of Medical Laboratory Scientists, and the Association of Nigerian Radiographers are getting more powerful and regulating better and even the authorities are working better. When we started, we didn’t have any problem but now every year, FCT (Federal Capital Territory) comes to inspect our facility to make sure we don’t have rats and ensure that we have the right doctors. So, it’s getting more and more organised and we are bound to see that translate into better results.
PT: What can be done to reduce the cost of cancer screening tests, especially for those in the rural areas?
ZAINAB: That is one of the things we have been conversing about today. We all believe that the way forward for us as a country is to ensure we have universal health coverage and health insurance for all. This health insurance is not something we can just wake up and ask a farmer in the Kebbi to go and pay insurance. We have excellent insurance systems in developed countries like the UK. The NHIS is one of the best in the world even though they don’t believe it and there are countries like Sweden where they have the best insurance system. But this works very well because people pay into that pool. We don’t pay into any pool, yet we expect to have fantastic care. Majority of our people are in the rural areas and they are not paying any insurance. However, they expect to go to the hospital and have American class service, it’s not possible.
What could happen is, we start a system whereby we improve the level of care, we make it nice and right for the rural people. Let them receive proper treatment and let there be dignity in the way health care professionals, nurses treat these people. After enticing them, we can now start a simple insurance system where you will task even the local framer. Some states are practicing it already, though I don’t think it’s successful yet. But we will be able to get that right only if we make sure that the level of care that we are offering is reasonable and it is a pleasant experience for the people.
PT: A study shows that the North has the highest prevalence in cervical cancer. With your position as a governor’s wife and doctor, what are you doing to educate women on this?
ZAINAB: I think statistics are a little bit easy now. We are going through a transition period whereby there is a lot of information about family planning, women are knowing their rights and the ability to make decisions to have less children. We are actually seeing a decline in cervical cancer in the northern part.
However, that is just semantics, cancer is there whether is in the north or in the south. I have been working on cancer for some time now, even before becoming the wife of the governor. But being the first lady and mother of the state, gives me a platform now and a voice people listen to particularly in the state. The cancer foundation has done a lot of training, developing human resources.
We have done a lot of work really. We have gone to secondary schools to teach the girls about awareness. I work with market women, traditional and religious leaders. In our areas, it is very easy to cross the line between cultural misbeliefs, illiteracy and traditional beliefs. It all comes together and you have this horrible combination where people don’t go to hospitals and when the illness comes they don’t even know where to get the care. So, we are going out and informing people about all this, especially on cancer and maternal health.
Another health area is immunisation because there are a lot of hindering beliefs around these things. People believe that cancer is an evil from the bush so they don’t immunise their children because they believe that you are going to make them sterile. So, we have outreach programs, we have free screenings too.
In the state, we are working with doctors and nurses in particular and teaching more and more people how to screen. We are helping to set up screening centres in every general hospital in Kebbi State. And we have the usual awareness, jingles, plays just to inform people about cancer. We are getting to the point where people know that, before it gets to a particular stage you have to visit the hospital. This may not happen in our four years stay, but very soon it will happen.
PT: You have been running a diagnostic centre in Nigeria, what have been the challenges so far?
ZAINAB: The biggest challenge is funding for our equipment and to get it to work right. The power issue is a big problem for us. Most of all, when we need to upgrade our equipment, we need to get the funds for it. Not all the banks are receptive on papers as they sound. You will hear things like one per cent (in securing loans) but when the reality comes, you are getting a double figure loan plus the charges.
We have applied for loans several times and we have gotten those offers but we have been unable to take them up because of the terms attached to them. So, to get the equipment to start with is an issue. We cannot charge the amount we need to maintain and sustain them. The company that manufactures these products will not go into agreement with what we have in Nigeria. They won’t give us a lease. If I were to be in America and the machine goes bad, within 24 hours, a backup machine will be in my centre because of the kind of agreement that we have.
But realistically, we can’t do that in Nigeria and we don’t even have the companies that produce these machines. Over there, when they are given a replacement machine, they abandon the older ones but we can’t afford to do that here. Sometimes, we have to wait for three months for the technician to come from abroad. We may have the money to pay for it but the technician travels round, therefore he doesn’t have time to come at once. Nigerians need to go extra miles to reach our promised land.