 There is a simple fact that Dr Tunji Toriola is grappling with. Ovarian Cancer is a bigger public health problem in Finland – and other northern countries – when compared to southern nations and nobody is exactly sure why.
‘Ovarian cancer is the most lethal female reproductive cancer and the fifth leading cause of cancer deaths among women worldwide,’ Tunji tells me. ‘It is more common in Industrialised countries, especially Northern Europe, than in any other part of the world.’ ‘ Ovarian cancer is very deadly’ he stresses, because there are few symptoms meaning the cancer can spread un-noticed and become ‘very difficult if not impossible to treat.’ ‘When ovarian cancer is diagnosed early before it has spread, chances of survival are very high but when it is diagnosed after it has spread, chances of survival are low: 75% of those diagnosed late do not live up to 5 years after they have been diagnosed.’ But why is it more common in the north? ‘There are many possible factors,’ Tunji tells me. ‘It could be the latitude of Finland; the way that it’s harder to get Vitamin D because there’s less sunlight. It’s possibly even the diet in more industrial societies . . . or a combination of these. So that’s what I’m trying to find out.’ It may even be to do with having fewer children in industrialised countries. ‘Public health is very different in Nigeria,’ says Tunji who practiced as a hospital doctor there specialising in anaesthesia. ‘There are a lot of preventable illnesses there like diarrhoea from people drinking water that it isn’t clean. Better knowledge could prevent all these problems.’ In Finland, by contrast, the public health problems are different and usually due to lifestyle choices.
‘It’s cardiovascular diseases and diabetes,’ Tunji says, ‘that are the most common problems. These may not be as common in Nigeria.’ Finnish Public Health Tunji came to Finland to improve his understanding of public health so that he could return to Nigeria and improve public health there. He’d been studying an International Masters in his field at Kuopio University when he was offered the possibility to research alcohol and cancer. But he was then offered a position at Tampere University researching ovarian cancer for which he is researching in Oulu. He now has an office near Oulu University Hospital. ‘Cardiovascular diseases and diabetes in Finland have genetic components’ he explains. ‘There is a hypothesis – known as the ‘thrifty gene hypothesis’ - that when people live in cold areas when there are times of lack where there are no nutrients . . . then their bodies store up fat for these times. But in modernised societies like Finland, this gene cannot handle abundant food and this leads to conditions like diabetes.’ Tunji has just began – at the beginning of March – to research the environmental hypothesis to try and understand why ovarian cancer may be more common in Finland and other Nordic countries.
Tunji didn’t even mention the problem of alcoholism in Finland at first because he thought it was so obvious.
'There are I think 3000 alcohol related deaths a year in Finland,’ he remarks. ‘It’s a very high number, it’s the leading cause of death among men and the second leading cause among women.’ Finland is in fact the only country in Western Europe where the leading cause of death is alcohol-related conditions such as liver failure. ‘It’s a major public health issue,’ Tunji explains. ‘I’m not sure exactly why. Finnish people are very different from Nigerians,’ he says. ‘Social relationships aren’t as strong.’ Tunji laughs when he thinks about how different Nigeria is. ‘A person that you work with is automatically your friend,’ he chuckles. ‘You might visit them at home but here even if you get on well with your work colleagues, the relationship usually ends at work! Nigerians are always laughing. I read somewhere that we’re the happiest nation in the world!’ Tunji wonders if this relates to the problem of alcohol. ‘It’s like there is a mutation on Friday and Saturday evenings!’ he laughs. ‘People drink a lot and they are totally laughing and friendly. There are drunks in the street and the society seems to tolerate and accept it but in Nigeria it would be embarrassing.’
He continues, ‘Finns become very free when they have alcohol. It’s like an escape for them . . . a new realm. They are very introverted but suddenly they are extroverted.’ Tunji contrasts this with Nigeria where drinking is just a normal part of life and is not seen as anything special. ‘It’s just normal’ he says. There is some research which has claimed that Finnish alcoholism is actually genetic and occurs because a lot of Finns do not carry a gene – carried in many European countries – which affords them resistance to alcohol. The same gene is found in parts of Russia. There is even some research that has claimed that Finns being quiet is a genetic issue and comes from living in a cold environment where it was important to hunt in freezing conditions and as such spend long periods alone, in silence waiting for prey. It is Finnish genes which makes Finland a particularly useful place to do research for Tunji though. ‘It’s a very genetically homogenous country’ Tunji explains. Being a Nigerian Being a Nigerian in Oulu has certainly been interesting for a Tunji so far. ‘It’s just a really different culture,’ he says, still slightly amazed. ‘Nigerian people are so exuberant. It’s really different!’ The weather has also been an issue and Tunji likes to ‘escape to England’ when it gets really cold because he can deal with the weather there and in some ways the English are little bit more like Nigerians. They are talkative. I talked with one English woman on a coach from Cardiff all the way to London!’ He points out that he has ‘lived in a flat with a Finn for six weeks now and the most he’s ever said to me is ‘Hello’!’ Tunji thinks that stereotypes in Finland about Nigerians and Africans have come about because, ‘Most of the Africans in Finland are asylum seekers who are not well educated, giving rise to the false belief that a lot of Africans are like that.’ He stresses that Africans – and Nigerians – are not all the same at all. He even thinks that Finns can learn from Nigerians about being more outgoing but at the same time he has been very impressed by Finnish ‘organisation.’ ‘That is something Nigeria can really learn from Finland’ he tells me. Tunji would like to be able to do some medical practice here in Oulu but he cannot because of the language issue so he focuses solely on solving the riddle of Finnish ovarian cancer.
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