PETER ANYANG\’ NYONG\’O
Let me begin by thanking the many Kenyans who sent me messages of support and who sincerely wished me quick recovery after they read my article last week. I am also grateful to those who have drawn my attention to problems that face us in delivering healthcare in government facilities and what we need to do about them.
I am particularly indebted to those who have gone out of their way to emphasise the need for a social solidarity approach to dealing with our health problems, pointing out the responsibilities of the individual, the government and society as a whole.
One particular person regretted the delay that we have had in putting in place a comprehensive social health insurance scheme. Such a scheme would help Kenya build a formidable healthcare system to treat Kenyans who suffer from diverse diseases including cancer.
According to him, a few individuals with selfish intentions have decided to stop the government from implementing this scheme with court procedures which will never help this nation achieve Vision 2030. Instead, we shall always be looking for external assistance to help us deal with our maladies.
As I said last week, prostate cancer is curable if detected in its early stage. But the cancer is also preventable if we take care of our bodies through proper nutrition, physical fitness and less stressful life.
But sometimes when we do all this we may still end up getting the cancer. Scientists say that cancer also has something to do with genetics. In other words, there are people who are likely to get it because of their parentage.
I also said last week that the older we get the more likely we are predisposed to get the cancer. It means therefore that the older we get the more we should be concerned about taking preventive measures to keep away from cancer.
It has now been proven that diet-the kind of foods we eat and fluids we drink-influence the likelihood that we shall get any form of cancer. Interestingly enough, traditional African foods are generally known to be cancer preventive.
Yet we have foolishly embraced western foods and ignored our very nourishing traditional dishes. A book has recently been published on such foods. It is called Using Our Traditions: A Herbal and Nutritional Guide for Kenyan Families, by the Trust for Indigenous Culture and Health, Nairobi, 2006 (ISBN 9966-7197-3-3).
Although this book does not have any specific section on cancer as such, it has a broad range of fruits, vegetables and herbs which are good for dealing with many ailments and keeping good health in general. It would be a very useful point to start from, at least to realise that one of the activities we treat very lightly-i.e. eating-is something we should purposefully plan for as it is the centre of our lives.
Seventh Day Adventists practice this in their religion. It is high time we learnt something from them.
Like all organs in the body and the body itself, the prostate gland needs to be nourished. It is now evident, from scientific research, that there are certain nutrients that are particularly good for the growth and health of the prostate and that may help in defending it from being diseased or becoming cancerous.
Leading in the line of useful foods are fruits and vegetables. Down the line as something which should be avoided is red meat, particularly the nyama choma type, and milk and sugar products. Scientists now know that up to 30 to 40 percent of all cancer cases could be prevented by eating sensibly, maintaining a healthy weight, and keeping physically fit through exercising, physical work and less stationary existence. Further, smoking is generally regarded as a cancer inducer.
Cancer begins from cells in our bodies dividing and subdividing unnaturally until they begin to attack fellow healthy cells. They will tend to do so if the body is malnourished and the cells are deprived of proper nutrients. As it were, cancerous cells are dangerous cannibals. A primarily plant-based diet that focuses on vegetables, fruits, whole grains and beans can fend off cancer in several ways.
The fruits and vegetables that are highly recommended for men\’s diet in the prevention of prostate cancer are beans, cabbages, kale, sukumawiki, spinach, mushrooms, wheat grass, tomatoes, strawberries, blueberries, carrots, cantaloupe, oranges, grape fruits, bananas, mangoes, groundnuts, cashew nuts, and all the traditional vegetables that we seem to be losing in Africa today. I can only remember their names in Dholuo: odielo, atipa, mtoo, kandhira (this must be "kale"), osuga, dek and many others. In the family of tubers, sweet potatoes, cassava and beetroot are good.
Carbohydrates like ugali will always remain the centre of a meal in Kenya; it provides the necessary energy for keeping the body going. But starchy foods should not be taken in excess: they tend to complicate the weight equation for people who do not burn such energy vigorously.
Fish, of course, is very essential. Fish eaters all over the world have been known to fend off many ailments, and prostate cancer is no exception.
We are, however, requested by nutritionists to go easy on fatty foods, taking too much salt, sugar, alcohol and smoked and pickled foods. Lean meat and poultry (or chicken) properly boiled and cooked with some herbs, particularly onions, is good any day.
Of course everything needs to be done in moderation. I don\’t think that nutritionists and health experts want us all to be vegetarians. But even when we eat meat, as the Japanese also do, the way it is prepared and the quantities we eat matter as far as our health is concerned.
But when all is said and done about diet, there is yet another aspect to being cancer-prone which is complex and beyond our influence.
This is the genetic composition of our bodies. It has now been established by scientists that there are some people whose genetic heredity-or their blood lineage in ordinary language-makes them prone to get cancer at one stage in their lives. So one can have the best diet, look after their weight properly, exercise regularly and keep away from a stressful disposition and still get cancer.
Further, a lot of literature on nutrition and cancer has been developed in non-African contexts hence they may not take into account our climatic and environmental contexts both of which have influence on diet and lifestyle issues. What is sure, however, is that enough cross-cultural research has been done to vouchsafe for a heavy vegetable and fruit diet to be good for preventing cancer and improving health after the onset of cancer.
In the final analysis it is necessary that one knows one\’s status from time to time so as not to be taken by surprise in case prostate cancer strikes. One can only know whether one has an onset of cancer or not by having annual health examinations. One of the items to be examined through a blood test is one\’s PSA (Prostate Specific Antigen) which is a scientific measure of the presence of prostate cancer in the body.
The normal range is 0-4; beyond this range cancer can be suspected. At that point in time, a biopsy should be taken to determine exactly whether cancer is present or not.
Remember your health is your most valued treasure; don\’t treat things that concern your life lightly. Be assertive and seek to understand what is going on. These days the internet is there to provide us with a lot of information. Use it.
If you cannot use it, your child or somebody around you can help download useful information to enlighten you provided you tell them what you need to know.
My recommendation is that we should emphasize a health policy based on wellness. Thus at every health facility we should have comprehensive care units where individuals should have annual check-ups to know their health status.
My Ministry needs to draw up a protocol for checking wellness every year and ensure that this is kept in every individual\’s electronic health records. By implementing a comprehensive social health insurance scheme, this will be a must. It is impossible to promote preventive health care without having mechanisms for knowing how well the people for whom diseases are being prevented are.
Vision 2030 states very well that our health strategy must be based on preventive health, with the responsibility of prevention devolved as much as possible to primary healthcare units. This is as it should be, for as you go to the secondary or tertiary levels of healthcare, only those who need treatment because they have been identified for the need will be attended to.
At the moment our referral system is not functional, and we are striving to improve it currently at the Ministry of Medical Services. In my next article I will discuss in more details what the government should do to prevent, diagnose and treat prostate cancer.
This article was first published in the Standard on Sunday. (Prof Nyong\’o is the Medical Services Minister)