Let’s talk about butts. Specifically, the part attached to your digestive system that makes colonoscopies both necessary and universally dreaded. Today’s tale involves Nigeria, a few thousand people who learned to listen to their guts literally, and a health victory so brilliantly simple it makes million dollar gene therapies look like overpriced confetti.

Imagine living somewhere where “cancer screening” means surviving long enough to afford the bus ride to a clinic that ran out of gloves three presidents ago. In Nigeria, – scratch that, in most of sub Saharan Africa – spotting colorectal cancer early falls somewhere between “fairy tale” and “rich tourist problem.” Most people show up with symptoms after the tumors have already started redecorating their lymph nodes like squatters with bad taste. This is not because Nigerians are biologically different, but because cancer education gets about as much funding as a middle school bake sale.

Enter a team of gloriously stubborn doctors who decided facts should be free. They printed bilingual flyers. Made church announcements. Played radio jingles that probably interrupted someone’s favorite ballad about cassava farming. All explaining exactly what your butt is trying to tell you when things get weird downstairs. Blood in places blood shouldn’t go? Check. Bowel habits resembling a moody teenager? Check. Family history of the big C? Double check.

Six months later, nearly everyone surveyed went from ”colorectal what now?” to reciting cancer symptoms like their grandma’s pound cake recipe. Of the 329 people nudged toward screening, 168 had risk factors screaming “get thee to a scope!” and 116 actually went through with colonoscopy. That’s right, these folks endured prep drinks so foul they’d make a goat gag voluntarily. Hero status unlocked.

Now for the kicker. They caught four cancers early. Not “pick out your coffin” late, but “we can fix this with minor surgery” early. They even found precancerous polyps in eleven percent of patients, those sneaky little troublemakers destined to ruin future birthdays. For comparison, the US spends enough on colonoscopy commercials to fund a moon colony, yet a third of eligible adults still skip screening.

Here’s what the good doctors proved. Health equity isn’t about shipping robots to Lagos. It’s about translating facts into the rhythms of daily life. A nurse explaining cancer signs while someone waits for blood pressure meds. A deacon slipping flyers between hymnal pages. Memes about poop consistency shared via WhatsApp groups. Technology is fabulous until it becomes an excuse. ‘Can’t screen for cancer here, Margaret! Our electron microscope is stuck in customs!’ Meanwhile Nigeria did more with paper handouts than some countries manage with tumor sniffing dogs.

We should be thrilled. Instead, I’m furious. Why? Because this program is the exception, burning bright against a tsunami of neglect. Twenty two percent of global cancer deaths happen in Africa, using only one percent of the cancer funding. Billions pour into extending rich lives by months while entire nations lack basic painkillers. It’s not aid. It’s malpractice with diplomatic immunity.

Every time I hear a pharma CEO gush about personalized vaccines priced like Picasso paintings, I think about those Nigerian radio jingles. About nurses walking miles to hand wrinkled posters to village elders. About two stage 0 cancer patients now alive because someone… and there is no softer word for this… gave a damn.

Bureaucrats love to wring hands about infrastructure like it’s a magic word that absolves them of guilt. No MRI machines! Power outages! As if early detection requires uranium fueled lasers. Nigeria reminded us that infrastructure is human infrastructure. That trust trumps tech when death comes knocking. That living requires nothing but stacking small kindnesses until they form a ladder out of hell.

So next time your insurance company denies a colonoscopy despite your butt staging a one man revolt, remember the Nigerian clinic with no waiting room. The patient navigators who walked grandmothers past roosters to get scoped. The two lives turned around because knowledge traveled via rumour and grace. Then ask why your billion dollar healthcare system feels poorer than a Nigerian market stall. I’ll wait.