Let us Listen to Kikwete On Cancer Screening [analysis]

On March 23, 2015, I came off a community centre in the west end of Toronto called Parkdale, a community that had endured gentrification not many years ago.

Here, I had worked with a marginal group of immigrant women from Asia on cancer screening and prevention. The incidence of death from breast and colorectal cancers in Ontario is high, although lung cancer is the number-one killer.

Obviously, we will point a finger at the high consumption rate of industrial tobacco in this country but there are many risk factors to cancer, including lifestyle, which we could manage.

Our focus is on lifestyle modification as an essence of behavioural change approaches in public health. While here, an email notification went off my phone at 12 noon. It was from my vivacious colleague and an internationally-celebrated HIV-access-to-treatment aocate, Henry Luyombya.

He had shared with me a 52-minute video clip of Tanzanian President Jakaya Mrisho Kikwete’s speech on his stage 1 prostate cancer treatment in the US, in November of 2014.

I stopped for a few minutes to listen to the video in the chilling -10oC cold at midday. I was moved! In my entire life, I had never heard any ruling president in Africa speak so freely and dedicatedly to his fellow citizens about his ailment.

Often, when a president is ill, we hear that he has gone on vacation. His death announcement in a foreign country comes afterwards. This is because African leaders have projected this false image of immortality, might, and infallibility.

The key message that the Tanzanian president gave to his listeners was simple but powerful, “please, wafanye ukaguzi wa afya kila mwaka.” Meaning: “Please let them perform annual medical check-up.” Period! We should listen to President Kikwete attentively.

Again, cancer, like every other chronic illness, can be defeated if detected early as Kikwete has aised. The World Health Organization (WHO) estimated that cancer caused 8.2 million deaths in 2012, a year when 14 million new cancer diagnoses were realized.

WHO further estimates that cancer cases will increase by 70 per cent in the next two decades. According to WHO, the five most common sites of cancer diagnosed in 2012 among men were lung, prostate, colorectum, stomach, and liver. And for women, it was breast, colorectum, lung, cervix, and stomach cancers.

In Uganda, a recent study of Kampala Cancer Registry (Kampala city and rural hinterland) spanning 20 years (1991-2010) by Wabinga, Nambooze, Amulen, et al (2014) revealed a marked increase in breast and prostate cancer diagnoses. Everywhere, chronic diseases are on the increase and health researchers are concerned about rapid lifestyle changes and environmental determinants.

There are notorious cancers like Kaposi’s sarcoma that has dominated cancer cases in Uganda for obvious reasons. However, cancer, like other chronic illnesses, when detected early, is effectively manageable.

An interesting qualitative study by Mwaka, Wabinga, Mayanja-Kizza, et al in 2013 explored perception of healthcare professionals on challenges and proposed remedies for cervical cancer help-seeking in post-conflict northern Uganda.

The study revealed, among others, fear about exposing women’s private parts, men’s lack of emotional support to women, perceived pelvic pain during examination, and lack of knowledge about cervical cancer as major interpersonal and community level barriers to seeking screening.

Among the professionals, lack of knowledge to manage cervical cancer was pervasive. Given the chronic lack of qualified gynecologists, as well as long distance to available facilities, people still perceive screening services as unnecessarily costly.

People still believe that hospitals should cure their diseases and blame the hospital if they die even when they seek treatment at aanced stages of their diseases.

The key message is that we should rate our healthcare facilities and services based on whether they are able to provide basic screening and preventive services. Often, we are obsessed with pharmacotherapy that should actually be second line of disease management.

We should not allow our people to get ill to the point of seeking medicine because most of the illnesses are preventable with regular screening, healthy lifestyle choices of foods, physical activity, socialization, recreation, living in peace and harmony, raising healthy children, and others.

The author is a Ugandan living in USA.

Source : The Observer


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