Francis Durosinmi-Etti One Thing I Cherish in Life is Integrity…

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Prof. Francis Abayomi Durosinmi-Etti (OFR) is an oncologist of repute whose impact in a tough and rare field has made history across the globe. Many will always remember him as the pioneer Chief Medical Director/CEO of the National Hospital Abuja. He also once served as the Secretary, Federal Character Commission. As the first Professor of Radiation and Clinical Oncology in Nigeria and possibly West Africa, he has not performed below par in the various capacities he found himself, including working at the United Nations International Atomic Energy Agency (IAEA) in Vienna, Austria.

Jovial, meticulous and incredibly unassuming, the extraordinary sanguine veteran has the right cheers for every situation, such that endear him to all. No wonder, he is a toast of patients, colleagues and even employers. Durosinmi-Etti who is one of the brains behind aided cancer treatment in Africa, has no doubt paid his dues, but still relentlessly paying more at ensuring that the cliché “cancer is a death sentence “is completely reversed. He shares with Omolabake Fasogbon how he intends to achieve this, experiences with surviving and dead cancer patients, love life and unconditional love for Nigeria.

Not just that he looks dapper in his two- piece suit matched with a suiting bow tie, which has become his signature overtime, his appearance in a neatly ironed white apron is such that brings message of hope and induces strength. No wonder every patient would not mind taking a turn to have him attend to them, amid other thousands of physicians. Durosinmi-Etti is not only great in skills, he boasts a rare psychology that magnets life. From overseas to Africa and now Nigeria, he is a sought after clinical oncologist, with tempting opportunities in the queue right from the beginning of his career even till and after retirement, but Nigeria of all, remained the priority of this University of Lagos graduate.

He explains: “After graduating from the College of Medicine at the University of Lagos in 1972, I had the privilege of being sent on study leave by Lagos University Teaching Hospital, LUTH, for my postgraduate training in Cancer Management at the world-famous Christie Hospital and Holt Radium Institute, affiliated to the University of Manchester, UK from 1975 to 1980. On completion of my studies, I had the temptation of staying back because of the offer of consultant position by some hospitals in England. However, I knew it would have been most improper for me to stay back when I knew my services were badly needed in Nigeria, my country and particularly LUTH that sponsored me, my wife and two children abroad. One thing I cherish in life is integrity and it was unthinkable for me to betray my country and my sponsors by staying back.

“Amazingly soon after I returned, I was offered a Lecturer 1 position at the College of Medicine, University of Lagos and also made a Consultant in Radiotherapy and Oncology in LUTH. The remunerations at that time were almost at par with what I would have been earning if I had elected to breach my bond with LUTH by staying back. I returned and have never regretted my coming back home since then. It is worth noting that if I had betrayed my country and stayed back after my training in the UK, I would not have had the unique opportunity of being head hunted by the United Nations and literally begged to take up the IAEA job in 1988, which turned to be a major boost to my career on the international scene as well as the opportunity to get more cancer specialists and equipment for other hospitals across Nigeria and other parts of the world.”

Interestingly, Durosinmi-Etti has always wanted to be a policeman or a pastor but fate, as he said, led him to a tougher responsibility on purpose. “I could rightly claim this was by divine inspiration. Soon after qualifying as a doctor in 1972 and during my housemanship at LUTH, it occurred to me that many of the cancer patients I treated presented with very late and advanced diseases such that they died under very pitiable conditions. The urge to do something to help alleviate the plight of the patients along with finding possible cure largely influenced my decision to train and qualify as a clinical and radiation oncologist. “

Despite being widely celebrated on the beat, he still has some regrets: “That over 80 percent of cancer patients present with late and advanced disease which they don’t get to survive in most cases is worrisome. I feel sad when any of my patients die especially when they are also children. Unfortunately, such scenarios play out regularly even as recent as yesterday, as most patients present with late and advanced disease. In this case, we always let the patient and his relations appreciate the seriousness of their condition and that what you are aiming at during treatment is for adequate palliation to relieve any distressing symptoms and keep the patient relatively comfortable before the inevitable end comes. We do not promise a cure, but the alleviation of distressing symptoms such as pain, bleeding, relieving obstructive airway and generally giving a patient a relatively good quality of life until the eventual death.”

This notwithstanding, the widely travelled physician has influenced many breakthroughs that is motivating him to do more. Sharing some of them, he says, “I have encountered a few who lived for about four to five years longer than expected. I have been in clinical oncology practice for 47 years and since I became a consultant clinical oncologist in 1981, I have had the opportunity of seeing some of my patients alive and well over 20 years later. I have had patients with huge and disfiguring lesions on their faces resulting in complete regression seen as total disappearance of huge cancerous growths following some courses of chemotherapy followed by external beam radiotherapy. Similarly, some patients with early cancer of the cervix treated many years ago also survived for many years later when they are lost to follow up.”

His breakthroughs on the job are the innovations he spearheaded. He enthuses, “I have had the rare privilege of working for about six years with the United Nations International Atomic Energy Agency (IAEA), in Vienna, Austria as the radiotherapy specialist in charge of all the activities of the IAEA in the field of cancer radiotherapy all over the world. This had been a very exciting period of my life and career and I have had the opportunity to help in the establishment of Cancer Radiotherapy facilities in several countries of the world including Africa, Asia and Pacific, Europe and Latin America, among others. I have been involved in the upgrading of Radiotherapy Cancer management and facilities at LUTH where I assisted in getting a brand new Cobalt-60 Radiotherapy machine in those days, along with two low dose rate Brachytherapy machines which made LUTH the West African sub regional Centre of excellence for cancer treatment in those days.

I was also able to ensure that due professionals were awarded long term IAEA Fellowship for postgraduate training and other clinical trainings at institutions abroad. Some staff were also trained abroad to ensure the smooth operation of their cancer treatment facilities. My joy today is that virtually all of them returned back to Nigeria on completion of their training and many of them later rose to exalted positions and have also helped to enrich and enlarge the field of cancer treatment in Nigeria”.

Thankful to Nigeria as always, Prof, as he is fondly called believes his story might not have been heard if not for the opportunity presented him by Nigeria, now rubbing off positively on the health system. He says: “Nigeria has been and is still being very kind to me. I was granted leave of absence from my duties to enable me take up my appointment with the United Nation’s IAEA for many years which were counted as being on National Diplomatic service, following which I returned to my old job at the College of Medicine, University of Lagos and a Consultant Radiation Oncologist to LUTH. Soon after, I was appointed the Acting Chief Medical Director of LUTH following which I was appointed the Pioneer Chief Medical Director /CEO of the prestigious National Hospital Abuja.

“The Federal Government in appreciation of my competence and dedication to duty also appointed me as the Secretary to the Federal Character Commission under the Presidency. I served in this position for eight years following which I voluntarily relinquished the position to enable me return to my primary duties as a Professor and Consultant in Radiation and Clinical Oncology at the University of Lagos. I was thereafter given less demanding part-time appointments at different times as the Chairman of the National Commission for Refugees and Internally Displaced Persons and later as the Chairman of the Governing Board of the Federal Medical Center, Ebute Metta, Lagos, which is still one of the best Hospitals in Nigeria.
“To top this up, Nigeria, my country which I love and served so meritoriously honoured me in 2006 with the National award of the Officer of the Order of the Federal Republic (OFR)”.

In nostalgia, he shares some of his enchanting experiences with patients in his over 47 years of practice this way: “I can never forget my experience during my training as a young registrar in Manchester, England. I was the only black doctor and very proficient and dedicated such that the patients often wished that I am the one to administer their chemotherapy injections. There was a white patient who was very fond of me and no one else could administer his chemotherapy apart from me. He had a condition called Lymphoma of the skin such that his skin is so fragile and unstable. During the administration of one of his drugs, in spite of all the care, some of the drugs extravasated into the skin. This resulted in a nasty ulcer for which he needed skin grafting as part of the treatments.

“As to be expected, we had to get the health insurance involved as the man told me to forget that we are friends but he had to claim from my hospital insurance which all doctors were mandated to have. Being the only black doctor, I was worried that my other colleagues out of jealousy would like to heap blames on me rather than see the root cause of the problem. I felt dejected even though my consultants understood and did not complain. However, the most senior consultant under whom I worked had an almost similar experience with another patient a few days later. I felt glad because that accident helped in saving my reputation and career as no one was able to pass any adverse comments about me without passing same on our boss. The incident looked small but remained indelible in my heart because I know God had a hand in saving me from inevitable and unfair racial comments which had nothing to do with our competence. Generally speaking, I have always had very good relationship with all my patients.”

He relays his sad moment on the job. One of such unforgettable experience occurred “In the past when cancer patients used to die as a result of lack of access to uninterrupted radiotherapy when machines available then were always breaking down for months due to poor maintenance culture. Thankfully this is no longer the case”.

Now the most senior radiation and clinical oncologist in Nigeria and the Chief Clinical Oncologist of newly established NSIA-LUTH Cancer Centre, he was once tempted to single-handedly establish a cancer centre in desperation to reduce cancer casualty: “When I observed the unusually high rate of increasing number of cancer patients in Nigeria and weighed it against the near total lack of treatment facilities in Nigeria due to neglect and poor maintenance of the previously existing services, I was tempted to take the risk of starting a private world class cancer centre to stem the tide of many cancer patients travelling abroad for radiotherapy, even to the centre at Korle Bu Teaching Hospital in Accra, which I helped to initiate years ago.

“Many patients usually travelled to India, Dubai, Britain and America among other places and ended up paying between $15,000 and $120,000 dollars for treatment excluding air fares and accommodation for the patient and the accompanying relative and other difficulties and indignities they experienced. I knew it was going to be a viable and affordably cheaper facility once this was developed. However, through divine help as I would like to see it, the NSIA went into a PPP arrangement with LUTH and established the current world-class standard cancer centre at LUTH which has saved many Nigerians the headache and huge financial burden of travelling abroad for probably more inferior treatment. As such, I have been saved from the temptation and hard work I would have had to do unaided by the coming on board of new cancer centres”.

On another hand, the septuagenarian tried to correct the belief that cancer might be a spiritual attack, he clarifies this, saying, “No! Cancer is not due to any spiritual attack. There is what we call risk factors which could expose individuals to specific types of cancer based on their exposure to such risks. There are also some of these risk factors which are modifiable such that we can prevent or reduce the risk of cancer while others are non-modifiable risks, which cannot be influenced. The proliferation of several anti-cancer NGOs have led to increasing public awareness of these risk factors. Spiritual attack is certainly not one of them.”

He however feels alternative therapies should be explored in the treatment of cancer. “I personally believe we in orthodox medical practice should collaborate with the alternative therapies to further explore their claims. While God is the ultimate healer of all sorts of infirmities, we do know that in some instances, we can have what we call the concept of spontaneous tumour regression.”

Until recently, Prof. has had 47 years of his life fixed to a routine that has nothing much to do with his personal life. He said, “The daily working schedule of a full-time consultant radiation and clinical oncologist could be very busy. Such clinical schedule is also often associated with your duties as a professor or lecturer at College of Medicine. I’ve had to make out time for various research activities and other administrative responsibilities bestowed on me by the University of Lagos.

“And of course, I have other family and societal commitments as a responsible elder within my community. These activities compounded by the usually chaotic traffic situation in Lagos while commuting between my house at Lekki, the University of Lagos and finally LUTH and the College of Medicine, University of Lagos, usually resulted in a busy daily schedule which starts from about 8am till about 8pm when I returned home.

These busy activities have eased up a lot since I retired from the University in 2018. I am currently on a special employment contract with NSIA-LUTH Cancer Centre. I thank God that I am still going strong and in active practice. Meaning, I am still busy studying and being up to date in my specialty.”
Though he is up there, he still aspires for more heights as he said, “I crave to ensure I raise worthy successors that will keep the specialty well sustained forever in Nigeria”.

Tired as he may be, he still creates time to catch up with social activities: “Yes, I try to relax and rest from time to time. I sleep a lot these days following the harrowing traffic situation currently in Lagos. Besides, I’m a squash and golf addict. I am also a life member of Ikoyi Club; member of Island club; member IBB Golf Club and some other exclusive and private clubs”.

The Septuagenarian also speaks on what he wished to be known for long after now. “I wish to be remembered as a gentleman and professor who sacrificed his life in making sure that curative cancer treatment facilities are available in many developing countries of the world, more importantly for his fellow Nigerians many of whom have died from non-availability of sustainable cancer treatment facilities in the past.”

He insisted that Cancer is not a death sentence. “The truth is that in this day and age, having Cancer is not necessarily synonymous with death. The key is to pre-empt it, prevent it and where inevitable, obtain early diagnosis and treatment. There are various kinds of cancers each having its peculiarities and mode of behaviour but the golden rule is to prevent it through various available cancer-specific screening tests. This is the message we try to promote every year when we observe “Cancer Month.”