
Ifeanyichukwu, a middle aged male, had a growth on his left temple. For many years, because of his fear of “dying in surgery,” he had failed to seek medical care for this simple skin cancer that, in early stages, would have been relatively simple to cure. As time passed, in order to hide the cancerous growth, he took to wearing a wash-cloth over his face. Over time, his simple basal cell skin cancer had invaded his skull base. Affected were much of the left side of his skull including the orbit of his eye, cheekbone and maxillary sinus, and into his nose, teeth and mouth. Lucky to be able to gather the money for surgery, and urged on by his family, he went into surgery. The operation took 24 hours to resect and repair the defects. Even with follow-up attention cosmetically, he looks terrible. He is alive though, and cured. The case demonstrates the effect of a lack of faith in medical care. If Ifeanyichukwu had gone to a doctor sooner this sad result might have been avoided. Ifeanyichukwu is not his real name, but we included this anecdote to call attention to similar cases that occur often in the poor communities of Nigeria that could have been handled if adequate hospital care were available.