What can be done to reduce cancer deaths in Uganda?

What you need to know:

As the country aspires to attain middle income income status, this will most likely come along with more sedentary lifestyles. And in a society where eating junk food and being pot-bellied are associated with a good life, we can predict unhealthy lifestyles to rise with rising incomes.

Recently, the media carried a story of a man who was left unattended to at the Cancer Institute in Mulago and died hours later. There have been a series of other emotion-evoking stories in the local media relating to the cancer problem in the country. First was the breakdown of the cancer machine at Mulago National Referral Hospital, and the subsequent referral of patients to Nairobi for treatment. We have also had fund-raisings for funds for treating cancer patients abroad. Beyond, the emotional response from the loss of lives to the disease, these events are expected, at the very least, to raise the concern and invoke a discussion on the cancer problem in the country and what we can do about it. Unfortunately, we have not had this discussion yet.
This article highlights some of the issues we can pick from these recent incidences that concern all of us. First is that cancer could be on the rise in the country. Second is the huge financial costs associated with cancer treatment, which most individuals and families cannot afford without external support. The third is the issues of healthcare and national preparedness to deal with cancer.
The discussion we need to have should address some of the questions that arise: Is cancer actually on the rise or is social media creating a false impression? How about the high costs associated with cancer treatment, what can we do about it? Apart from repairing the broken cancer machine, what else needs to be done to reduce these incidences?
According to research done at Mulago hospital using the Kampala Cancer Registry, the oldest registry on the continent over the past two decades, there has been a surge in cancers associated with Western lifestyles. Other cancers associated with HIV and those associated with poverty such as cancer of the cervix, throat and stomach have remained high over the period. Apart from poverty, HIV and Western lifestyles, recent gains in life-expectancy are expected to increase cancers as people tend to get cancer at older ages.
As the country aspires to attain middle income income status, this will most likely come along with more sedentary lifestyles. And in a society where eating junk food and being pot-bellied are associated with a good life, we can predict unhealthy lifestyles to rise with rising incomes. Thus, cancer is on the rise and judging by current trends, we can only expect it to increase in the next years. The several fundraising campaigns highlight the issue of financial preparedness and ability of families to meet the costs. Most of these campaigns are always seeking monies in the range of Shs80m to Shs150m for treating a single patient, mostly in India. This sum may be too much even for a moderately privileged household. A single case of cancer can economically devastate a ‘middle income’ household and plunge it into poverty. This is yet another reason why Ugandans shouldn’t continue waiting for the national health insurance policy and its implementation. Hopefully, when the policy is finally implemented, it will cover expensive costs associated with treatment of non-communicable diseases.
Health economists have also proposed the establishment of a public facilitated loan-like scheme to assist families. Whatever we choose to do, as the national burden of cancer rises, we need to be mindful and actively look for solutions to the financial catastrophe associated with these diseases – lest we launch our own campaigns when our turn comes.
The recent death of the man at the cancer institute was tragic. It also highlights a major issue at the heart of the cancer problem – that of late cancer detection. Public health research conducted in the country shows that most patients are diagnosed with late stage cancer – when little remedial action can be done. Often times, this even makes fundraising efforts for treatment even futile. Much as regularly screening for cancer for all high risk individuals according to stipulated standards may be expensive for the nation at present, some interventions for early detection and prevention are within our reach. These include, for example, HPV vaccination of young girls and cervical cancer screening for women.
Our recent research in eastern Uganda revealed embarrassing findings: That less than 5 per cent of women in Bugiri and Mayuge districts have ever screened for cervical cancer. Cervical cancer screening modalities are affordable. If we are to come closer to early cancer detection, we need public health experts, social workers, civil servants and everybody to promote cancer screening. The earlier we detect cancer, the lesser the cost of treatment.

Mr Mukama is a research associate at Makerere
University School of Public Health.
[email protected], the media carried a story of a man who was left unattended to at the Cancer Institute in Mulago and died hours later. There have been a series of other emotion-evoking stories in the local media relating to the cancer problem in the country. First was the breakdown of the cancer machine at Mulago National Referral Hospital, and the subsequent referral of patients to Nairobi for treatment. We have also had fund-raisings for funds for treating cancer patients abroad. Beyond, the emotional response from the loss of lives to the disease, these events are expected, at the very least, to raise the concern and invoke a discussion on the cancer problem in the country and what we can do about it. Unfortunately, we have not had this discussion yet.
This article highlights some of the issues we can pick from these recent incidences that concern all of us. First is that cancer could be on the rise in the country. Second is the huge financial costs associated with cancer treatment, which most individuals and families cannot afford without external support. The third is the issues of healthcare and national preparedness to deal with cancer.
The discussion we need to have should address some of the questions that arise: Is cancer actually on the rise or is social media creating a false impression? How about the high costs associated with cancer treatment, what can we do about it? Apart from repairing the broken cancer machine, what else needs to be done to reduce these incidences?
According to research done at Mulago hospital using the Kampala Cancer Registry, the oldest registry on the continent over the past two decades, there has been a surge in cancers associated with Western lifestyles. Other cancers associated with HIV and those associated with poverty such as cancer of the cervix, throat and stomach have remained high over the period. Apart from poverty, HIV and Western lifestyles, recent gains in life-expectancy are expected to increase cancers as people tend to get cancer at older ages.
As the country aspires to attain middle income income status, this will most likely come along with more sedentary lifestyles. And in a society where eating junk food and being pot-bellied are associated with a good life, we can predict unhealthy lifestyles to rise with rising incomes. Thus, cancer is on the rise and judging by current trends, we can only expect it to increase in the next years. The several fundraising campaigns highlight the issue of financial preparedness and ability of families to meet the costs. Most of these campaigns are always seeking monies in the range of Shs80m to Shs150m for treating a single patient, mostly in India. This sum may be too much even for a moderately privileged household. A single case of cancer can economically devastate a ‘middle income’ household and plunge it into poverty. This is yet another reason why Ugandans shouldn’t continue waiting for the national health insurance policy and its implementation. Hopefully, when the policy is finally implemented, it will cover expensive costs associated with treatment of non-communicable diseases.
Health economists have also proposed the establishment of a public facilitated loan-like scheme to assist families. Whatever we choose to do, as the national burden of cancer rises, we need to be mindful and actively look for solutions to the financial catastrophe associated with these diseases – lest we launch our own campaigns when our turn comes.
The recent death of the man at the cancer institute was tragic. It also highlights a major issue at the heart of the cancer problem – that of late cancer detection. Public health research conducted in the country shows that most patients are diagnosed with late stage cancer – when little remedial action can be done. Often times, this even makes fundraising efforts for treatment even futile. Much as regularly screening for cancer for all high risk individuals according to stipulated standards may be expensive for the nation at present, some interventions for early detection and prevention are within our reach. These include, for example, HPV vaccination of young girls and cervical cancer screening for women.
Our recent research in eastern Uganda revealed embarrassing findings: That less than 5 per cent of women in Bugiri and Mayuge districts have ever screened for cervical cancer. Cervical cancer screening modalities are affordable. If we are to come closer to early cancer detection, we need public health experts, social workers, civil servants and everybody to promote cancer screening. The earlier we detect cancer, the lesser the cost of treatment.