Dr Jafaru Momoh is the Chief Medical Director of the National Hospital, Abuja. In this interview, he speaks on milestones recorded by the hospital in cancer treatment in the last few years, as well as how COVID-19 affected cancer care in the country among others.
Cancer care is a major public health concern in the country. How is the National Hospital, Abuja helping to tackle the disease?
The National Hospital, Abuja is a major cancer care center; and facilities have been provided by the government to ensure that the hospital is able to provide the care that cancer patients need at all levels; from the time of diagnosis, counseling to taking medications and other treatments.
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There are also radiotherapy and brachytherapy machines in the hospital for patients who require them for treatment.
We have two radiotherapy machines in the hospital. So we are one of the centres that are well equipped in Nigeria to care for cancer patients in terms of diagnostic and treatment facilities.
In the last three years, all our machines have been functioning and we have been able to maintain them to remain functional.
In 2017, the federal government commissioned a radiotherapy machine at the hospital , then in 2019, the Nigerian National Petroleum Corporation (NNPC) and Shell Nigeria Exploration and Production Company Limited (SNEPCo) donated another one to the hospital . How have the machines met the needs of patients?
The one bought by the federal government in 2017 is a multi- linac state of the art equipment. We also commissioned CT simulation which enables precise treatment in the facility. They have both remained functional since then. They have also been treating patients on daily basis.
NNPC joint venture and SNEPCO donated the second linear accelerator radiotherapy machine , and state of the art equipment for treating patients, and the equipment has also remained functional.
These two machines have ensured that there is no stoppage in treatment of patients . Because when one is undergoing maintenance, the other one is still functional , and when the two of them are working, they are able to treat so many patients.
Some years ago the hospital had challenges repairing the previous radiotherapy machine whenever it broke down because of lack of trained engineers. What is it like now in terms of maintenance for the two radiotherapy machines ?
We have trained in-house engineers for routine minor maintenance. We also have a management services agreement for routine maintenance on long term schedules maintenance attending to major faults and minor faults with the manufacturer.
Elekta is the company that manufactured the equipment . We have local partners that have trained engineers that are actually on ground . So we don’t have a downtime that is more than three days when they need to maintain . So this has worked perfectly for the past three years.
There is a referral system for cancer patients among teaching and tertiary hospitals in the country especially those with cancer treatment centres. Is your hospital being overwhelmed with referrals from hospitals whose radiotherapy machines break down frequently ?
Yes of course, we are the only center in the north that has two linac radiotherapy machines, the only other center in the country that has two linacs and is a government center is the Lagos University Teaching Hospital (LUTH) which is a Public Private Partnership (PPP).
Two or three centers in the north also have one linac each that are older and not so consistent , so that makes it quite tough for us to cope with the load of patients. But we are trying to make sure we have enough manpower.
So you can imagine the pressure we are under. Firstly, because we are cheaper, we can take much patients including those who cannot afford to pay fully, and also most of the hospitals in the north and north- central refer patients to us.
Colleagues across various teaching hospitals, Federal Medical Centers and state hospitals know that their colleagues here are working, and that our machines are working, that is why our hospital cancer center is always full.
So we are starting a program to train more manpower in these areas. We have taken more physicists, absorbed all our oncology consultants who qualify in the last five years, and will continue to take residents to train in these areas in other to always have adequate manpower. We also recently opened an additional clinical space for cancer care.
The government has given us all the necessary support to enable us cope with the work load.
Affordability is another issue with cancer care. What is your hospital doing to make care affordable for patients?
Because we are not running on a Public Private Partnership (PPP) , we are able to provide care for some indigents patients.
Governments has also provided some catastrophic funds to subsidize cancer treatment and the details of that is under the Ministry of Health, and patients can benefit from that as things work out.
How is the hospital deploying newer and innovative treatment modalities in the treatment of cancer?
There are standard treatment protocols and there are researches going on worldwide on newer treatment modalities.
In terms of what is available now, an experimental drug remains experimental until it is validated , and also approved by the National Agency for Foods and Drug administration and Control (NAFDAC).
So we will not just pounce on a drug because someone said it is working and give it to a patient. We have to make sure we follow all the protocols.
How do you think COVID-19 affected cancer care in the country?
During the first lockdown in the first wave, some patients were reluctant to come to the hospital for care. The lockdown affected access because even interstate travel was banned at a time.
So if you are referred from Enugu, Port- Harcourt, Sokoto etc and you are not able to travel it affects care. After the lockdown was eased, people all came in and we had to up our game to make sure we capture the backlog.
We also observed that because of the ban on international travel, a lot of Nigerians who could afford to travel abroad to access care returned home, and had to come and continue radiotherapy at the National Hospital, Abuja.
So that was when they knew we could do some of the things they travel out for , or they knew but chose to treat themselves in other countries. So inward bound medical tourism happened during that time.
The COVID-19 pandemic put more pressure on our staff, hospital, and resources . So we found that we have more cancer patients to take care of now not because cancer cases is more but because people could not travel abroad like before. That is people found it difficult to access care even when they have the money to go to other countries.
They were forced to come to us thereby increasing the work load that we have so this is the way it affected cancer care and affected other diseases as well.
What is your advice for Nigerians on cancer ?
Nigerians should remember that cancer is real. We know that there is COVID-19 pandemic but people should not abandon their routine medical checkup, and breast self-examination because of that.
And if they are in doubt, they should come to the hospital and get properly screened and examined via diagnostic procedures to be sure that they don’t have cancer. Women should do screening for breast cancer , while men should go for prostate cancer screening.
These cancers are the major concerns in our environment. So Men should go for checkup, and breast self-examination is what we encourage women to do. If they do regular checks like on monthly basis, and notice any changes, they should go to the hospital .That is my advice .
We also thank the government for its continuous support for the National Hospital, Abuja, through funding for us to continue what we are doing.
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