Fighting cancer requires more skilled health workers - research

More than half of the world’s cancer deaths occur in developing countries. Inadequate capacity of health workers, low level of awareness, late diagnosis and treatment remain the major factors behind cancer deaths in Uganda.

While releasing the findings of a research study titled; ‘Training Needs Assessment for the East African Centre of Excellence in Oncology’, Dr Roy Mubuuke, a lecturer at Makerere University School of Medicine, said the rising burden of cancer in the country amid limited resources requires more skilled health workers.

In the study conducted among health workers, patients, academic experts and government officials, medics were making great effort to provide the much-needed comprehensive cancer care.
However, the researchers noted significant gaps between what is currently provided and what would ideally be required.
“These gaps require urgent training interventions to boost the capacity of the health workers,” Dr Mubuuke said.

He also cited the need to train nurses that specialise in management of cancer.
However, the concern about whether there are any specialised trainers in the country for the nurses that will manage cancer remains unanswered.
Similarly, while reacting to the research findings, Mr Robert Odok Ocheng, the director of training at the Ministry of Health, said the increasing burden of cancer is alarming.

Mr Odok, however, promised to consult with the permanent secretary in the Ministry of Health, and Education ministry to roll out the initiatives to equip health workers better.
Other key areas such as counselling, communication and interpersonal skills were greatly lacking among health workers in the cancer management sector.

Caretaker speaks out
Sarah, who is taking care of her mother, a skin cancer patient at the Uganda Cancer Institute (UCI), agreed that sometimes the health workers are arrogant.
Sarah has for the last one month been spending her nights on the cold hospital veranda.
She was, however, hopeful that her mother’s condition will improve, and by the end of November, they will be home.

Up to 80 per cent of patients admitted at the facility often die. This makes a number of people seek alternative ways to treat their ailments.
Use of herbal medicine to manage cancer remains highly prevalent among Ugandans.

Dr Victoria Walusaura, the deputy director at UCI, decried the current trend where herbalists are recommending marijuana to “naïve” cancer patients as the fastest cure.

“Most of those patients come to the institute when they are in the very late stages of cancer and we cannot help much,” Dr Walusara said.
Dr Gerald Mutungi, the acting Commissioner of Non-communicable diseases at the Ministry of Health, while commenting on the findings of the research, decried the habit of local herbalists delaying victims from coming for early expert diagnosis and enrolment on treatment.

Dr Mutungi, however, added that there is already a law that will efficiently regulate the local herbalists, which is awaiting the President’s assent.
“We have invested in setting laboratories. Any herbalist who thinks he has herb that treats cancer should bring it for quality assessment at the laboratory,” he said.

Other highlights from research
• Peer to peer knowledge sharing was the best way health experts enhanced their skills.
• Patients were largely unaware about the diagnosis and steps to take for accessing treatment. They majorly depended on family members for advice.

• Quality of care and counselling skills are still lacking among the service providers.
• Cancer patients from rural areas are largely unaware and they report very late for treatment

Uganda Cancer Institute sets up regional cancer centres

Apart from cancer being scary, limited access to treatment and right information are some of the challenges that hinder patients from completing treatment.

This could partly be because many do not know that there are other cancer centres in Uganda besides Uganda Cancer Institute (UCI).
Dr Noleb Mugisha, the head of the Comprehensive Community Cancer Programme (CCCP), says while it is very difficult to have a cancer treatment centre in every district because of the cost, UCI is establishing regional cancer centres to ease access.

For instance, in the west, Mbarara Regional Referral Hospital has a cancer unit equipped with staff and equipment, and it currently provides care to about 5,000 patients.
Dr Mugisha says land has already been given by Mbarara University of Science and Technology to build a bigger facility.

In West Nile, Arua Regional Referral Hospital has a ward with some equipment and a team of hospital staff who support patients with cancer in consultation with the team at UCI.
The team from Kampala goes to Arua to assist their counterparts.
“In the past, medicine was carried from Kampala to Arua but owing to its level of sensitivity, this could not go on,” Dr Mugisha says.

In Gulu, land has been allocated though with new district formation, it is now found in Amuru District but it is still called Gulu Regional Cancer Centre.
“Ministry of Health has already secured the money to build a fully equipped centre that should be ready by the end of next year. All we will need to look for is human resource,” Dr Mugisha says.
In eastern region, the centre will be at Mbale Regional Referral Hospital and the dream is to have a fully-fledged cancer centre there as well.

In Mayuge District at Kigandalo Health Centre IV, there is a community cancer centre which houses a rural population-based cancer registry.
Dr Mugisha says they plan to have health teams in all health centres countrywide so that community cancer education and some testing to help early diagnosis of some cancers can be done.

October free testing/ discounts

International Hospital Kampala: Prostate cancer at 30 per cent discount, HPV-V brush at Shs125,000, PAP smear (Cervical Cancer) 30 per cent, breast cancer physical examinations.
Alexandra Medical Center: Free doctor’s consultation and breast cancer screening, 50 per cent discount on cervical cancer screening (pap smear test) for two weeks.
UMC Victoria hospitals. Free breast cancer screening at Bukoto and UMC Entebbe clinics, free consultation, 50 per cent discount on extra investigation like, breast ultra-sound @ Shs30,000 and cervical cancer screening at @ Shs50,000, discount on cervical cancer vaccine.

Additional reporting by Joan Salmon

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