The wards may be full and the waiting times long, but at least the patients at the Cancer Diseases Hospital (CDH) in Lusaka, Zambia have a chance of surviving their illness.
Before the centre opened in July 2007, cancer sufferers who could not afford private care had two options: they either had to join a long waiting list for treatment in Zimbabwe or South Africa or, more often, they simply died.
The CDH is the first and only cancer treatment centre offering radiation therapy in this country of over 14 million people. In the past ten years, around 16 000 people have been diagnosed and treated at the hospital. The country has witnessed a three-fold increase in the number of cancer cases since the hospital opened. Seventy percent of cancer patients are women.
The IAEA, through its Technical Cooperation Programme, has supported the hospital since planning began in 2002.
Radiation medicine is a vital component of cancer control. Procedures such as X-rays, CT scans and mammograms are used for the early detection and diagnosis of cancer. Radiotherapy can treat and manage the disease and provide substantial pain relief for patients when cure is not possible.
Rebecca Siabwati received radiotherapy for cervical cancer at the CDH in 2010. The retiree now works voluntarily as a counsellor, encouraging women to be screened for cancer and supporting them before and after treatment. “In our community, there are a lot of myths,” she said. “People just associate cancer with death, so they’re afraid to come forward for screening.”
“Sometimes they go to traditional African doctors, who give them herbs or medicines from trees. They even sell their cows and property to pay for this. But they’re just wasting their money and time.”
As part of her work, Siabwati attends gatherings in towns and rural areas where she informs women that cancer can be detected early and treated.
“At the hospital, I talk to patients. I give them hope. I tell them that I’m a cancer survivor, I’m not dead. If I survived, then there is hope for them too.”
Rachel Mwale was treated for breast cancer, but the cancer spread to her lungs and she needs further treatment. “I felt very sad at first. I thought about my children. But now I have hope. Sometimes when the doctors and nurses talk to you, they give you hope,” said the 52-year-old. “This hospital is very good and the staff is very helpful.”
The IAEA contributed to the design of the facility, arranged training for medical professionals, assisted in the establishment of radiation protection measures for patients and staff and even helped the Government secure a loan to finance the project.
“Without the assistance of the IAEA, it would have been very difficult for us to set up a highly technical centre like this one and care for so many patients,” said Lewis Banda, the CDH’s Senior Medical Superintendent.
The IAEA still plays an important role. It sends medical students from other African countries for two-year training programmes and continues to help the hospital acquire essential medical supplies.
The centre’s two teletherapy machines administer 130 sessions of radiotherapy per day. Two brachytherapy units treat the rising number of patients with cervical cancer, the commonest cancer in Zambian women. There are also mammography services for the early detection and diagnosis of breast cancer.
Cancer care in the rest of Zambia
Outside Lusaka, the situation for cancer patients is very different.
At the central hospital in Livingstone, in Southern Province, there are facilities to screen and make a clinical diagnosis of cancer, but there are no services to treat cancer or even analyse tissue samples.
Chief Surgeon Kelvin Moonga said: “We don’t even have a pathologist here, so we need to send samples to Lusaka. It can take up to a year to get results back. Sometimes we lose patients because it just takes too long.”
When faced with a cancer diagnosis in Livingstone, patients are told that they need to make the seven-hour journey to Lusaka, at their own cost and often without their families and friends. “We tell patients the cancer treatment is free, but you have to get to Lusaka. They have to make multiple visits for treatment. This is expensive and most of our patients can’t afford it,” said Moonga.
He added that many patients do not even start their treatment, while others do not finish it.
To cope with the chronic lack of cancer treatment facilities, the Zambian Ministry of Health has launched an ambitious project to expand services throughout the country.
The towns of Livingstone and Ndola have been designated as the locations for the first phase of the expansion plans. The IAEA will be helping Zambia to prepare for this expansion through expert advice and training.
“If we have a cancer treatment centre here in Livingstone, it will mean there are no travel costs for the patients,” said Moonga. “It’s these costs that sometimes stop them getting the treatment they need. And if they have direct access to treatment, they’ll be more motivated to seek it, before it’s too late.”