Messaging matters to reduce cancer in Africa

With 60 percent of cases now in low- and middle-income countries, cancer has become a “silent epidemic” in the developing world, according to Sally Cowal, senior vice president of global health at the American Cancer Society.

The African continent faces a particular threat. By 2030, new cancer cases and death are projected to double in Africa, due in part to the increase in behaviors such as smoking, unhealthy diets and physical inactivity. Nigeria now sees more than 100,000 new cases of cancer every year. Some 38 to 40 women die daily from the disease there, according to the data by International Agency for Research on Cancer.

Caleb Egwuenu, the founder of Stand Up To Cancer Nigeria, thinks the situation may be even worse. “From working in cancer control for more than nine years now, I think this incidence might be an underestimate,” he said.
Tackling cancer faces particular challenges in Nigeria. After watching two of his relatives succumb to the disease, Egwuenu devoted himself to empowering the community. While some of the tools his organization uses would sound familiar across the globe, Egwuenu has also helped pioneer innovative approaches. He spoke to Devex about Stand Up To Cancer Nigeria’s strategies.

Breaking the stigma about screening

Cancer in sub-Saharan Africa is characterized by late diagnostics, Cowal said, noting that “more than 80 percent of patients begin treatment at an advanced stage, partly due to fear of cancer and stigma and lack of awareness about cancer signs and symptoms.”

“If we could get people to be more aware of the warning signs, for instance, a lump in the breast, then we could get them access to treatment,” she said.

Egwuenu agrees. He said that the stigma associated with the screening exercise has often limited their ability to reach more people. As a result, they are constantly looking for new ways to create awareness and break down the barrier.

Last year, Stand Up To Cancer Nigeria introduced a screening exercise called “Eat and Screen,” where they provide free food and drinks in a social atmosphere as an incentive to attract people to attend the screening event.

Eat and Screen was cost effective: The organization spent about 140,000 naira ($395) to organize the first event and about twice that for a more recent program last week. With 240,000 naira ($790), the team did more publicity and screened over 100 women in a day.

Stand Up To Cancer Nigeria has organized about 50 events that have reached over 5,000 people. Caleb Egwuenu said his team mobilizes people in their communities and neighboring states to attend its quarterly screening exercise by creating publicity on different social media networks and mainstream media at minimal cost.

Preventative lifestyles

Changing lifestyles have been a major contributing factor in the rise in cancer cases. The male obesity rate in some parts of Nigeria is as high as it is in Western countries, Cowal pointed out. Other habits such as smoking are also on the rise.

“As the economy is growing and individuals are becoming wealthier, the tobacco companies are seizing on that opportunity, and they are really marketing their products really hard in Africa and they are having some success,” Cowal said.

Through the right prevention programs, people need to be reminded about the risk factors associated with tobacco use, obesity, a lack of physical exercise and alcohol use.

Egwuenu said messaging is important. Many international organizations’ campaign materials for World Cancer Day, for example, show Westerners. He recently made a call to one of the organizations to complain about the use of white-only models in their campaign materials. “Many people still believe that cancer is a white man’s disease” that cannot affect them, he said.

“You can’t put up a white hand and expect a black person to relate to the campaign message,” he said. The first reaction of people to such messages will be indifference, Egwuenu said.

Volunteers at Stand Up To Cancer Nigeria are now developing educational materials in the form of comics, which are distributed on different social media channels to provide information about cancer in a localized context.

Volunteer commitment

Almost a decade old, Stand Up To Cancer Nigeria relies on volunteers to organize events and spread the message.

Their commitment toward raising cancer awareness in the country caught the attention of some international organizations early on. Australia Aid and the Association of Spouses of Heads of Mission in Nigeria provided support for their activities in 2012 and 2013, respectively.

“We didn’t write a grant [proposal] to them, but they saw what we were doing,” Egwuenu told Devex.

“I try to tell other NGOs that there are some things you can mobilize people to do because it is their responsibility to the society,” Egwuenu said.

For more Devex coverage on global health, visit Focus On: Global Health