Globally, March is a landmark month for women. March 8 is International Women’s Day (IWD) and Mothering Sunday will be celebrated on March 14 in Nigeria, as in many other nations. Both IWD and Mothering Sunday celebrate the social, economic, cultural and political achievements of women and also signifies a call to action to overcome all the challenges faced by women, including mothers.

The theme for IWD 2021 is: 'Women in leadership: Achieving an equal future in a COVID-19 world.' The campaign hashtags for this year is #ChooseToChallenge. This hashtag highlights the fact that a challenged world is an alert world and from challenge comes change and urges all to #ChooseToChallenge.

Furthermore, several “missions” have been created including: celebrating tech women, applauding women in sport, educating women on beneficial life choices, building inclusive workplaces for women to thrive, increasing visibility of women creatives and forging women’s empowerment worldwide.

However, for the purpose of this article, we shall be focusing on the often neglected “mission” of women’s health, because without health all other missions are “missions impossible”. In particular, IWD is an opportunity to draw attention to peculiar challenges posed to women by cancer and to challenge women and their loved ones to #chooseToChallenge so as to cause change in the present unacceptable situation with respect to cancer in Nigeria. This deliberate emphasis is in line with the current focal cause of ↓↑GivingTide International, which is the “BIG WAR” Against Cancer.

The latest data by WHO indicate that the global burden of cancer has risen to 19.3 million cases and 10 million cancer deaths in 2020 with more than 50 million people living within five years of a past cancer diagnosis. In Nigeria, there were over 120,000 new cancer cases in 2020 with a higher incidence in women (about 73,000 cases), whereas the incidence in men was about 51,000 cases. Nigerian women also have a higher burden of cancer deaths with over 44,000 deaths in 2020 whilst the number of cancer deaths in men was about 34,000.

This higher burden of cancer deaths in Nigerian women is the opposite of what obtains globally where men have both a higher cancer incidence and a higher cancer mortality. Apart from the direct burden on them as individuals, Nigerian women also bear the brunt when their spouse or children are affected by the disease. Too often, unaffected female caregivers end up dying from stress-related illnesses, even before the cancer victim they are caring for. I recall the sad death of an otherwise healthy young mother who succumbed to the stress of seeking for funds to care for her 8-year old daughter with eye cancer.

The disproportionate higher cancer deaths in Nigerian women is totally unacceptable, especially because most of these deaths are preventable. It is tragic that Breast and cervical cancer are together responsible for more than half of cancers in Nigerian women. While the latter (cervical cancer) is virtually 100% preventable and is at the verge of being eliminated in developed countries, prompt diagnosis and effective treatment can cure breast cancer, which now has a survival rate of up to 90% in advanced countries. It is noteworthy that the cervix is the door to life for humanity and the breast is the sustainer of early human life. We must #chooseToChallenge this status quo, to ensure that the givers of life are not “rewarded” by preventable suffering and untimely death.

The disproportionate burden of cancer mortality in Nigeria is largely because of the dearth of infrastructure for cancer care in the country. For instance, whilst India has over 200 Comprehensive Cancer Centres, most of which are the products of non-governmental/nonprofit endeavor, Nigeria has none. Consequently, Nigerians who can afford it, go abroad for treatment, spending over $1billion annually, an amount sufficient to establish 20 Comprehensive Cancer Centre (CCC) in Nigeria every year! Tragically, those who seek care abroad often die from late intervention. This financial haemorrhage is unsustainable and the waste of lives is unacceptable. Moreover, the COVID-related global lockdown has shown that medical tourism may not always be available, even if one could afford it.

Nigerian women MUST play a pivotal role in reversing the current trend, by taking a cue from the exemplary efforts made by their fellow women in those parts of the world which have better female cancer statistics. For instance, in 1884 when the very first CCC was established in the USA (the Memorial Sloan Kettering Cancer Center or MSKCC, New York), a woman (Mrs. Charlotte Astor) was the prime mover. Charlotte convinced her husband (John Astor) to provide the take-off grant for the MSKCC, by drawing his attention to the plight of female cancer patients, who were then being rejected as hopeless cases by the Women’s Hospital, New York, where she was a board member.

Furthermore, the massive public awareness on cancer that was championed by the American Cancer Society, gained significant momentum through the effort of the “Women’s Field Army”. In 1936, Mrs. Marjorie Illig, a field representative of the American Cancer Society, initiated a legion of volunteers whose sole purpose was to wage war on cancer. The recruits of the Women’s Field Army donned khaki uniforms, complete with insignia of rank and achievement, and went out into the streets to raise money and educate the public.

This resulted in an increase in the number of people active in cancer control throughout USA from 15,000 in 1935, prior to the initiation of the Women’s Field Army, to about 150,000 at the close of 1938. More than anything else, it was the Women’s Field Army that moved the American Cancer Society to the forefront of voluntary health organizations. This extraordinary movement by the American women contributed significantly to the improvement in cancer survivorship both in the USA and globally. Nigeria definitely needs a “Women’s Field Army”. Will you bell the cat?

The last shining example to inspire women as we mark International Women’s Day/Mothering Sunday is Mrs. Mazumdar-Shaw, the main sponsor of the largest Comprehensive Cancer Centre in the world, opened in 2009. The Mazumdar Shaw Cancer Centre (MSCC), India, named in her honour was built at a cost of $150 million. She put down part of the funds, and then mobilized her associates to contribute the rest. Incidentally, the MSCC is the fourth CCC in Bangalore, a city of 8 million people (less than one-third of Lagos!) Mrs. Shaw was motivated by the experience of her husband - John Shaw, who was diagnosed of renal cell carcinoma in 2007 and her best friend who died of breast cancer. The MSCC treats poor patients for free in the evenings, so they could continue to work and care for their families during the day. As fate would have it, Mazumdar’s mother was later successfully treated for cancer at the MSCC.

Together, we can cause a change in the cancer situation in Nigeria. Inspired by the foregoing examples, we urge Nigerian women to arise and #chooseToChallenge cancer! Let us all rise in support of the current effort being made by ↓↑GivingTide International, which is championing the BIG WAR Against Cancer in Nigeria. ↓↑GivingTide is an initiative aimed at promoting synergistic, concerted and catalytic philanthropy for the common good. The↓↑GivingTide Global Trust is managed by Messrs FBNQuest Trustees, a subsidiary of FBN Holdings.

The BIG WAR is operated by the National Cancer Prevention Programme (NCPP), a nongovernmental initiative of mass medical mission which has been spearheading community-based preventive cancer care across the country since 2007. The immediate goal of the BIG WAR is to establish the first Comprehensive Cancer Centre in Nigeria, whilst sustaining the existing mobile system of preventive cancer care using Mobile Cancer Centres (a.k.a. the PinkCruise).

A CCC is NOT merely a hospital which has a radiotherapy machine. Rather, a CCC is a world-class, stand-alone tertiary health institution, with all its departments focused on cancer care. The CCC houses cancer research, preventive, curative and palliative cancer care in one place, thereby leading to better outcomes across a range of measures – including, most importantly, cancer survival.

Together, we can establish the first CCC in Nigeria, and in record time too. But only if we dare to ACT! (Attack Cancer Today! Attack Cancer Together!! Attack Cancer Totally!!!)

The last word goes to Bill Gates, “You do not need to be the chair of a large foundation to have an impact. Risk takers need backers. Good ideas need evangelists. Forgotten communities need advocates. And whether your chief resource is volunteer time or hard-earned dollars, for a relatively small investment catalytic philanthropy can make a big impact.” In line with Bill Gate’s exhortation, let us ponder on the fact that if one in seven Nigerians donated only N1,000 (one thousand naira) each to the ↓↑GivingTide Global Trust, Nigeria’s first CCC would be ready within seven months. Therefore, there is no reason for the holocaust of preventable catastrophic deaths from cancer. Together, it is possible!

Here is wishing you all a happy International Women’s Day (IWD) and a Mothering Sunday of joy and good health!

•Dr. Abia Nzelu (Executive Secretary, ↑↓GivingTide international); can be reached via info@givingtide.org

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