In Zimbabwe, cancer is on the prowl, leaving several devastated victims dead, or barely clinging to life. With the cost of treatment out of reach for many, if not all, and only two hospitals capable of dispensing cancer treatment, a diagnosis has become a death sentence.
By Davidson Kaiyo
The report that the government of Zimbabwe will soon be using some of the funds from AIDS levy to help fund activities to fight cancer comes as sweet news to the ears of many cancer activists. That cancer is one the prowl and has become a threat to society is now a fact in the country. Recently the media fraternity lost two prominent colleagues Sharon Maguwu of the Daily News and Christina Taruvinga the former Editor in Chief of Zimbabwe broadcasting Corporation. And not many days after that the nation was plunged into morning again after Cde. Dick “Cde Chinx” Chingaira succumbed to cancer of the blood (leukemia) same as Sharon while Christina battled breast cancer. The death of these prominent people in the space of days is just the tip of an iceberg. Cancer has become the highest killer disease in Zimbabwe at the moment. Even the dreaded HIV/AIDS has been relegated.
While the cancer diagnosis in itself is not a death sentence many deaths have been recorded in the country. This is mainly because most people present for treatment when the disease has advanced and when it’s difficult to treat. It can also mean a death sentence due to the high cost of treatment The cost build-up from examination, diagnosis, lumpectomy, surgery and treatment are it chemotherapy or radiotherapy, even surgery, runs into thousands of dollars with no subsidies to alleviate the financial burden. Radiotherapy costs between US$3 000 and US$4 000 for an entire course, while chemotherapy sessions costs between US$100 and US$1 000 per cycle, depending on the stage which the cancer has reached, according to the Ministry of Health. A patient may need a minimum of six cycles, but these can go up to 12. Many people end up dying because they just cannot afford to get treatment. Diagnosis and treatment of the disease are also a challenge to many people, who do not have adequate knowledge about the disease which has wrecked havoc in the country.
The other major challenge of the fight against cancer has to do with funding. While there has been a flurry of activity like the AIDS levy around diseases like HIV and Aids, tuberculosis (TB) with major government and donor funding channelled towards these diseases, little is being spared for cancer, which is now fast becoming a serious financial burden for the health delivery system and households and with the envisioned cancer levy still to be considered by policy makers. With the taxpayer already overburdened it may take a while before the cancer levy idea coming to fruition. More resources are needed to provide free or subsidized treatment as with the case with HIV/AIDS. Even screening and diagnosis need to be made accessible and free especially for those in the marginalized areas. Researches into cheaper and affordable treatment also need resources so more must be done.
According to World Health Organization (WHO) projections, the majority of people with cancer worldwide live in developing countries. This is causing enormous pressure on already overstretched health systems. The African region, in particular, is facing a major public health challenge due to the rising burden of cancer. According to WHO it has also been projected that 70% of all cancer deaths occur in low and middle-income countries, such as Zimbabwe, where there are limited or non-existent resources for prevention, diagnosis and treatment of cancer. This is a precarious situation and has Zimbabwe needs to mobilize its resources from human to financial for the country to combat this surge.
Zimbabwe is proud to have one of the few functional national cancer registries in Africa, which was established in 1985. The most recent report of the registry for the year 2013 was published in August 2015. According to this report, 6,548 new cancer cases were diagnosed in 2013. The latest statistics released by the Cancer Registry shows that there has been a steady increase in reported cases. In 2011, recorded cases were 5 553, while in 2012 cases stood at 6 107 before escalating to 6 548 in 2013. And this represents an increase of about 6,7 percent. These figures are an understatement compared to what is on the ground. Many people are living with cancer undiagnosed only to present for treatment when it is too late or when they succumb to it their deaths are not recorded by the cancer registry especially those in the rural areas. It is not everyone who can afford to get screened or diagnosed and yet statistics are based on those who would have been diagnosed, screened or whose deaths are registered.
According to reports access to screening, early detection, diagnostic and palliative care services is limited due to resource constraints. Another problem is that most diagnostic, treatment and palliative care services are centralized, so limiting access for many patients. Cancer treatment is currently only available at two government hospitals in Harare and Bulawayo; private chemotherapy services are also available, mainly in the cities. There are no private radiotherapy services in the country. The centralized nature of the services also poses transport and accommodation problems, leading to treatment delays. Meanwhile, the more affluent patients seek services outside the country.
Cancer has surely become a menace to the Zimbabwean community and the unfortunate thing is ignorance. While most people are aware of cancer, many forget or are not empowered to take the steps to have a plan to detect the disease in its early stages and encourage others to do the same. Early detection is a major weapon to defeat breast cancer. The other good news is that with the advancement of technology cancer can be treated, but for many people a cancer diagnosis can be taken as a death sentence. Diagnosis of cancer induces fear both in the individual and in families. As a nation, we need to do more to raise awareness and advocate for more action to be taken to fight this menace. We need to fight the ignorance in people, hence the need for strategies for social change leading to improved health care.
Zimbabwe has had her success in fighting disease, for example the HIV/AIDS prevalence which came down from 18% in 2004 to 15% in 2011. This was achieved through a coordinated, multidisciplinary approach and all stakeholders, putting hands on the deck. Success in HIV control in Zimbabwe brings hope for the fight against cancer.