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Rumbidzai Ngwenya Features Writer
After experiencing abdominal pain and bleeding for two months, Tarisai (not her real name), a mother of four from Muzarabani, went for cancer screening in August this year at St Albert’s Mission Hospital in the Mashonaland Central province.
More than a month later, the results came back positive and she was referred to Parirenyatwa Group of Hospitals (PGH) for further treatment. She went to stay with her brother in Chitungwiza.
Upon arriving at Parirenyatwa her hopes were shattered.
“When I went for radiotherapy I was disappointed,” said an emotional Tarisai.
“I was not even attended to, neither did the nurses at the radiotherapy department read my referral card before appointing me to see the doctor on October 3.
“All I needed were pain killers, but I received none.”
The two months that followed were the longest for her. She suffered without any form of medication or any information about the cancer.
She started taking over the counter pain killers. She refused to eat and stayed indoors, shutting herself from the world. Her bleeding worsened and she deteriorated as she waited for her appointment to see the doctor.
She was petrified when the Herald talked to her before the day of her appointment.
“I am afraid that in my long wait for treatment, the cancer will spread and maybe become harder to treat. By the time I start receiving treatment it maybe be too late,” she said crying.
“I think I am going to die.”
Tarisai was stressed and hopeless.
She even tried private hospitals, but they could not help her without a referral letter from Parirenyatwa Hospital.
On October 3, when she went back to Parirenyatwa Hospital she was at least attended to and her road to treatment began. At stage two, she started chemotherapy and radiotherapy last week and was admitted for five days while receiving treatment.
Although she was in pain at least she now takes her meals regularly and is positive. The waiting was slowly killing her.
“I met other cancer survivors at the radiotherapy sessions and I have hope that I can also survive it,” she said.
However, the cost of cancer treatment is tormenting her more than the disease. For just the week she spent in the hospital she used more than $300 for medication, scans and admission fee.
Since she will be going to Parirenyatwa daily for the next three weeks for treatment, she is likely to spend even more as drugs are now expensive and most pharmacies now require US dollars. There are also transport costs to be considered.
She fears she won’t afford to receive full treatment.
“The money that is required to treat me is too much. I don’t think I will afford it. Already I have almost exhausted the little I had and my husband is running around trying to get a loan,” she said.
But for someone who is not formally employed and has a family to look after at her rural home, it is a challenge.
Tarisai is worried she may die either from late treatment or simply by failure to access the drugs due to prohibitive costs.
Cancer, be it breast, prostate or cervical, has become a major killer in Zimbabwe.
According to the National Cancer Registry, about 7000 new cancer cases are being recorded every year, with around 2500 deaths.
Zimbabwe has few cancer treatment centres. The country only has two radiotherapy centres at Parirenyatwa and Mpilo central hospitals.
Cancer treatment machines at Mpilo have broken down and all cancer patients across the country were now being directed to Parirenyatwa hospital.
The country has a ratio of one radiotherapy machine per every 2,6 million people.
A Parirenyatwa report indicated that: “an average of 1 461 new cancer cases are seen at Parirenyatwa Hospital Radiotherapy Centre per annum and 60 percent of these require radiotherapy treatment. So on average the department treats 65 patients per day using radiotherapy”.
About 130 cancer patients are treated on average per day at Parirenyatwa due to an increase in the number of patients.
The Cancer Association of Zimbabwe has called for subsidisation of cancer treatment to help poor patients.
“CAZ has programmes to support cancer patients such as information dissemination and counselling services, but when it comes to the medication it is still a challenge in Zimbabwe.
“Although we offer medical support it becomes a challenge with the increasing numbers of cancer cases. We cannot accommodate everyone on the list,” said Lovemore Makurirofa, an information officer for the association.
“Cancer treatment should be subsidised. Through the National Pharmaceutical Company, the Government should procure, stock drugs and make them available at public hospital pharmacies. That way they will be accessible and a bit affordable. As long as the drugs are being found in private pharmacies only the prices will be very high and unaffordable to many.”
Makurirofa also said there was need to decentralise treatment centres.
“Centralisation of cancer services has led to extra costs to the patients and their families. We have always talked of drug and medication costs but there are costs such as transport, accommodation and food. Decentralisation will go a long way to reduce challenges being faced by cancer patients,” he said.
The United Nations Family Planning Fund (UNFPA) reproductive health specialist Dr Edwin Mpeta urged women to get screened for cancer regularly.
He said early diagnosis or treatment of cancer was critical for the survival of women.
“Cervical cancer can be prevented through early screening. So it is important for women to go for screening earlier to avoid comoplications,” said Dr Mpeta.
“As UNFPA we have supported the Ministry of Health and Child Care to set up screening and treatment centres so that many women can have access. The response is overwhelming when treatment centres are closer to them.”
He also emphasised the need to prioritise the availability of treatment services in the public sector for women with advanced cases of cervical cancer to reduce deaths associated with cancer.
Cancer is curable and when quickly detected treatment is possible and deaths reduced. But some die because of late detection and unaffordability of treatment costs. Some even deteriorate during months of waiting for treatment.
In rural areas cancer cases may go undetected. Even if detected most cannot afford transport and accommodation costs in Harare.
People are dying and most of these cases may even go unreported.
With the increasing numbers of cancer, the country needs more radiotherapy centres in the public health sector that offer affordable treatment.
Although Zimbabwe has better radiotherapy centres compared to many other African countries, there are still not enough to cater for rising cases of cancer.
Africa and most other developing countries continue to record high cancer deaths because the disease is often not detected and diagnosed early enough due to a lack of screening and access to treatment. Cervical cancer, for example, kills hundreds of thousands of women in Africa each year but can be largely avoided with a vaccine or successfully treated if it is detected early enough.
In Zimbabwe, cancer is now the second biggest killer disease after HIV and official health figures indicate that the disease is killing more 1 500 every year. Out of this figure, 80 percent of the victims visit health institutions late for treatment when the disease is already at an advanced stage. Oncologists in Zimbabwe attributed this to either poverty or lack of knowledge about the disease. According to new WHO figures (2015) released this year, some 8,8 million people died from cancer, of which approximately two thirds occurred in low- and middle-income countries.
In addition, each year over 14 million people are diagnosed with cancer and the WHO says this figure is projected to rise to over 21 million by 2030 if nothing is done.
Experts say supportive care is essential for comprehensive cancer control as well as providing access to pain relief.
Online Reporter