Fighting Cancer in Tanzania: A Family Affair (July 2007)
Three months ago Tima Omary, 50, left her home in Arusha, northern Tanzania, to take her sister to the doctor. She hasn't been home since.
Tima's sister, Kibibi Stambuli, 43, had been complaining for months about chest pains and difficulty swallowing. But doctors in her home town of Tanga were unable to make a diagnosis: one said it might be pneumonia, another thought it was a stomach ulcer. The doctor in Arusha suspected cancer. He said Kibibi should go immediately to the Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania's only cancer and radiotherapy centre.
The two sisters travelled by bus to ORCI where Kibibi was admitted with oesophageal cancer. Both women wept when they heard the diagnosis. Kibibi says she knows cancer is very serious but she's hoping the chemotherapy and radiotherapy she is receiving will help her to get better. "I just want to be healthy again," she says.
Tima's home is now an open-sided shelter in the hospital grounds. Like dozens of other relatives who have travelled to Ocean Road to be with their loved ones, she is unable to afford hotel accommodation and has nowhere else to go. "I'm here to help Kibibi in any way I can, to keep her spirits up," she says. Even if that means foregoing personal comfort.
The two sisters' story highlights the cancer challenges facing this East African nation of 37 million. With health services focused on communicable diseases like HIV/AIDS and TB, cancer has been largely overlooked and ignorance of the disease is widespread. Misdiagnosis is still common, while some 80% of cancer sufferers seek help too late for anything but palliative care. And because cancer services are concentrated in Dar es Salaam, patients from poor, rural areas have to make long and expensive journeys to get treatment.
This low-income East African country has one of the continentīs highest cancer rates and only one cancer treatment centre.
Cancer is the second most common cause of death worldwide after cardiovascular disease. Over 7 million people died of cancer in 2005, and close to 11 million new cancer cases were diagnosed, according to the World Health Organization (WHO). More than 70 percent of cancer deaths now occur in low and middle income countries - the very countries least able to address this growing burden. Cancer-related deaths are projected to increase to more than 9 million people annually by 2015. Already cancer claims twice the number of lives worldwide as AIDS. Low income nations now face a dual burden of communicable and chronic diseases such as cancer.
The harsh reality of developing nations is one of overburdened health systems with little cancer screening and unnecessarily late cancer diagnosis and non-curative treatment. The IAEA estimates that approximately 5,000 cancer care centres and systems - plus the doctors and other health workers to operate them - are needed to help low and middle income countries fight cancer. Currently, only about 2,500 radiotherapy machines are operating. Moreover, most developing countries lack effective public health policies and comprehensive diagnostic programmes that are essential to managing the growing cancer epidemic.
On World Cancer Day, the IAEA announced its decision to install a MDS Nordion Equinox cancer therapy system at the Tanzanian clinic as part of a larger PACT effort to help the country advance its National Cancer Strategy and Action Plan, which will now for the first time include not only curative treatment but also cancer surveillance, prevention, early detection, and palliation.
The majority of cancers prevalent in Tanzania today require radiotherapy treatment. PACT has established the first Centre of Excellence at the Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania. The ORCI estimates that each year there are over 20,000 new patients with cancer in Tanzania. Currently, ORCI can treat only about 2,500 patients per year - only a fraction of radiotherapy needs in Tanzania. To meet future needs, Tanzania will need many more machines and a corresponding number of doctors, nurses and technicians to operate them, according to PACT. The additional cancer therapy system from Canadian-based MDS Nordion will allow the Institute to treat another 1,000 patients per year.
Sound public health policies in cancer care must include cancer prevention, education, as well as early detection programmes. Investing in these areas greatly amplifies the benefits of investing in radiotherapy by ensuring that individuals with curable cancers receive early, lifesaving treatment.