Being a patient of any ailment in Nigeria is challenging because of the less than adequate health services.

It is even more challenging and particularly frustrating for patients of cancer diseases, end stage kidney disorders, heart diseases and other chronic ailments.

They are often compelled to run from pillar to post trying to raise funds to travel abroad to obtain treatment because the facilities and expertise are unavailable in Nigeria.

The hope of millions of Nigerians is that the government and the public sector should raise the ante, and provide the enabling environment and lead the way to take healthcare to the next level in Nigeria.

In this encounter, Segun Akintunde, a middle-aged man diagnosed with prostate cancer a decade ago, speaks about his frustrations as a cancer patient in Nigeria. Excerpts:

My frustrations began in 2010, when I did a biopsy. I did not know I had a prostate problem. My frequency of urination was high and I thought it was diabetes. I went to the hospital, and although my sugar level was okay, a scan showed that my prostate was enlarged.

From there, a Prostate Specific Antigen, PSA, test was recommended. I had been to the hospital earlier in 2009 and was recommended to do all these tests, from scan to the PSA test, and the doctor said I had to do biopsy because the PSA was not conclusive although it could be indicative. I did the PSA and biopsy and my problem started.

Two weeks after I did the biopsy, my result came out but the hospital pleaded with me that I had to repeat the biopsy because as they said, enough tissue was not taken the first time. I knew the pain I went through doing it and I was reluctant to do it again.

Eventually, I found myself in Germany where I repeated the PSA and it was still high but before I could do the biopsy, my visa had expired and I returned to Nigeria to continue with tests.

I was placed on antibiotics, but my PSA was still going up. It took another year before I went to India. The point is that the first biopsy I did had been okay and I obtained the correct result, I would not have gone abroad. That was my first frustration.

When I went to the Fortis Hospital, in India, I was placed on antibiotics, painkillers and other drugs. I did another biopsy and did not have the pain I had in Nigeria, that was when the result showed that I had prostate cancer.

Treatment started, but my PSA was so high that I could not start radiotherapy immediately. The doctors advised that the PSA had to go down first. Normally, the PSA should be around 4.0: if it is 5.0 – 7.0 it is considered high, but mine was reading up to 180 and that was alarming.

I had 36 sessions of radiotherapy, and I have done brachytherapy. I go to India two or three times a year and that cost so much money. If there was good healthcare in Nigeria I would not have to do that. This is another frustration.

This brings me to one of the bigger frustrations. I did high dosage brachytherapy in 2018, and during my last check-up, there was a biochemical failure and the doctor had to do low dosage brachytherapy. Afterwards, he gave me an appointment to return.

I have been going to India since 2010, but for the first time, I had to complain. I told the doctor that I’m an African, I live in Nigeria and it costs money to be going to India three times in a year. He tried to help and said if I could get a place to do Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET) scans in Nigeria and send him the result, I would not have to travel back to India.

A PSMA PET scan is a test that can identify and pick up cancerous cells in any part of the body. I have tried as much as I can, but I cannot get this test done in Nigeria. So, in three months I would be going back to India because there is no place that I can do that scan in Nigeria.

It is very frustrating, I feel for myself but feel more for Nigeria, that a country that is as huge would lack these facilities and lack healthcare which I feel government should consider a priority.

In 2017, when I went for a routine check, I was okay and strong; the same PET scan showed residual uptake, and that was when brachytherapy was recommended.

Before then, I was on Zoladex injection. It is a kind of steroid that brings down the PSA and prevents the cancer from spreading but it has side effects including osteoporosis. The bones can be affected, it also affects libido, causes enlarged breasts, pains, etc.

Another thing are the drugs. Getting genuine drugs in Nigeria is an issue. Whenever I’m to travel to India, many other cancer patients and those with kidney and liver issues and all types of ailments, ask me to help buy drugs.

They practically beg for the favour because the drugs in Nigeria are adulterated. I remember I once had a bag full of drugs while I was travelling. When I was stopped by the immigration and they saw that I had so many drugs, I explained that I was a cancer patient and when they checked my papers, they let me go.

But in the bag were drugs for all sorts of ailments—diabetes, kidney, liver problems, etc. This development is embarrassing and a big problem for patients who travel. When you run out of your drugs you have to look for someone who is travelling to help you buy because the ones in Nigeria are substandard.

There are some of these drugs that require special preservation. For instance, Zoladex has to be at a certain temperature and with the epileptic nature of electricity in Nigeria, one has to spend extra to make sure it is well preserved.

I remember I used to buy enough to last one year. These are some more of the frustrations. I do know that there will be returns from healthcare if the government, the public and private sectors venture into it as business instead of just allowing people to die.

You can imagine the number of people that would be doing the PET scan. Really, I do not know why we are not seeing healthcare as business. Even if you can afford it, you would fly economy class to go to India, you will pay about N600,000, you will stay in a hotel, hire taxi to run around, etc., that is a lot of money, even it is just for checkup, we are talking of about N1.5 million and you have to go three times in a year, it is too expensive.

So what about those who cannot afford it? Now science is helping out, there are researches and medications are coming out to give hope that cancer is no longer a death sentence. Cancer patients are living longer and healthier, is it the same story for the patients in Nigeria?

It should be the same story. We are now talking of proton therapy. Proton therapy targets cancerous cells directly and spares the good cells unlike other types of therapy that in trying to destroy the cancerous cells also destroy the healthy cells and this tends to lead to making the cancer patient have low immunity.

I have heard instances where cancer patients die of other infections and situations other than cancer itself because of low immunity. Indians make so much money from Nigerians and are looking for ways to come to Nigeria now to build hospitals and start running them. If they do that, the money will be flying back to their country.

When we go to India they charge us higher than their own people and we pay 25 percent surcharge as foreign patients—this is a lot of money. And we pay so willingly.

So, I would urge our entrepreneurs, the Aliko Dangotes, the Femi Otedolas, and the Adenugas, let them go into healthcare as business, because so much of our money is in flight. India has invested so much in healthcare and education and it is helping them, they are making so much money from medical tourism and it feels odd that Nigeria cannot do it.

When they see so many Nigerians in their country for treatment, they wonder why we can pay the bills but don’t have good hospitals in Nigeria. And that is what is making so many medical staff want to come to Nigeria to start running medicals.

They know that their own people cannot afford to pay for these treatments but we just pay, so they are wondering how come we can pay the bills, but cannot establish such hospitals in our own countries. I have been asked so many times, why we do not have good hospitals in Nigeria. I feel bad when I’m asked this question.

What surprises me is why the government and even the private sector have not taken healthcare as business. We travel abroad for treatment and see the number of people who travel. When we get there we are charged 25 percent surcharge for foreign patients—that is a lot of money. Imagine if you are charged $50,000 and you still have to pay 25 percent surcharge as a foreign patient. This is what we face.

If the Federal and state governments as well as the private sector took health as business and built some state-of-the-art hospitals in Nigeria, we would not be going abroad and Nigeria would be making some money from health business.

I feel that Nigerians can make so much money investing in healthcare. We are paying so much going abroad, we see so many Nigerians paying for treatment that can be obtained in Nigeria if only we took these things seriously.

The PSMA PET-CT scan is the current industry standard for prostate cancer diagnosis and treatment. It helps in the early detection, staging and follow up of prostate cancer cases. It is currently unavailable in Nigeria, patients have to travel to India or Europe to access it at great costs.

My frustrations began in 2010 when I did a biopsy. I did not know I had a prostate problem. My frequency of urination was high and I thought it was diabetes. I went to the hospital, and although my sugar level was okay, a scan showed that my prostate was enlarged. From there, a Prostate-Specific Antigen, PSA, test was recommended.

I had been to the hospital earlier in 2009 and was recommended to do all these tests, from scan to the PSA test and the doctor said I had to do biopsy because the high PSA was not conclusive although it could be indicative.

I did the PSA and biopsy and my problem started. Two weeks after I did the biopsy, my result came out but the hospital pleaded with me that I had to repeat the biopsy because as they said, enough tissue was not taken the first time. I knew the pain I went through doing it and I was reluctant to do it again.

Eventually, I found myself in Germany where I repeated the PSA and it was still high but before I could do the biopsy, my visa had expired and I returned to Nigeria to continue with tests. I was placed on antibiotics, but my PSA was still going up.

It took another year before I went to India. The point is that if the first biopsy I did had been okay and I obtained the correct result, I would not have gone abroad. That was my first frustration.

When I went to the Fortis Hospital, in India, I was placed on antibiotics, painkillers and other drugs. I did another biopsy and did not have the pain I had in Nigeria, that was when the result showed that I had prostate cancer.

Treatment started, but my PSA was so high that I could not start radiotherapy immediately. The doctors advised that the PSA had to go down first. Normally the PSA should be around 0.4: if it is 5.0 – 7.0 it is considered high, but mine was reading up to 180 and that was alarming. I had 36 sessions of radiotherapy, and I have done brachy therapy.

I go to India two or three times a year and that cost so much money. If there was good healthcare in Nigeria I would not have to do that. This is another frustration. This brings me to one of the bigger frustrations. I did high dosage brachy therapy in 2018 and during my last check up, there was a biochemical failure and the doctor had to do low dosage brachy therapy. Afterwards he gave me appointment to return in three months. I have been going to India since 2010, but for the first time, I had to complain.

I told the doctor that I’m an African, I live in Nigeria and it costs money to come to India three times in a year. He tried to help and said if I could get a place to do Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET) scans in Nigeria and send him the result, I would not have to travel back to India if it is not necessary. They would only invite me if result of the test indicates so.

These are some more of the frustrations. I do know that there will be returns from healthcare if the government, the public, and private sectors venture into it as a business instead of just allowing people to die. You can imagine the number of people that would be doing the PET scan. Really I do not know why we are not seeing healthcare as a business.

Even if you can afford it, you would fly economy class to go to India, you will pay about N600,000, you will stay in a hotel, hire taxi to run around, etc., that is a lot of money, even it is just for a check-up, we are talking of about N1.5 million and you have to go three times in a year, it is too expensive. So what about those who cannot afford it?

Now science is helping out, there are researches and medications are coming out to give hope that cancer is no longer a death sentence. Cancer patients are living longer and healthier, is it the same story for the patients in Nigeria? It should be the same story.

We are now talking of proton therapy. Proton therapy targets cancerous cells directly and spares the good cells unlike other types of therapy that in trying to destroy the cancerous cells also destroy the healthy cells and this tends to lead to making the cancer patient have low immunity. I have heard instances where cancer patients die of other infections and situations other than cancer itself because of low immunity.

Indians make so much money from Nigerians and are looking for ways to come to Nigeria now to build hospitals and start running them. If they do that, the money will be flying back to their country. When we go to India they charge us higher than their own people and we pay 25 percent surcharge as foreign patients – this is a lot of money. And we pay so willingly.

So I would urge our entrepreneurs, the Aliko Dangotes, the Femi Otedolas, and the Adenugas, let them go into healthcare as a business, because so much of our money is in flight. India has invested so much in healthcare and education and it is helping them, they are making so much money from medical tourism and it feels odd that Nigeria cannot do it.

When they see so many Nigerians in their country for treatment, they wonder why we can pay the bills but don’t have good hospitals in Nigeria. And that is what is making so many medical staff want to come to Nigeria to start running medical business. They know that their own people may not afford to pay for these treatments but they have insurance.

You see very poor Indians going through treatments you know that they cannot afford. It is insurance. Good healthcare system. In Nigeria such people will die. But when they bill Nigerian highly we just pay, so they are wondering how come we can pay the bills, but cannot establish such hospitals in our own countries.

I have been asked so many times, why we do not have good hospitals in Nigeria. I feel bad when I’m asked this question. What surprises me is why the government and even the private sector have not taken healthcare as a business. We travel abroad for treatment and see the number of people who travel.

I have also gone for treatment in United States and the UK and I know how expensive it is especially for cancer care. When we get India we are charged 25 percent surcharge as foreign patients – that is a lot of money although it is cheaper than going to Europe or America. Imagine if you are charged $50,000 and you still have to pay 25 percent surcharge as a foreign patient. This is what we face. If the Federal and State governments as well as the private sector took health as a business and built some state-of-the-art hospitals in Nigeria, we would not be going abroad and Nigeria would be making some money from health business.

India is good on healthcare. You can compare. many of their hospitals and schools with those in Europe and America. They are doing well with healthcare. When I entered the theatre for brachy therapy I saw gadgets and developed confidence that one would not die here if it is not the will of the Almighty Creator.

They have facilities and manpower. I feel that Nigerians can make so much money investing in healthcare. We are paying so much going abroad, we see so many Nigerians paying for treatment that can be obtained In Nigeria if only we took these things seriously.

Now, I have to travel to India to do a test that no Nigerian facility offers. How painful it is. How frustrating it is. And what about those who cannot afford such costs? Nigeria can do better.

We thank God for His mercies and pray He touches the hearts of our leaders to change and make us a better country. (Vanguard)