Dr Bolaji Lateef Salako, a consultant radiation and clinical oncologist at the Federal Medical Centre, Idi-Aba, Abeokuta, in this interview by SADE OGUNTOLA, speaks on prevalence of quackery in the health sector, increasing maternal and childhood mortality, unemployment, among others. Excerpts
Is there an aspect of medical care that is left out of quackery?
Quackery and quack are terms that resonate ominously in the healthcare sector, casting a long, dark shadow over both the healthcare community and the industry itself. This menace has serious consequences for the health system. Medical quackery is the art or science of promoting fraudulent or unproven medical practices that have no scientific or clinical basis for commercial purposes. This health fraud encompasses a wide range of healthcare malpractices that are detrimental to human health.
Common elements of general quackery include questionable diagnosis using questionable diagnostic tests as well as untested or refuted treatments, especially for serious diseases such as cancer. Quackery is often described as ‘health fraud’, with the salient characteristic of aggressive promotion and it is prevalent throughout the healthcare sector.
What is the difference between quackery and medical scams?
Both medical scams and quackery involve acts of deceit orchestrated for the sole purpose of financial gain. However, it is essential to recognise that quackery is not always driven by fraudulent intent. Sometimes, it is perpetrated out of ignorance. Oftentimes, they also prey on the doubts and fears of the vulnerable, while health or medical scams are primarily motivated by financial gain through the sale of healthcare products and promises about ‘cure-all’ products, medicines and treatments that can appear to be legitimate treatments for many different medical conditions. A lot of money goes to companies that make fake claims about those products and treatments, cheating people of their money, time, and even their health. They use undocumented testimonials from patients or doctors, claiming, ‘You’ll get miraculous results.’ They use bogus phrases like ‘scientific breakthrough’, ‘miraculous cure’, ‘secret ingredient’, ‘exclusive product’, or ‘ancient remedy’ that give a misleading impression or that are simply not true.
The history of quackery dates back to ancient times, with remedies and treatments often based on superstition, folklore and dubious claims. For example, ancient Egyptians believed that wearing amulets made of animal faeces could ward off disease, while the ancient Greeks turned to bloodletting as a way to cure various ailments.
What forms does medical quackery take in Nigeria?
The prevalence of quackery in Nigeria is a concerning issue. It can also be committed by people working in the same field; it is not just a profession-specific crime. For example, as a consultant radiation and clinical oncologist, my expertise lies in cancer care. However, if I were to involve myself in obstetric or surgical cases unrelated to oncology, I would be engaging in quackery in those fields. This problem extends to optometrists posing as ophthalmologists, radiographers emulating radiologists, nurses acting as pharmacists and doctors training auxiliary nurses on a regular basis.
Such pretentious behaviour is a persistent threat to public health and wellbeing, contributes to professional quackery, increases maternal and childhood mortality, increases the unemployment rate for professionals, leads to poor treatment outcomes and weakens the healthcare system.
By staying informed, being sceptical, reporting suspected cases and consulting reputable healthcare professionals, you can protect yourself and your loved ones from the dangers of fraudulent medical treatments and remedies.
Government at all levels, including professional bodies and other relevant stakeholders should reactivate their anti-quackery machines for effective usage. We also need robust anti-quackery laws with effective implementation.
If you’re curious about a treatment, talk to a healthcare provider about it. They can be asked questions about how the product or treatment actually works, the evidence that proves it to work and the possibility of adverse side effects or interactions with other drugs or supplements. ‘Natural’ doesn’t mean either safe or effective. More importantly, we must always know that our health is too precious to be entrusted to the hands of charlatans masquerading as medical professionals.
As an oncologist, what constitutes quackery practice in cancer care and how can they be identified?
As a consultant radiation and clinical oncologist, I am acutely aware that fraudulent or ill-informed practices in cancer care, motivated by financial gain, have dire consequences. Such individuals often claim to possess a multitude of skills, masquerading as radiologists, pathologists, nurses and even pharmacists. Their success stories rely more on anecdotal testimonies than scientific or clinical evidence and they deceive vulnerable patients with promises of curing all stages of cancer, often charging lower fees and adopting a warm, approachable demeanour that blurs the boundaries between healthcare providers and patients. These unethical practices are fuelled by the pursuit of financial gain and fleeting popularity.
What could be fueling quackery in cancer care and treatment in Nigeria? What are the implications of this, with the high cost of healthcare and out-of-pocket spending on health?
The roots of this issue delve deeper into societal attitudes, where people often seek miracles where none exists. Individuals flock to those who claim to offer miraculous cures. Furthermore, the scarcity of healthcare centres staffed with sufficient personnel exacerbates the problem. The exorbitant costs of treatment, particularly in cancer care, place it out of reach for many. Most healthcare services remain inadequately covered by insurance schemes.
Shockingly, some of our medical colleagues are complicit in this malpractice by renting out their certificates to engage in unprofessional activities. The government’s failure to implement robust regulations and policies to curb the activities of these health miscreants exacerbates the situation. The fallout from quackery is palpable, with elevated mortality and morbidity rates in cancer cases and artificial unemployment among qualified professionals, which puts the reputation of the entire profession in disrepute.
What fraudulent cancer treatment products should be avoided in Nigeria?
Claims such as if patients stop eating sugar, drink pineapple with hot water, drink lemon juice before meals for three months and take spoonfuls of coconut oil morning and night, the cancer will ‘disappear’ are on websites or social media platforms like Facebook and Instagram. They are all false cancer cures.
Certain phrases that are common in these products that claim to cure cancer include ‘treating all forms of cancer’, ‘miraculously killing cancer cells and tumours’, ‘shrinking malignant tumours’, ‘selectively killing cancer cells’ and leaving healthy cells intact and more effective than chemotherapy. As part of their claims, chemotherapy kills.
So, we should be wary of cancer drugs that claim to treat multiple cancers simultaneously or those that present themselves as superstars in cancer management without having clinical evidence, formal training, or education in medicine and oncology. They also claimed to have secret formulas that could perform miracle cures. They may use pseudoscientific jargon to bamboozle their victims and create the illusion of credibility. In reality, their claims lack scientific validity.
How best to stay up-to-date on medical scams, quackery, or deadly treatments, especially the proliferation of bogus cancer treatment claims on social media?
As an unwavering advocate against quackery, I continually stress the importance of discernment. Not all information disseminated through print, television, radio, or social media is reliable. It is imperative to seek guidance from medical professionals or experts when faced with health challenges, rather than succumbing to the allure of quick fixes or resorting to self-medication. Both the government and professional bodies must intensify their efforts to raise awareness about the perils of quackery through educational programmes. It is only the professional bodies that can define what constitutes quackery and identify quacks within a specific field.
It is crucial to obtain information about cancer and other health issues from reputable sources, like official websites and organizations for professionals in medicine. Credible sources of cancer and other health information should make it easy for people to learn who is posting the content. They should make clear the original source of the information, along with the expert credentials of the people who prepare or review the online material.
With the increasing incidence of cancer in Nigeria, how can it be stemmed?
Breast cancer is the most common cancer among women and prostate cancer is the most common among men in Nigeria. There is no single cause of cancer; it is multifactorial. Clinical studies have found that the most common cancer risk factors include smoking, alcohol consumption, age, sex, obesity, exposure to cancer-causing substances, chronic inflammation, diet, ionizing radiation and infectious agents.
Screening is at the heart of any effort to stem the tide of cancer deaths, as early detection remains the only hope of a cure for a disease that has emerged as one of the leading cause of morbidity and mortality in the world.
In recent times, the detection of cancer cases has seen a marked increase compared to the past. This surge can be attributed to improved awareness and education. We believe that when detected early, cancer is more likely to respond to effective treatment and can result in a greater probability of surviving, less morbidity and less expensive treatment.
So, the most potent weapon in our arsenal against this menace is to prioritise our health and regular visits to the hospital for check-ups, while also embracing safe health practices. These practices include avoiding tobacco use, including cigarettes and smokeless tobacco; maintaining a healthy weight; consuming a balanced diet with plenty of fruits and vegetables; engaging in regular exercise and practicing safe sex.
Improving the knowledge and understanding of Nigerians will also enhance their behaviours related to common cancers, encourage early presentation and detection and improve the proper management and treatment of cancer. In this way, we can work towards a healthier future and a world where quackery no longer thrives.
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