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Breakdown. The breakdown of the cancer machine has attracted widespread condemnation of government inaction
About 2,000 cancer patients in need of radiotherapy treatment in Uganda will have to wait for about two years to receive relief from unbearable pain following a breakdown of an old Cobalt 60 radiotherapy machine last month.
The breakdown of the machine has caused national and international public outcry and has attracted widespread condemnation of government. Some sections of the public criticised government for failing to prioritise cancer treatment in the country following a Shs1.4 trillion supplementary budget passed by Parliament last week without funds dedicated to cancer.
At a hastily organised press conference by the Uganda Cancer Institute (UCI) yesterday, the Health Minister, Dr Elioda Tumwesigye, instead defended government for “astronomic budget increments to UCI.”
“From the 2014/15 budget, government gave UCI about Shs8 billion, Shs17 billion this financial year and in the financial year 2016/2017, government is going to give the cancer institute about Sh41b,” Dr Tumwesigye said.
He said government has already placed an order to the International Atomic Energy Agency (IAEA) to replace the old Cobalt 60 machine installed 21 years ago.“There are different types of radiotherapy machines and what we have is an older model and there is another machine we are buying and I think a receipt has been provided to you. We will be bringing a Cobalt 60 Machine,” the minister said without being specific on the date.
He said the machine has been offering free treatment to many foreigners running away from high treatment cost in their countries.
However, Dr Tumwesigye said the new machine has been delayed by construction of a bunker to house it since the old bunker was found to have safety problems.
Terming the bunker construction process as complex, Dr Jackson Orem, the director of the UCI, said it has taken about two years to have the designs of the bunker approved by IAEA since it uses nuclear and atomic technology.
He said the process of constructing a bunker will last about one year or more depending on the speed of the contractor and availability of funds. It will then be followed by the process of manufacturing and shipping of the machine.
“We have gotten the design of the bunker and we are now left with the company to have work done. We have three reputable international companies which are being evaluated and if all goes as planned the groundbreaking ceremony should take place in the first week of May,” said Dr Orem.
A receipt document seen by this newspaper circulated by UCI on social media indicates that government paid 325, 297Euros ( Shs1.2 billion) to IAEA offices based in Vienna, Austria on May 22, 2013.
“This amount represents a voluntary contribution from the government of Uganda, through Mulago Hospital Complex for the purchase of the Cobalt 60 Telepherapy machine under the IAEA Cooperation project UGA/6/015,” indicated the receipt in part.
Dr Tumwesigye said the machine break-down has negatively impacted on the capacity to treat cancer by less than 20 per cent since there are other cancer treatment methods like chemotherapy and surgery.
However, an official from the cancer institute told this reporter that about 75 per cent of cancer patients require radiotherapy treatment.The machine has been treating about 100 patients per day.
By definition, radiation therapy is a type of cancer treatment that uses beams of intense energy to kill cancer cells. Therefore, the breakdown and delays to replace the treatment, will leave about 2000 cancer patients treated every year with unbearable pain.
According Dr Tumwesigye, the construction of the bunker is expected to cost the government a total of about Shs30 billion which will be disbursed in lumpsum after the health ministry agrees with that of Finance on how to make the money available. He said the infrastructure will have about seven bunkers which will house other cancer machines like the recently acquired high dose blackytherapy machine for cervical cancer and others to be purchased at a later stage.
The institute also lacks a magnetic resonance imaging (MRI scan) and positron emission tomography (PET) scan, all specialised instruments required for proper cancer treatment and diagnosis.
With the current stalemate, Dr Orem said that the institute will provide alternative treatments to patients who have been on radiotherapy and also provide palliative care to about three quarters of the patients whose cancers have reached advanced stages.
“We always receive patients with advanced disease and my only appeal is that we need to come early for screening if cancer is to be treated and managed,” Dr Orem said.
According to Dr Tumwesigye, the country has about 200,000 cancer cases of which 60,000 are new cases and about 46,000 patients die of cancer each year. It is estimated that about 300,000 cancer cases will be registered in the next five years with more young people at risk of the disease because of body inactivity, poor diet, tobacco and infections.
The mortality rate remains high with a survival rate of only 20 per cent at the Uganda Cancer Institute. Six per cent of the patients are from Kenya, the Democratic Republic of Congo, Burundi, Rwanda, Tanzania, Kenya, Somalia, Ethiopia and Eretria.
Government is in the process of establishing four regional cancer treatment centres in Arua, Mbarara, Mbale and Gulu to increase early disease detection and screening.