Health
Prevention, Detection, Care For Cancer (II)
Minister of Health, Dr. Isaac Adewole
This is the concluding part of this article first published on the 10th of February, 2016
According to the latest
analysis released on World Cancer Day by Cancer Research, United Kingdom, cancer death rate has fallen by almost 10 per cent in the last 10 years. In 2013, 284 out of every 100,000 people in the UK died from cancer – around 162,000 people. A decade ago, this was 312 in every 100, 000. Similarly, the World Hepatitis Alliance said that 80% of liver cancer deaths can be prevented, saving hundreds of thousands of lives each year globally, and called for the establishment of comprehensive hepatitis strategies to help prevent the 800,000 liver cancer deaths each year.
While marking the World Cancer Day, The Hope Light Foundation launched the “Beacons of Hope” project to unite lighthouses throughout the world to work together in the fight against cancer, just as the Irish Cancer Society used the occasion of the celebration to call on the public to support its message: “We can shape policy change” by working with influencers to close the cancer gap.
The Health and Environment Alliance (HEAL), also called on Europe’s most influential cancer societies to urge governments to put an immediate ban on glyphosate, a chemical used as a herbicide. In a letter sent on World Cancer Day, HEAL’s President, Dr Peter van den Hazel, reminded leading national cancer groups that a ban on glyphosate represents a significant opportunity in cancer prevention.
In Nigeria, a litany of events have been held in different cities, including Port Harcourt, Lagos, Abuja, Enugu, Asaba, and elsewhere, to draw attention to the rampaging effects of cancer, and how, as a people, we can prevent its spread through early testing, detection, treatment and care. More events are still being organized to enhance public awareness on the disease.
At an event in Abuja, National Coordinator, Cancer Control Programme, Dr Ramatu Hassan, said that the Federal Government has concluded plans to upgrade the programme to National Agency for Control of Cancer. In addition, Chairman, National Committee on Cancer Control, Prof Francis Durosinmi-Etti, emphasized the need for more private-public partnership to boost access to cancer care across the country. Both also called for greater awareness amongst Nigerians of the urgency for concerted action to curb the menace of cancer in our national life by committing to early preventive care, testing, detection, treatment and support for survivors.
In Rivers State, Chief Medical Director, Hospitals Management Board, Dr Dorathy Oko called for synergy among all stakeholders to increase awareness, boost testing and detection, and encourage requisite treatment, further stressing that there was need to use knowledge to demystify cancer. She listed free cancer screening and testing centres in the state to include the Braithwaite Memorial Specialist Hospital (BMSH) and University of Port Harcourt Teaching Hospital (UPTH).
For the avoidance of doubt, it is important to note the link between lifestyle and cancer risk. According to WHO, four non-communicable diseases (NCDs) – cancers, cardiovascular diseases, respiratory diseases and diabetes – are responsible for 80% of all deaths from NCDs worldwide. This is despite the fact that there is a clear link between lifestyle and non-communicable diseases. Indeed, about a third of the most common cancers can be prevented through diet, maintaining a healthy weight and taking regular physical activity. Therefore, behaviour change is key to the prevention and control of non-communicable diseases, particularly as the number of cancer cases are expected to rise globally over the next two decades.
However, there are 10 cancer prevention recommendations generally accepted by experts globally. There cover body fatness; physical activity; foods and drinks that promote weight gain; plant and animal foods; alcoholic drinks; preservation, processing, preparation; dietary supplements; breastfeeding; and cancer survivors.
The first is to be as lean as possible without becoming underweight. In fact, research shows that there is strong evidence that weight gain, overweight and obesity increases the risk of a number of cancers, including bowel, breast (postmenopause), prostate (advanced cancer), pancreatic, endometrial, kidney, liver, gallbladder, oesophageal (adenocarcinoma) and ovarian cancers. Therefore, maintaining a healthy weight – through a balanced diet and regular physical activity – helps reduce the risk of developing cancer. Thus, ensure you are as lean as possible within the normal range of body weight. It is vital to ensure that your median adult body mass index (BMI) is between 21 and 23, depending on the normal range for different populations. Also ensure that body weight through childhood and adolescent growth projects towards the lower end of the normal BMI range at age 21. Maintain body weight within the normal range, and avoid weight gain and increases in waist circumference throughout adulthood.
The second is physical activity. Experts advise physical activity for, at least, 30 minutes every day. Be moderately physically active, equivalent to brisk walking, for at least, 30 minutes every day. As fitness improves, aim for 60 minutes or more of moderate, or for 30 minutes or more of vigorous, physical activity every day. Limit sedentary habits such as watching television.
The third is to avoid foods and drinks that promote weight gain. In fact, it is necessary to limit consumption of energy-dense foods, especially foods that are high in fats and/or have added sugars and/or low in fibre) and avoid sugary drinks. Ensure that the average energy density of diets are lowered towards 125kcal per 100g, just as you consume energy-dense foods sparingly, particularly “fast foods”, if at all.
The fourth is to eat more of plant foods, especially a variety of vegetables, fruits, whole grains, and pulses such as beans. Specifically, it is advised to eat, at least, five portions/servings (at least 400g or 14oz) of a variety of non-starchy vegetables and of fruits every day. Eat relatively unprocessed cereals (grains) and/or pulses (legumes) with every meal, and of course, limit refined starchy foods. However, those who consume starchy roots or tubers as staples should also ensure intake of sufficient non-starchy vegetables, fruits, and pulses (legumes).
While the fifth is to avoid animal foods, and if not possible, limit consumption of red meats (such as beef, pork and lamb) and also avoid processed meats, the sixth suggests drastic reduction in the intake of alcoholic drinks. In fact, if alcoholic drinks are to be consumed at all, limit consumption to no more than two drinks a day for men and one drink a day for women.
It is also necessary to limit consumption of salt and avoid mouldy grains and cereals, by limiting intake of salty foods and foods processed with salt (sodium). Minimise exposure to aflatoxins from mouldy cereals (grains) or pulses (legumes). Particularly avoid salt-preserved, salted, or salty foods; preserve foods without using salt, and limit consumption of processed foods with added salt to ensure an intake of less than 6g (2.4g sodium) a day.
Furthermore, do not use dietary supplements to protect against cancer, but aim to meet nutritional needs through diet alone. This is because dietary supplements are not recommended for cancer prevention. Also, breastfeeding is best strategy to prevent cancer. It is best for mothers to breastfeed exclusively for up to 6 months, and then, add other liquids and foods as complementary thereafter. Reasons: Breastfeeding protects both mother and child from diseases, including cancer. Lastly, after treatment, cancer survivors should strictly follow the recommendations for cancer prevention, and ensure they receive nutritional care from an appropriately trained professional. If able to do so, and unless otherwise advised, aim to follow the recommendations for diet, healthy weight, and physical activity.
To achieve a cancer-free society, therefore, it is vital that we inspire and take action; make healthy lifestyle choices; prevent cancer; understand that early detection saves lives; challenge perceptions; and ask for support. Besides, we must create healthy environments; support others to overcome; help improve access to cancer care; take control of our individual cancer journey; help build a quality cancer workforce; pursue love, and be loved; and mobilise our networks to drive progress. We also have to have confidence in ourselves; work assiduously to shape policy change; return to work when we are fit; make the case for investing in cancer control; share our story; work together for increased impact; and speak out against those things that promote cancer epidemic.
Let’s go for counselling, and follow up with testing. That will enable detection, treatment and care that we desperately desire.
Susan Serekara-Nwikhana
To address the increasing number of rape and defilement cases in Lagos communities, the State Ministry of Health has trained healthcare workers on the prevention and management of sexual assault cases.
The Director, Public Affairs in the ministry, Tunbosun Ogunbanwo, in a statement on Monday said the training equipped health workers with the knowledge and skills to provide professional, compassionate, and timely care to survivors.
Dr Folasade Oludara, Director, Family Health and Nutrition, State Ministry of Health, said the growing number of rape and defilement cases in Lagos communities necessitated the upskilling of healthcare workers who are often the first responders to survivors.
Oludara, represented by Dr Oluwatosin Onasanya, Deputy Director, Child Health, said the government recognised the critical role of health professionals in both clinical management and legal documentation of sexual assault cases.
She explained that the training was designed to ensure healthcare workers are adequately equipped to identify, document, and manage sexual assault cases effectively.
According to her, the training will strengthen Lagos’ coordinated health system response to gender-based violence.
She disclosed that the state government had already provided equipment and specimen collection tools to health facilities, noting that the training complemented this investment by building the competence of personnel handling such sensitive cases.
Oludara explained that doctors and nurses at the primary, secondary, and tertiary levels who serve as first contact points for survivors were carefully selected from all 57 LGAs and LCDAs, particularly from areas with higher incident rates.
The SGBV Programme Manager, Lagos State Ministry of Health, Dr Juradat Aofiyebi, emphasised that the capacity-building initiative was a strategic step toward improving survivor-centred healthcare delivery and prosecution outcomes.
Aofiyebi added that the training underscored the government’s commitment to reducing the prevalence of sexual assault through a robust, multi-sectoral approach.
“The training provides healthcare workers with the knowledge to properly identify survivors, document findings accurately, and provide comprehensive care, all of which contribute to justice delivery and prevention of repeat offences.
She said the ministry would sustain such training to ensure that every survivor who presented at a Lagos health facility received quality, non-judgmental care.
Mrs Adebanke Ogunde, Deputy Director, Directorate of Public Prosecutions (DPP), Lagos State Ministry of Justice, highlighted the importance of medical documentation in sexual assault trials.
She explained that most convictions hinge on the quality of medical reports and forensic evidence provided by healthcare professionals, noting that medical reports served as vital corroborative evidence in court, particularly in cases involving children.
“Your medical reports are crucial; they can determine whether justice is served or denied,” she said.
Ogunde reminded health workers of their legal duty to report suspected sexual assault cases to the police or the Lagos State Domestic and Sexual Violence Agency (DSVA).
Similarly, Dr Oluwajimi Sodipo, Consultant Family Physician, Lagos State University Teaching Hospital (LASUTH), underscored the importance of timely medical attention, psychosocial support, and non-stigmatising care for survivors.
Sodipo explained that immediate presentation within 72 hours of assault improved chances of preventing infections and collecting viable forensic evidence.
He commended Lagos State for sustaining its inter-agency collaboration and continuous professional training on SGBV.
Sodipo, however, called for the strengthening of DNA and forensic capacities, improved insurance coverage, and better remuneration for healthcare workers.
“We must sustain motivation and continuous retraining if we want to retain skilled professionals and enhance justice outcomes,” he added.
Also, Mrs Margret Anyebe, Claims Officer, Lagos State Health Management Agency (LASHMA), said domestic and sexual violence response had been integrated into the ILERA EKO Health Insurance Scheme.
Anyebe explained that survivors of sexual and domestic violence are covered for medical treatment, investigations, and follow-up care under the state’s Equity Fund for vulnerable groups.
“Hospitals are to provide first-line care, document, and refer survivors appropriately, while LASHMA ensures prompt reimbursement and oversight,” she said.
The technical session of the ongoing National Council on Health (NCH) meeting on Monday reviewed 35 out of the 82 policy memos submitted ahead of full Council deliberations scheduled for later in the week.
Dr Kamil Shoretire, Director of Health Planning, Research and Statistics, disclosed this on Tuesday during the Technical Session of the 66th Regular meeting of the NCH ongoing in Calabar, Cross River.
He said that 10 of the memos considered were recommended for Council’s approval, eight were noted, and 18 stepped down for further work.
According him, two additional memos were deferred and will be re-presented after revisions are made.
At the reconvening of the session, Ms Kachallom Daju, Permanent Secretary, Ministry of Health and Social Welfare, said that there were five memos from the Coordinating Minister of Health, adding that they were all related to the Department of Food and Drugs.
Daju said that the memos were stepped down on Monday and scheduled for re-presentation.
She also provided clarification on the previously contentious healthcare waste-management memo, explaining that the N3.5 million requests tied to the proposal had already been repurposed by the Global Fund.
“I have followed up, and I am informed that the funds have been reprogrammed. Just so we put it to rest, we will not be discussing that memo anymore,” she said.
She also said that the final memo considered on Monday was the proposal for the inclusion of telemedicine services under the National Health Insurance Authority (NHIA).
“The next memo scheduled for presentation is the proposal for the establishment of Medipool as a Group Purchasing Organisation (GPO) for medicines and health commodities in Nigeria.
Meanwhile, Dr Oritseweyimi Ogbe, Secretary of the Ministerial Oversight Committee (MOC), formally notified the Council of the establishment of Medipool, a new public-private GPO created to strengthen the procurement of medicines and health commodities nationwide.
Presenting an information memorandum at the technical session, Ogbe explained that Medipool was the first nationally approved GPO designed to leverage economies of scale, negotiate better prices, and ensure quality-assured medicines.
He said this was beginning with primary healthcare facilities funded through the Basic Health Care Provision Fund (BHCPF).
According to him, Medipool was established after a proposal to the Ministry of Health, followed by appraisals and endorsements by the Project Implementation and Verification Committee (PIVAC) and the Ministry of Finance Incorporated (MOFI).
“It subsequently received Federal Executive Council approval, with MOFI now owning 10 per cent of the company’s shares. The Infrastructure Concession Regulatory Commission has also approved its operations.
“Under the model, Medipool will work with Drug Management Agencies (DMAs) in all states to aggregate national demand and negotiate directly with reputable manufacturers to obtain competitive prices and guaranteed-quality supplies.
“The platform will function as a one-stop shop for DMAs, who will then distribute medicines to health facilities through existing state structures.”
Ogbe added that while Medipool will initially focus on BHCPF-supported primary healthcare centres, it was expected to expand to other levels of care nationwide.
“The organisation will provide regular reports to the ministry of health and participate in national logistics working groups to ensure transparency, oversight, and technical guidance,” he said.
The News Agency of Nigeria (NAN) reports that Day One of the 66th NCH technical session opened with a call reaffirming the Ministry’s commitment to advancing Universal Health Coverage under the theme “My Health, My Right”.
“The delegates also adopted the amended report of the 65th NCH, setting the stage for informed deliberations.
The implementation status of the 19 resolutions from the previous Council was also reviewed, highlighting progress and gaps.
The authorities of Police Clinic in Port Harcourt have reported high cases of Malaria in its facility.
The revelation was made by Mrs Udoh Mba Robert, a Chief Superintendent of Police and senior medical personnel in the Clinic.
She told The Tide that,”the Hospital admits sixty (60) to seventy (70) patients in a month”.
On how the facility runs, she stated that the hospital is under the National Health Insurance Scheme as most patients are treated almost free.
She maintained that staff of the hospital have been trained professionally to manage health issues that come under the purview of the National Health Insurance Scheme.
Mrs. Robert explained that malaria treatment also falls under NHIA, as patients are expected to pay only 10 per cent for their treatment while the government takes care of the outstanding bills.
NHIA, she further stated covers treatment and care for uniform personnel like the police force, military men, civil servants and all others working for the government.
Urging the public to seek professional medical attention, Mrs. Robert said the facility is open to workers in the federal services, especially police staff.
Favour Umunnakwe, Victory Awaji, Excel Nnodim
