Adedayo Joseph

Adedayo is creating an ecosystem of collaborative action amongst different stakeholders in order to bring public attention to the prevalence of childhood cancer and rapidly improve the capacity of early detection and treatment in West Africa and beyond.

Every year, more than 30,000 children in Nigeria die from pediatric cancer even though many of these cases are preventable. Adedayo is raising awareness and innovating to rapidly build the capacity of the health system and society at large to address the unmet needs of these children through research, policy action, educating the public, and training hundreds of pediatric oncologists/radiologists on early detection of childhood cancer.

Adedayo’s critical and timely efforts provide the government and multiple stakeholders with the evidence and information needed to understand the urgency of making pediatric cancer a public healthcare priority. Her systemic approach is bringing attention to the issues while also ensuring appropriate human capacity and infrastructure is being developed to treat and save the lives of affected children. She continues to challenge the government to invest more in healthcare and more directly in cancer care while shifting the mindset of society and the healthcare industry to seek out and embrace alternative and tailor-made strategies to improve equity, affordability, and access to good healthcare for children with cancer.

By creating an alternative system to tackle pediatric cancer, she is establishing new standards and practices to demonstrate to health practitioners and society at large how they can contribute to combating other similar issues confronting the Nigerian health sector.

According to the Global Cancer Observatory (GLOBOCAN), Nigeria has a high incidence of childhood cancer, with an estimated 40,000 children under the age of 19 diagnosed with cancer each year. Of these, approximately 30,000 die from the disease meaning that about 75% of children with cancer do not make it. This high mortality rate for pediatric cancer in Nigeria is due to factors such as lack of accurate data, late diagnosis, lack of access to treatment, poor quality of care, and lack of awareness about cancer and its prevention, among others.

Elsewhere around the world, more than 1,000 children according to the World Health Organization are diagnosed with cancer daily, a diagnosis that sets the affected and their families on a demanding and life-changing journey. Although pediatric cancer prognosis and outcomes have improved significantly in developed countries, the reverse is the case in most low- and middle-income countries (LMICs) like Nigeria.

In the past six decades, significant strides have been made in the understanding of cancer biology and knowledge of cancer treatment in general. The positive impact of this has largely been seen in the category of cancers that affect children, as survival rates for pediatric cancers have risen dramatically in the last half-century in most developed countries. In Nigeria, studies have indicated that lack of policy advocacy, knowledge, and effective engagement of families and managing expectations are some of the most significant barriers to improving pediatric cancer survival in Nigeria. This problem does not only exist with pediatric cancer, but it is also prevalent with the entire healthcare infrastructure focused on terminal illnesses.

In the area of policy advocacy, pediatric surgical oncology is not yet regarded as a public health care priority as the emphasis has been on preventive and curative services, mainly for types of cancer occurring in adults, such as cervical, breast, prostate, colon, and lung cancers. Sadly, in the 2018 National Cancer Control Plan, no line in the document mentioned pediatric cancer. As such, the pervasive nature of pediatric cancer is difficult to estimate because there is no national pediatric cancer registry and no national database or surveillance mechanism for childhood cancer. Moreover, there are very few standalone pediatric institutions and no public pediatric oncology center in the country.

Regarding the knowledge gap, many doctors lack the adequate knowledge to close the gap. Sadly, for a country like Nigeria with a population of 220 million and a youth bulge of 40% with an average of 30,000 pediatric deaths per year, there are only 69 practicing pediatricians to cater to the huge deficit.

In terms of engaging families and managing their expectations, pediatric cancer poses a special challenge owing to the expensive nature of treatment in Nigeria, and it's not being covered by health insurance schemes. As such, families are forced to spend a lot of money out of pocket on treatment costs which can be financially and emotionally demanding. As a result, families expect nothing short of the impossible from the few pediatric cancer surgeons who are often harassed by the families when the results lean towards the negative. In addition to this, pediatric cancer is associated with stigma due to superstitious beliefs held by families and society. This makes it difficult for healthcare professionals to diagnose the disease early on when the patient has more chances of survival because the families most times don’t seek proper medical attention until the symptoms become full-blown.

Adedayo’s Dorcas Cancer Foundation, armed with an in-depth understanding of the challenges in the Nigerian pediatric cancer care field, developed a multidimensional strategy from the onset that involves collaborative action amongst various stakeholders. The strategy revolves around Research, Early Detection, Accurate Diagnosis, and Prompt Treatment.

Adedayo has developed a new system that brings together medical professionals from across the West African region to put pediatric cancer research and treatment on the front burner. She is leveraging this network effect to advocate for the government to include a childhood cancer elimination strategy in their health budget and to increase the overall budget for health in Nigeria.

She created a curriculum from her years of intensive research and experience that now serves as a template for pediatric cancer treatment throughout West Africa. The curriculum feeds into her unique Pediatric Radiation and Oncology course which is a virtual learning course for pediatricians to learn best practices of how to treat and handle pediatric cancers. So far, over 300 specialist doctors have taken the course and are implementing her unique model to tackle challenges in their specific specializations. As a result of her work, radiation oncologists who used to make the common mistake of applying radiation therapy levels that are significantly lower dosages to children than that given to adults now know that it ought to be the opposite as children require more dosage than adults.

She has also created the “Look-Again-Campaign" designed as an early detection system that involves training community health workers to look again at the symptoms to make accurate referrals. Her training for community health workers is crucial due to the fact that parents of pediatric cancer patients who live in rural and underserved communities usually go to community health centers due to their ubiquity and inexpensive nature. It is from the community health centers that these trained health center workers implement their training to determine if the disease is cancer. Once they determine that it is in fact cancer, they promptly refer them to Adedayo’s non-profit who then take it up from there. By doing this, Adedayo is activating community health workers and ordinary citizens as responsible care providers for pediatric cancer. Her approach is innovative, patient-centered and is leading to improvements in the way pediatric cancer is treated in Nigeria. It also eliminates delayed referrals. Using her “Five Tools and Five Questions Tool,” Adedayo and her team have trained personnel in over 1,000 primary healthcare centers across Nigeria in techniques of early detection of childhood cancer.

Adedayo is ensuring that every child that is diagnosed with cancer is treated by a team of pediatric oncology specialists. To achieve this, her foundation only funds treatments carried out at teaching hospitals under the care of these specialists. By way of improving access to these professionals, her foundation facilitates patient appointments, while educating patients and their families on the importance of attending these appointments.

As a young child, Adedayo witnessed the traumatic death of an older sibling whose life could not be saved by a doctor. This experience ignited in her a strong desire to become a medical doctor who would always save people. Her venture into oncology specialization was born out of curiosity and has become one that has gone on to shape her life.

While undergoing her residency at a teaching hospital, she began helping pediatric cancer patients cover their treatment costs through funds she helped raise. Unfortunately, she suffered a bad experience with one patient’s family who diverted the funds raised for their child’s treatment and vanished at the beginning of the treatment. Determined not to let this ever happen again, she decided to set up an independent foundation that would raise funds to offset treatment costs for children living with cancer. Thus, the Dorcas Cancer Foundation was born and was named in honor of a very empathetic child patient whom she had treated but eventually lost to osteosarcoma.

Adedayo is a clinical radiation oncologist and recognized cancer control advocate with a special interest in cancers that affect children. As a part of her long-term strategy, she consults with the NSIA-LUTH Cancer Centre of the Lagos University Teaching Hospital and Lakeshore Cancer Centre, the premier private cancer center in Nigeria to build her credibility in the sector that allow her to build partnerships for her nonprofit. She is a recipient of multiple awards for her innovations in support of early detection practices and her commitment & contributions to childhood cancer survival in Nigeria.

By embracing alternative methods and challenging the health establishment, she is drawing the attention of her colleagues and stakeholders in the health sector to new ways of drawing attention to and tackling diseases from a socially responsive angle.