Stakeholders’ collaboration required to make cancer care affordable – Adaorah Enyi

Adaorah Enyi, a visionary physician and co-founder of Oncopadi Technologies, is revolutionising cancer care with digital solutions. Leading a team of experts, she’s at the forefront of developing mobile health tools to improve patient outcomes and accessibility. From her groundbreaking work on cancer side-effect reporting to her recognition as a TechWomen Fellow and Nigerian Volunteers Award recipient, Enyi’s commitment to societal impact is undeniable. In this exclusive interview, she shares insights on digital healthcare, women’s health, and the future of cancer treatment. Temitayo Ayetoto-Oladehinde, BusinessDay’s senior health journalist, brings the excerpts.

Can you share with us what sparked your interest in medicine, particularly digital health and oncology?

My interest in medicine is somewhat innate. I have wanted to be a doctor right from my childhood days, making the decision to pursue a career in the field rather easy. Oncology became an area of strong interest after losing a friend to cancer while studying at the College of Medicine, Lagos. The unfortunate incident sparked an interest that led me into oncology and discovering the issues with cancer care in Nigeria.

One of the biggest challenges we face is the lack of access to quality healthcare. This is worsened by the high cost of cancer care. As a professional, you quickly discover that patients are not visiting hospitals as they should for various reasons, and when they eventually receive treatment, they need some form of care outside the hospital, which they do not often receive. This challenge ignited my love for digital health, as it has helped us to take care of patients when they are outside the hospital. It also has greater reach and limitless possibilities.

Working at Oncopadi Technologies Limited as a co-founder and chief operating officer, as well as serving as the director of research and innovation at Pearl Oncology Specialist Hospital, has given me a better understanding of the cancer care gap. Consequently, I decided to make concerted efforts to ensure more women have access to the right healthcare services to enable them to make better decisions about their lives.

“Digital healthcare is akin to taking your traditional healthcare methods and putting them in digital devices such as laptops and phones to provide the services you typically enjoy in a hospital.”

What is your idea of digital healthcare in the context of cancer treatment?

Digital healthcare is akin to taking your traditional healthcare methods and putting them in digital devices such as laptops and phones to provide the services you typically enjoy in a hospital. It is similar to a shopping experience where instead of visiting traditional stores to get items, you just go online to an e-commerce store and get what you need. This method takes away some of the things that keep people away from hospitals, such as the stress of commuting and seeking approvals from the workplace if you are a worker, while providing users with a seamless experience.

With digital healthcare, consultation is less cumbersome, and should you be prescribed tests, there are marketplaces where you can get information about where to take the tests along with their costs. This way, a doctor can provide care to patients in different locations; for instance, I have patients outside of Lagos that I have been consulting with yet never met. It is about leveraging technology to empower professionals to provide services to people.

As a medical practitioner advocating for equitable healthcare, what challenges have you faced in deploying innovative solutions?

There are a myriad of challenges with healthcare in Nigeria, but chief among them is our lack of infrastructure and limited human resources. We are starting to see the effect of the brain drain in the sector characterised by a shortage of doctors in hospitals. Our population in Nigeria is estimated at 200 million, yet we have less than 100 cancer specialists nationwide. According to the Medical and Dental Council of Nigeria (MDCN), there are supposed to be about 90,000 fully qualified doctors in Nigeria, but sadly, less than 40 percent of that number are practicing today.

Then we have the infrastructural problems that are just as huge as the personnel. It is interesting to know that 18 of the 36 states of our nation do not have cancer centres, meaning that cancer patients in those states have to travel to receive care. There’s also the issue of internet connectivity, where penetration is not as entrenched as we would have desired. Electricity is another challenge, as the national power supply is not as steady as desired. There is also the cultural stigma associated with cancer treatment in particular, as patients do not openly discuss it.

However, it is worth noting that digital health is not a replacement for traditional healthcare; rather, it is an enabler, as it affords specialists the opportunity to attend to as many patients as they can despite the associated challenges.

Could you tell us about some of the most impactful projects you have spearheaded in improving cancer care experiences for patients while at Oncopadi Technologies Limited?

I have spearheaded a lot of projects, but one that stands out is leading the development of Nigeria’s and Africa’s first cancer app, PROSECARE. This app is a digital tool that connects patients with carers and medical practitioners so that they can receive vital information on cancer care. The app has over 1,000 users from eight different countries, and it has received international recognition, particularly from the American Society of Clinical Oncology and Microsoft for Africa.

Another project that I have enjoyed is the Oncopadi app that accelerates cancer care. It is our virtual board that allows for multidisciplinary management of cancer such that individuals can receive the best cancer care from specialists around the globe who review the patients’ cases and get them on the best plan. In addition, one of our newest projects is a cancer reporting tool that enables patients on treatment to remotely lodge the side effects they are experiencing and get clinical advice from professionals.

In what ways is cancer care in Nigeria and the African continent in general different from what is obtainable in developed countries?

One of the ways that care differs is in terms of personnel. In developed nations such as Canada and the USA, the ratio of specialists to patients is about 1 to 110, whereas in Nigeria that ratio is 1 to 1,500 plus. There’s also the problem of infrastructure. In Nigeria, there are only about nine functional radiotherapy centres and a vast shortage of trained professionals in comparison to developed countries.

In addition, there is a huge difference in our screening and early detection programs. In the Western world, patients can access screening programs and get on treatment plans easily, whereas ours in Nigeria are not as specific due to the high cost of care. There are also technological advances that are available in the Western world but nonexistent in Nigeria and most African countries. Finally, the high cost of treatment—which ranges between 4 million and 20 million naira—is a huge difference between both societies.

Read also: UK kicks off trial of lung cancer jab in world’s first

In 2022, you were listed as one of the Sanofi Future Women in Tech Scholars; can you tell us more about that?

Achieving the listing was one of the proudest moments of my career. The programme aims to encourage, recognise, and support talented women who are making waves in the STEM field. This gave me the opportunity to attend the One Young World Summit in Manchester, where I got to meet and network with like-minded professionals from around the world and share ideas on how to improve our countries by leveraging technology. The recognition has encouraged me to enhance my investment in improving the lives of young women.

Volunteering appears to be a passion of yours. Can you share some of your volunteering experiences with us and what motivates you to do them?

My volunteering experiences started as far back as secondary school from my desire to give back to the community, having attended Queen’s College, Yaba, Lagos. However, my first major volunteering experience was in my third year in medical school when we organised a hepatitis B vaccination campaign at the College of Medicine, Unilag, that attracted over 2,000 medical students. I also had my first volunteering experience with Sebeccly Cancer Centre in 2015, when we attempted to set a Guinness World Record for the highest human ribbon for breast cancer awareness at the Teslim Balogun Stadium. The attempt was unsuccessful, but I was proud to have coordinated over 500 people to participate in the attempt that had over 7,400 people. There are several other volunteering experiences to share, and I find the act of committing your time, intellect, and expertise to the service of others fulfilling.

As mentioned, you volunteered as a Lagos State COVID-19 First Responder, for which you received the 202 Award of Recognition Case Management Pillar from the Governor. How did this experience impact your perspective on public health emergencies?

The COVID-19 experience was personal to me, as my dad contracted the virus early. There was insufficient information about the virus at the time, and the fact that isolation centres were not fully set up meant that I had to manage his condition at home. As soon as he recovered and the Gbagada Isolation Centre was ready, I volunteered there. Lagos State was one of the first states in Nigeria to respond swiftly to the pandemic, and the general experience of how people banded together to tackle the virus reinforced my convictions that so much can be achieved if we work together. It also served as a reminder to all of the quality of medical personnel we have in the country, as evidenced in our low mortality rate during the pandemic. Unfortunately, these professionals are often overlooked in favour of their foreign counterparts.

Can you briefly explain why it appears as though your work is focused on the female gender?

Yes, a lot of my work is centred around women and generally about women’s health. This is because women have been disadvantaged for so long as seen in our society. Women lack access to quality healthcare, they are underpaid at work in comparison to men, and so many other disadvantages, which made me decide to focus on women. Women need to advocate for one another, as the healthcare challenges facing women are unique. For instance, the most prevalent forms of cancer nationally are breast, cervical, and prostate cancers, which are largely experienced by women, hence the need for more women to advocate for one another.

Cancer care in Nigeria is expensive and out of reach of the majority of the population. What innovative strategies can be put in place by the public and private sectors to bridge this gap?

Yes, I agree with you. Cancer care is financially toxic. I say that people are just one cancer diagnosis away from poverty. The government has been trying to help in this regard, and one of the ways they have gone about this is the establishment of the National Catastrophic Health Fund that can be utilised for cancer care.

Also, the education sector requires more investment. We need to train more clinical oncologists to meet the national needs. Furthermore, we need to establish more cancer treatment centres. Currently, there are only 5 government-owned radiotherapy centres nationally, with the others owned by individuals, and we all know the high cost associated with private centres. One way the government has been trying to bridge this gap that I am aware of is the encouragement of public-private partnerships in the sector, which are starting to yield dividends.

Can you give us an insight into some of the projects you are currently working on?

We are doing some amazing work at Oncopadi, such as the first Patient-Reported Outcome/Side-Effects (PROSE) tool to help cancer patients report their services in real-time, but more importantly, to get the necessary clinical advice. In Nigeria, we have over 125,000 cancer patients, and cancer care is such that side effects are present regardless of the type of treatment used. However, these side effects usually do not manifest until they are at home and are therefore disconnected from the care they need. The PROSE app, therefore, is a tool that will help these patients who are at home, or wherever they may be, to report their side effects in real-time.

We are currently developing the second version of the app as we onboarded over 137 cancer patients on the first version who reported over 50,000 side effects from over 80,000 interactions with their care team. The utilisation rate of the app stands at 60 percent, and one of the most heartwarming feedback received was from a boy with a head-and-neck tumour that the app helped him do the right things and he is now cancer-free.