, NAIROBI, Kenya, Mar 6 – Mariam Nadzuwa, a 35 year-old mother of three children who hails from Kilifi County, in the Coast region has been battling breast cancer for the past five years.
Nadzuwa who is currently not on any treatment including chemotherapy, got to know her status three years ago, but declined to heed the doctor’s advice to undergo a mastectomy.
The main obstacle is that Nadzuwa firmly believes that her situation is as a result of witchcraft.
With a bit of nudging from family and friends to seek treatment, Nadzuwa eventually went to the Kenyatta national Hospital.
Unfortunately her breast cancer has spread affecting most of her vital organs and radiotherapy could not solve the problem at hand.
Nadzuwa is currently under palliative care, which is mostly to help manage the pain.
Nadzuwa’s incident is just but one the many case studies showing how widespread cultural beliefs are, due to lack of awareness and accurate information about cancer.
She also serves as a prime example of the many people struggling with cancer in Kenya.
Challenges/barriers to control cancer
Cancer accounts for 27,000 of deaths annually with more than half of those in productive ages being affected according to statistics by Kenya Cancer Statistics & National Strategies.
The most common cancer cases in men include prostate and esophagus whereas women are frequently diagnosed with breast and cervical cancer.
The report also indicates that at least 7 per cent of cancer related deaths are recorded annually.
Despite significant breakthroughs in the understanding, prevention, and treatment of cancer, the disease continues to affect thousands of people in the country.
“The number of oncologists and technical staff specialising in cancer care is still small in ratio with the number of patients that need the services,” pointed out David Makumi of the Kenya Network of Cancer Organizations.
“The public national hospitals hosts most of Kenya’s oncology expertise and technology. About 78 per cent of Kenyans live in rural areas, which mean that many patients requiring care may travel up to 600 km to access cancer services,” he noted.
Access to cancer care remains a challenge to those in the rural areas since most cancer care services are concentrated within a 5km radius of each other.
That not being the only challenge, available radiotherapy centers handle 3,800 patients a year, which is far below the needs of the country.
“Patients referred from other periphery hospitals have to wait for months before they can access at the national referral hospitals leading to a majority of patients presenting themselves while at the late stages,” said Makumi.
Makumi points out that there will be an increase in number of people that will be diagnosed with cancer in the next 10 years.
“70pc of new cancer cases will be recorded globally; unfortunately it is projected that developing countries will be ill prepared to deal with this.”
Among the contributing factors to the rise in cancer cases includes: unhealthy eating and poor lifestyle, pollution from industries leading to environmental degradation.
“Currently 41,000 new cases are recorded annually and the numbers are going up,” said Makumi.
On access to medication Makumi says that cancer drugs are still expensive calling on the Pharmacy and Poisons Board, which regulates the pharmaceutical industry to ensure price of medicine is standardized so that patients do not pay significantly more than patients in other countries.
“It is the responsibility of the government to ensure drugs are affordable for majority of Kenyans. We do not want something called disease capitalism where people capitalize on sickness for people to make super profits,” said the Makumi.
A huge disparity exists in patient outcomes between low-income countries like Kenya and high-income countries like the United States.
Take cervical cancer as an example: due to pap testing, cervical cancer is rare in the US; however, it is the number one cause of cancer deaths in Kenyan women.
Prevention and screening has just not been available or accessible to most people in Kenya.
Most cases are often undiagnosed or misdiagnosed, which is partly due to inadequate healthcare infrastructure.
Last year NHIF reviewed its benefits introducing a new package that would see patients suffering from chronic diseases such as diabetes, hypertension and cancer get covered.
It is worth noting that the reviews to the NHIF benefits have tremendously helped address challenges in regards to access to medical treatment as well as help defray some of the bills and also prevent hospitals from incurring losses due to patients’ inability to pay for their medical expenses.
The latest World Health Organization (WHO) statistics predicted 13.2 million cancer-related deaths worldwide by 2030, which is up from 7.6 million in 2008 when the last report was published.
With the continuing growth and aging of the world’s population, the global burden of new cancer cases is estimated to rise from 12.7 million in 2008 to 20.3 million by 2030.
So what actions are required to reduce barriers to cancer prevention and care?
To effectively address cancer, concentration should be put in improving awareness, control, screening as well as scaling up prevention efforts, both on a personal and policy level for cancers that are amenable to prevention such as cervical cancer.
“The many people currently struggling with cancer, and those to be diagnosed with the disease in the coming years should not be deprived of cancer care due to their geography or inability to pay,” stated Makumi.
To facilitate disease prevention, non-communicable diseases (NCDs), which include cancer and other chronic conditions that share common behavioral risk factors, must be reduced to facilitate disease prevention.
Schools too need to prioritize physical activities to address obesity cases, which are on the rise. Smoking and alcohol abuse are on the rise too while air pollution is potent in urban areas.
“The government should improve the budget spent on health to the recommended 15pc in the Abuja Declaration 2001, and much of its treatment rather than prevention,” states Makumi, “This will result in long-term economic gains.
Makumi also notes that the National Cancer Prevention and Control Act which was established in 2012 needs to be implemented to stipulate the establishment of a National Cancer Institute among other important advances to counter the disease in Kenya.
“It is worth noting that great strides have been made to counter Cancer disease but a lot more is needed,” noted Makumi.