As well as being the Chief Executive of Medicaid, Dr Zainab Bagudu, the First Lady of Kebbi State, is the founder of Medicaid Cancer Foundation (MCF), which creates awareness and funds cancer patients in Kebbi state and Nigeria as a whole. A Pedestrian and Neonatologist, Bagudu studied Medicine at the Ahmadu Bello University in Zaria and went on to London to specialize in Paediatrics and Neonatology. With her impressive medical CV and achievement, Zainab has served on many technical committees, including the steering committee for the National Cancer Control Plan and a Ministerial committee to build world-class diagnostic centres in six geopolitical zones of Nigeria. A passionate advocate for women, children, and youths, Zainab Bagudu is at the forefront of championing the awareness of cancer and also providing aid to those who need it most. In this interview, she speaks to FUNKE BABS-KUFEJI about her foundation, its progress and what she hopes to achieve in the cancer space in the nearest future.
You are in the medical field. Would you please tell us about your area of specialization?
I am a consultant paediatrician, and I translated my passion for the health and wellbeing of children into a career in diagnosing and managing children’s illnesses. I have had the privilege of over two decades in medicine, and I see a career in medicine as a higher calling to the wellbeing of humanity. This belief and perspective have driven everything I have done over the years, from the formation of Medicaid Radio-Diagnostics to the inception of the Medicaid Cancer Foundation(MCF).
You established an NGO as your pet project as the First Lady of Kebbi state; what is it called, how old is it, and what was the inspiration behind it?
I founded Medicaid Cancer Foundation 13 years ago; therefore, it is not a pet project due to my role as First Lady in Kebbi State. Working in the public sector, I was confronted with the challenges Nigerians faced accessing quality healthcare services. A qualified and enthusiastic medical personnel cannot gloss over gaps in infrastructure, knowledge and systems, so, 13 years ago, we decided to help tackle the lack of awareness about cancer in Nigeria. That decision has translated into many strides along the cancer cycle of care. We are working to advocate for the adoption of healthy lifestyles and vaccination as a means of prevention. We are advocating for improved access to screening and diagnostic services from the primary health care level upwards. We are also linking patients to subsidized and free treatment programmes. We are very committed to defeating cancer on all fronts.
What kind of services does your NGO provide, and what’s its relationship with the diagnostic centre?
At Medicaid Cancer Foundation, we are passionate about reversing the trend in cancer prevalence in Nigeria. We exploit traditional and new media platforms to spread cancer prevention messaging, increasing awareness and driving citizens to get screened if they are at risk. Most Nigerian women do not know that they should have a pap smear periodically, nor do men over 45 years of age know to get screened for prostate cancer annually, and MCF is helping to change that mindset. MCF also raises funds to support cancer warriors through their treatment journey; our Patient Access to Cancer Care (PACE) program collaborates with the pharmaceutical industry to provide therapies at a significant discount. We also provide psychosocial support to warriors, their caregivers, and their families through the 1CallAway program.
We are able to offer financial support and discounted screening and diagnostic services through our partnership with Medicaid Radio-Diagnostics & Clinics (MRD). MRD happens to be one of our major donors.
NGOs need heavy funding to succeed. What has been your biggest fundraising event, who are your sponsors?
Nigerians are our major donors! Individuals and corporate organizations have over the years, supported efforts to increase cancer awareness and access to care. Asides from MRD, UBA Foundation and Bank of Industry (BoI) have consistently supported our efforts.
Our biggest fundraiser is the annual walk for cancer, WalkAwayCancer. It took place on the 16th of October 2021 in Abuja this year. We set a 100 million Naira target for this year’s funds raising. By purchasing the walk shirts, caps, etc., we raised funds towards achieving that target. Like I said earlier, we also have established relationships with the pharmaceutical industry in Nigeria. They support cancer screening projects and access to care programs.
Many First Ladies have created NGOs focusing on different areas of the welfare of their indigenes, some of which have been quite successful. But the big question is why there is no continuity after their tenure, considering the act is for a good cause, why can’t these NGOs move from one successor to the other? Isn’t there a backlash due to discontinuity after every tenure?
It is important to note that MCF is in a unique position in this discourse; we have been at the forefront of cancer awareness and advocacy for the past 13 years. Consequently, it is a commitment that predates the tenure of the Governor of Kebbi State, Senator Abubakar Atiku Bagudu.
I have placed sustainability at the heart of all the efforts we have championed in Kebbi State, ensuring that we work through government institutions; we do not set up parallel structures. The platform my role in the state provides is channelled into working with willing partners to strengthen our state ministries of health, education, women affairs, etc. We work to leave a legacy that will support future governments to benefit the people of Kebbi State.
What plans are you putting in place to ensure your NGO continues to function in Kebbi State even after your tenure?
Our history and work, which predates my platform as a governor’s wife, has shown that our passion and commitment is not linked to political office. We will continue to advocate and champion the cause of cancer warriors and work to increase the adoption of healthy lifestyles as a means of prevention.
I have committed to building a foundation led by both the heart and the head in equal measure. Our passion is guided by a team of competent and technical leaders who will deliver sustainable interventions that will continue to secure support and partnerships locally and internationally. All initiatives of the Foundation are run in conjunction with the state Ministry of Health, which will ensure continuity in the future through the state Ministry of Health.
What advice will you like to give other First Ladies concerning the continuity of projects with their predecessors?
I will advise my colleagues, other First Ladies like myself, to prioritize the sustainability of their interventions, support the state structures and collaboratively accomplish their objectives.
We have shown how to do this in Kebbi State; the interventions we champion in cancer are institutionalized. The state Ministry of Health runs them, and my role is to use my platform to support the actualization of their efforts.
Aside from sponsors for your NGOs, do you have any collaborations with other First Ladies?
Yes, we work with First ladies from various states and their respective foundations. We have joined hands to form an alliance called First Ladies Against Cancer (FLAC). The coalition combines our collective strengths and platforms to increase awareness, access to cancer care and influence policy direction in Nigeria concerning cancer. Simply put, our collective aim is to reduce the cancer burden in Nigeria.
Concerning your primary care and aside from your NGO, what is Kebbi State itself providing for its indigenes to fight cancer?
The Kebbi State government has been committed to improving cancer care in the state; it is a trailblazer state in the nation in respect to this.
The State Ministry of Health launched the first state-level cancer registry in the country thanks to the data from this unit; we know the cancer prevalence trends in the state and let data drive the allocation of our resources. A cancer control desk was set up initially through my advocacy; this has now transitioned to a unit headed by an Assistant Director in the State Ministry Of Health. We are in the process of sponsoring a bill to make cancer awareness a mandatory part of governance. We also have a “road map” to reducing the burden of cancer in the state.
Kebbi State became the second state in the federation to publish its cancer control plan, which is now in its second year of implementation: Kebbi State Strategic Plan for Cancer Control. The state government launched an indigent cancer health fund; patients at our two cancer treatment centres in Birnin Kebbi can now access financial aid and free drugs towards their diagnostic and treatment needs.
The Governor has encouraged partnerships with the pharmaceutical industry and development partners, which has brought in significant investment in the capacity building of our health workers. Breast and cervical cancer screening are now available through our primary health care centres across the state, and this is key to achieving early detection, and I am most proud of it.
Do you believe cancer patients’ emotional and mental wellbeing should be taken care of because these play considerable roles in the outcome of their ailment?
Just hearing the doctor say the word “cancer” can profoundly affect a person’s mental and emotional health. A cancer diagnosis does not only affect the emotional health of a patient; it also takes a toll on their families and caregivers and can trigger a slide into poverty. Therefore, therapy must include care of the mind, and we are facilitating support groups to help clinicians with this at several centres through in-person and remote sessions. One of the best things patients and their families can do to improve their quality of life, is learn more about their cancers, making the disease less mysterious and frightening. Information from doctors (oncologists), survivors, and other credible sources can be beneficial in this regard.
Strange as it sounds, you say many middle-class people reject chemo as a form of treatment more than the rural class. Why is that?
Thank you for asking this question; the rejection of chemo by the Nigerian middle-class stems from a couple of places. Due to the low level of awareness about cancer in Nigeria, many of our people don’t think that cancer is a disease that Africans can have. Instead, they believe it is a “white man” disease and because of this notion; it is usually hard for people to accept their medical prognosis when they have cancer. They go through the stages of grief and sometimes find it hard to get out of the denial stage, which is why the onus is on us to change that narrative. Awareness and advocacy are just as important as the treatment itself because what good is having all that if there are Nigerians who would rather die silent than admit that there is an issue at hand.
How do you intend to create more awareness among rural people on the utmost importance of early detection?
Educating the healthcare workers that serve rural communities on cancer and building their capacity to conduct primary screening is the most effective and sustainable approach to addressing the current gap. We also work very closely with the community gatekeepers like Emirs, Imams and pastors.
Medical outreaches alone cannot solve the problem; it only reaches those that come out for the two or three days you are in the community. That is why we are constantly building the capacity of healthcare workers at the primary healthcare level in Kebbi State. These workers serve their communities and will champion awareness and screening services all year round.
This approach will eventually bring about awareness that will naturally demand screening services among our rural communities. We see something similar in the demand for insecticide-treated nets in rural communities now; this example also shows that we must keep at it. It will take dedicated action.
It’s been said that pediatric patients have a better prognosis; why is this so, and how old is the youngest patient your NGO has supported?
We supported a seven year old boy diagnosed with Leukaemia living in Bauchi State between 2020 and 2021. His grandmother reached out to the Foundation during the peak of the public health restrictions that restricted inter-state movement due to the COVID-19 pandemic. Though they had the funds, they could not get one of his chemotherapies in Bauchi and could not travel to Abuja to get it, so we had to leverage our designation as frontline workers to get the drug in Abuja and deliver it to his family home in Bauchi. We made this trip on two occasions. Unfortunately, we lost him in July 2021 after making significant improvements and even returning to school. Some context is needed for the second part of your question. In high-income countries where comprehensive medical services are accessible, childhood cancers have more than an 80% chance of being cured. In contrast, in low- and middle-income countries (LMICs) like ours, only an estimated 15 – 45% of cases are cured, which is usually due to lack of diagnosis or misdiagnosis, barriers to affordable or accessible care, which sometimes lead to the abandonment of treatment entirely.
Has your training as a paediatrician helped you cope better with cancer patients?
I am not sure about the word cope in your question. However, my training as a neonatologist has definitely helped sustain my dedication to cancer warriors in a very challenging environment. Working in a neonatal intensive care unit prepares one for emotional outcomes daily: some good, some bad. But most importantly, it has helped me institute a one-patient approach to our interventions at the Foundation, focusing on the need of the individual rather than the usual one size fits all approach we tend to see in our healthcare system.
We provide the support that is respectful of the individual, responsive to their needs, preferences and values.
You are on record to have said that some cancer patients are at risk of exploitation. How so?
The catastrophic impact of cancer on the lives of affected Nigerians is unfortunately now being exploited by unscrupulous elements in ‘fake’ fundraising and self-promotion. We have to do a lot of due diligence to ensure that people who approach us to support a cancer warrior do not exploit the intended beneficiary. We now channel our financial support to making direct payments to cancer centers when there is need to pay for drugs and making payments only in the name of the cancer warrior when we want to support their welfare.
From a medical background, even though no one can pinpoint one thing to causing cancer, what can one do to try and minimise their risk of contracting it?
Cancer is classed as a non-communicable disease. So you cannot “contract” cancer; however, infection with the Human Papillomavirus or Hepatitis B can result in developing cancer. Thankfully, there are vaccines available to prevent both diseases.
We champion prevention and screening because we are almost helpless when it comes to cancer. Adopting a healthy lifestyle reduces the risk of cancer significantly in your lifetime. You can reduce your risk of getting cancer by staying away from tobacco, including exposure to second-hand smoke. Exercising daily does wonders for your health; it helps keeps the doctors away. Cut down on processed foods and read the labels of the products you ingest or put on your skin; you need to limit your exposure to carcinogenic materials. Carcinogens are substances capable of causing cancer; a popular one around us in Nigeria is Asbestos!
Unfortunately, you can do all the right things and still develop cancer, which is why my response will not be complete by stressing the need to get screened regularly. Make your family doctor your friend, visit them for your annual check-up. Early detection saves lives!
Having worked with so many patients on their road to recovery, what recovery story stands out to you?
There is no one recovery story that is greater than another. There is resilience and lessons to learn in all the stories of the cancer warriors we work with. You must remember that living with cancer in Nigeria is literally like walking “through the valley of the shadow of death”. I must also point out that the road to recovery is not easy and is still uncommon because 80% of patients I see are diagnosed late, so the prognosis is poor.
The lovely Zainab Yakassai (in photo) is a survivor living life to the fullest; she is carrying on with her life almost as if cancer never happened. She is also a proud advocate who is helping many in their journey.
When you are not working with the NGO or diagnostic centre, what do you enjoy doing?
I love my tea time, it is always nice to have a good laugh, so I spend quality time with my family and friends. My younger ones are my stress busters, and we have a family WhatsApp group that keeps me in stitches. I also enjoy nature in all its forms and writing.
Being a northern woman where many women have their voices subdued because of religion or traditional beliefs, what words of encouragement do have to say to northern women to be more visible and heard in society?
In general, irrespective of where they are from, women face different barriers, so we must always have a strong will and support circle. My parents and husband are my support system.
The issue you have raised is not a Northern problem, it is a Nigerian, African, and global challenge that we are tackling heads on, and we can see that the narrative is changing all around us. Women are taking their place and letting their voices be heard across Nigeria. Their excellence across all walks of life is shattering the constructs and laws are being enacted to protect women and girls across the country.
What would you like to see accomplished in the cancer space in Nigeria over the next five years?
I would like to see an acceleration of eliminating vaccine-preventable cancers. I would like to see the National Primary Health Care Development Agency NPHCDA and State Primary Healthcare Development Agency work to deliver universal access to Human Papillomavirus vaccine and the Hepatitis B vaccine.
The federal and state governments should prioritize the actualization of universal health coverage for catastrophic conditions such as cancers. And the first step to achieving this will be, allocating 15% of the 2022 budget to health as this will help address many problems the sector faces.
Introduce cancer prevention and primary screening training into the curriculum of healthcare workers at the Primary Health Care level.
These three things will transform the cancer narrative in Nigeria in a decade, and we will see reductions in mortality rate and prevalence numbers.
Lastly, what can be done to better the health sector in Nigeria?
Health and education are pivotal to the development of any nation. These areas must be treated as pivots for the future that Nigeria aspires for by governments at every level.
We need a major overhaul, transformative levels of investment from government and development partners. I must stress that development partners include the private sector and the non-profit sector. The covid19 pandemic exposed the weaknesses in our health system and should serve as a wake-up call to focus on providing better hospitals with equipment, build the capacity of our health care workers, and create awareness amongst people on better health-seeking behaviours.
Our hospitals must be upgraded across all levels, improving infrastructure and operational processes. We must incorporate new technologies such as telemedicine to help us do more with available resources, we must also build sustainable partnerships to create a better working environment for health workers so we can stem the efflux we are witnessing. We also need to revamp the training of health care workers across every cadre in Nigeria. Medical training in Nigeria must be brought into the 21st century.