Twenty years ago, Zainab Shinkafi-Bagudu returned home to her native Nigeria full of ideas for healthcare.
She was influenced by what she had learned while training and working as a paediatrician in Britain at the National Health Service (NHS). But what she quickly saw in Nigeria’s rural and disadvantaged communities was mothers having to make impossible decisions, forgoing basic necessities to support their children and often being forced to delay urgent healthcare until a late stage in their own illness.
Zainab, the present First Lady of Kebbi - a state in Nigeria, reflects on her initial reaction to the despair she saw written on the faces of young mothers all those years ago. “I longed to create a one-stop shop where women could come and have all their health needs looked after, from maternal care to breast health and cervical checks. I wanted to deliver a model where people could access care easily, when they can afford it and ideally before chronic disease could develop. I was immediately thinking and implementing solutions like lifestyle and diet advice, health checks and basic screening.”
The new local clinic was a success as women screened during health checks were identified and referred earlier than previously observed but Zainab soon wanted more for her patients. So in 2009, she opened a comprehensive diagnostic medical facility twenty minutes away. However, she notes, “It is one thing to solve how a patient gets a mammogram, but what if they have a tumour? How are they going to get treatment? I began to see that I couldn't solve this on my own, that nobody could, and that partnership would be key. I set about pulling every person and organisation that I could think of together so that we could all play our part.”
She started by asking partners from governments, clinicians, development agencies, cancer advocates and industry to come together to focus on access to treatment. In resource-constrained countries like Nigeria, mortality rates are higher as women are often diagnosed with breast and cervical cancer at a more advanced stage, where a positive outcome is less likely.
In 2012, Zainab brought together industry partners such as Roche, international development agencies, cancer survivors, their families and some high net worth Nigerians who were equally concerned about cancer care for the less privileged to launch the Medicaid Cancer Foundation. The Foundation supports disadvantaged cancer patients by offering them better access to treatment. To date, the Foundation has supported over 5,000 people to get diagnosed and treated. It has also raised over $2 million USD and continues to support those in need of care.
However, Zainab saw that there was much more to accomplish. In 2015, she became the First Lady of Kebbi, a state of Nigeria. Driven by passion and leveraging her access to government, she started fostering partnerships with like-minded individuals, policy makers, the private sector and healthcare organisations to raise awareness while providing practical solutions to tackle the cancer burden. During this time, she brought Roche and the Government of Kebbi together to collaborate on a breast cancer access programme that provides end-to-end care for the state’s disadvantaged breast cancer patients. Through this partnership, Kebbi is still the only one of Nigeria’s 36 states with its own indigent cancer fund.
Today Zainab also serves as the Chair of First Ladies Against Cancer, a coalition of past and present wives of Nigerian state governors that support initiatives that improve the cancer ecosystem. Together, the First Ladies are advocating for dedicated taxes to cancer care and improve access and awareness.
“Cancer is a complex disease. To give patients the best possible outcomes, we need synergy between policymakers, the private sector and advocates.”
Zainab continues to utilise her role as First Lady to bring people together in partnership. She scales the success that partners have achieved in Kebbi, Nigeria and in other countries facing similar challenges. Through her work as a board member on the Union For International Cancer ontrol (UICC), she shines a light on what drives her: the inequity in cancer care she sees across the world. She is resolved to continue bringing more access to those that need it most by ensuring practical solutions are delivered in partnership.
“70% of global cancer deaths are in low and middle-income countries. If left unchecked, this number will rise further. I want to change this by ensuring that cancer is not forgotten in any developing country. But we need to provide the support to make this a reality.”
One of the practical ways she plans on doing this is to continue to bring global cancer plans and proposals to the right people at a local level in a way in which engages them. She notes that cancer affects more than just the patient, reaching their family, community and ultimately also the national economy, and that this can be a powerful message.
“If you finance health properly, there are endless gains. All parts of society benefit. If our policy makers can truly understand this message and ensure that cancer care is supported, our communities will flourish.”