AS the world grapples with a myriad of problems, ranging from unfavourable climatic conditions and population pressure on resources, disease burden is arguably one monster that continues to destabilise the very essence of life.
Nothing can adequately prepare one for the devastating news of being diagnosed with the dreaded cancer condition; a disease that “eats up” an individual, only to be revealed at a later stage, after the damage has been done.
Former Health ministers Anyang’ Nyong’o and his counterpart, Beth Mugo were among high ranking government officials who came out openly to declare they were battling prostate and breast cancers respectively; a move they hoped would challenge others to follow suit and access early treatment.
“It is imperative to emphasize that cancer is not a death sentence,” said Mugo during a past interview. She has gone on record challenging the public to seek for treatment once they have been diagnosed with the disease.
Mugo says former cases that used to result in death can now be cured. She is emphatic that prevention is the most cost effective and sustainable way of reducing the global burden in the long-term.
According to government’s health records, a worrying seven million cancer-related deaths occur annually worldwide; a shocking revelation which further reveals that the disease is a leading killer, more than HIV and Aids, Malaria and Tuberculosis combined.
And with hopes dwindling daily, the Health ministry says cancer cases will rise to 16 million by 2020, and will contribute to 10.3 million deaths annually, if the current trend is not contained and reversed.
Leading cases that continue to torment Kenyan women are breast, oesophagus and cervical cancer. While cancer of the oesophagus, prostate and Kaposi sarcoma are giving men sleepless nights, with very minimal hope of survival, especially for the poor majority.
Cervical cancer records the second most prevalent cases in Kenya after breast cancer, but the leading killer amongst women.
And in efforts aimed at giving women a lifeline, the Bill and Melinda Gates Foundation has entered into a four year partnership programme with Marie Stopes hospitals to conduct a countrywide cervical cancer screening.
Senior health officials, led by a representative from the division of Reproductive Health, Mary Gathitu is now appealing to women to embrace routine screening of the disease to enable experts arrest it while still at early stages.
Speaking recently at the launch of the Cervical Cancer Screening and Treatment project, which is set to inject sh3.7 billion into screening 645,910 women aged between 30-49 years, Gathitu called for renewed vigour in creating public awareness.
“Screening for early detection and treatment is essential if we have to reduce the cases of cervical cancer,” she said, adding that the disease is easily detectable and curable in its early stages.
An estimated 2,454 cases of cervical cancer are reported annually, which contribute to 1676 deaths. The numbers are projected to rise to 4,261 new infections if there will be no accelerated interventions to overturn the tides.
Human Papilloma virus, a common sexually transmitted infection that affects both men and women, has been attributed to 99.7 per cent of all cervical cancer cases.
Experts say 30 per cent of cancer deaths can be prevented with adequate investments in prevention and control strategies.
While addressing participants at a workshop convened by the African Cancer Foundation, Nyong’o, who sits on the board as chairman called on oncologists to draft guidelines that will facilitate proper diagnosis and management of cancer cases countrywide.
“We need guidelines, protocols and regulations to guide people in diagnosis and management of cancer,” says Nyong’o. He blames improper diagnosis and procedures, which he attributes to wrong treatment of the disease which accounts for seven per cent of Kenya’s total deaths annually.
Nyong’o has been instrumental in the fight against cancer, even as records indicate that over 28,500 new cases are diagnosed in Kenya, with an annual death toll of 22,100.
More than 60 per cent of those affected are below 70 years, making it a modern day threat to the country's development agenda, as those affected are instrumental in driving the economy.
Nyong’o is reiterated the need for concerted efforts to control infections, saying that types of the disease that are being discovered keep on increasing, “hence the urgent need for the development of country-specific guidelines”.
The director of Medical Services, Francis Kimani, while appealing for quick interventions, says that over 40 per cent of cancers can be avoided through cost-effective interventions that include the reduction in exposure to risky behaviours that include smoking, junk foods, which result in obesity, industrial toxins and lack of regular exercises.
Kimani categorises risk aspects into four types; behavioural, biological, environmental and genetic risk factors. Behavioural risks include tobacco and alcohol use, unhealthy diet and physical inactivity.
Overweight, obesity, age, sex of the individual and their genetic/hereditary form the biological factors. “Environmental risks include exposure to ecological carcinogens such as chemicals, radiation and infectious agents. However, early detection is only successful if linked with effective treatment. The aim of early detection and cancer treatment are cure, prolongation of life and improvement of quality of life."
Cancer treatment involves surgery, chemotherapy, hormonal therapy and radiotherapy.
In an attempt to narrate her ordeal, a distraught Rose Odhiambo from Naivasha is yet to come to terms with the death of her 43-year old son, in 2008, through cancer of the rectum.
She is still struggling to settle the debts she incurred five years ago, while nursing him in various hospitals.
“I got to a point where I asked God to take him, and spare him the pain he was going through,” Rose says, adding that the family had spent every penny in their savings with the hope that he would survive. “Things happened so fast, as his condition continued to desperately deteriorate.”
Rose says that the condition was the first of its kind in her family's history. This posed numerous challenges, as most health advices she accessed from different sources were contradictory, making it hard to maintain a specific track of information and treatment.
Sadly though, in Kenya high cost of training has locked out many experts who may have wished to get specialised knowledge on cancer management and treatment. The few oncologists, mandated to cater for Kenya’s 40 million people, have aired their displeasure at government’s emphasis on malaria, HIV and Aids at the expense of cancer, a costly major killer.
Last year, the Nairobi Hospital acquired a state-of-the-art, ultra modern cancer machine; the third of its kind nationally, with two others based at MP Shah and Aga Khan Hospitals.
While the development is laudable, these facilities can barely address the rising statistics, of a disease that causes shivers to all persons, irrespective of social status.
Kenyatta National Hospital is the mwananchi’s only hope, but is largely challenged with the chocking number of patients who frequent it, against the back drop of archaic equipment and inadequate resources. Its few trained physicians are no-doubt overwhelmed by the workload.
As Kenyans continue to peg their hope on the devolution hype, a lot is expected from the new government, as public expects the ruling elite and politicians to honour their pledges to improve health services down to the grassroots level.
While assuring the public of government’s commitment to bridge the gap and decentralise treatment services, former President Mwai Kibaki said that cancer centres will be established in each of the 47 counties to ease burden of logistics and cost of accessing treatment in Nairobi.
“We are setting up facilities in our counties to cater for more Kenyans in need of these services. What is important is not to cry on how these things are spreading, but to spread the centres of treatment,” Kibaki said.
While technology is taking centre stage in improving lifestyles, some professionals are blaming the modern trends to rising cancer cases.
Though no scientific proof has been documented to this effect, nutritionists are urging the public to carefully scrutinise their diets to avoid falling prey to cancer related complications.
However, many people feel the government is not doing enough to inject resources into fighting this modern day behemoth.
Despite the numerous cases, infrastructure is still a major setback; patients are compelled to seek for treatment in Nairobi, as facilities in counties lack the prerequisite capacity.
Moreover, due to lack of a comprehensive national cancer control programme, public awareness of cancer is low. This has contributed to people availing themselves to hospitals with advanced cancer cases, when treatment is near impossible.
Kimani attributes the lack of national structured screening programmes for treatable cancers to lack of policy on screening. Stand-alone projects have attempted to screen for cervical cancer, but they too lack national outlook.
And as the country continues to record rampant cases, majority of the poor who bear the brunt cannot afford radio and chemotherapy. Worse still, those who may be privileged to afford the therapies quickly run out of financial resources, as it fleeces their investment bases.
Inadequate funding of this noble initiative has resulted in failure of establishment for comprehensive and integrated cancer prevention and treatment programmes.
To resolve this standoff, experts say the government needs to expeditiously revise the medical budget to march the Abuja Declaration, which compels member states to allocate 15 per cent of the total expenditure towards health.
"This will ensure that health centers are equipped with early detection of cancer machines to fight the silent killer. It shall further avail chemotherapy drugs, pain suppressants, medication and dressing materials for wounds," says Victor Ng'ani, the Kenya Medical Practitioners Pharmacists and Dentist Union chairman.
Cancer is not only a health issue, but a socio-economic one; a chronic disease whose management is costly. It continues to impoverish individuals, families and the society at large.
Cultural myths have also played a significant role in sky-rocketing the figures, while subjecting the patients to unwarranted for stigma.
An immediate action-oriented comprehensive approach is required to urgently tackle the menace.“Let us work together and play our role in combating this disease,” Mugo said.