Two years after the National Cancer Centre was due for full operation, there are still many Malawians that are turning to hospitals abroad for radiotherapy. Why is this the case?
As Malawi reels in cancer devastation, partly reflected in frequent calls for support for someone diagnosed with cancer to access treatment abroad, the national cancer centre is still not close to offering full services.
This is, in part, because there are international standards to meet, according to the Ministry of Health.
In 2019, government build hope through the National Cancer Control Strategic Plan (2019-2029) when it said the cancer centre was due to open in 2020.
“Cancer treatment in Malawi is anticipated to take new dimension with the development of the National Cancer Treatment Centre (NCTC) in Lilongwe which is due to open in 2020.
“The operationalisation of the cancer centre will be the single most important initiative in the national cancer control programme of Malawi, given the fact that cancer treatment is currently highly fragmented and provided in over-extended hospitals with limited infrastructure, consumable supply chain problems and limited skilled and experienced human resources,” government said in the strategy.
But two years on, there is no hope in sight as to when it can provide full services.
The Ministry of Health says “there is no fast forward” to make the centre operational.
“You know we started using the cancer centre. And there are three ways of treating a cancer patient; the first is chemotherapy, then surgery that sometimes involves removing the affected organ. Then there is radiotherapy.
“As it stands, we offer the two services and not radiotherapy,” Ministry of Health spokesperson Adrian Chikumbe told Malawi News on Thursday.
He added: “The rules are quite dangerous; that is why we have to be cautious. Any clinic that offers radiotherapy has to be certified by International Atomic Agency.
“They are supposed to monitor the structure if it meets the required guidelines and see if it is going to be a hazard to staff and other patients and so right now, before we install the proper equipment, we are supposed to make sure that it is safe for everyone.
“So, there is no fast forward. We have to make sure that we are complying with international standards. We are making sure that we continue providing the other two of the three services that are supposed to be provided at the cancer centre,” he said.
Executive Director for Malawi Health Equity Network (Mhen) George Jobe said cancer keeps exacting its toll on the country when the cancer centre was supposed to be providing relief.
Jobe said while others are able to source and raise funds to access radiotherapy abroad, there are several others that are lying helpless because of the unavailability of the services in the country.
“It is unfortunate that government looks somehow comfortable with the services it is offering. A lot of research has shown that cancer is one of the leading killers in the country and if we prioritised the centre, we would save a lot of lives. We actually needed the centre fully up and running like Friday.
“There are organisations that are working on cancer related issues but what government would offer goes a long way because it caters for those that are less privileged,” he said.
One social media activist who has run funding mobilisation campaigns for cancer patients said most times, cancer cases that need medical attention outside Malawi usually require K10 million or more depending on the nature of the problem.
“The reason why such cases are a burden is because mostly they are very costly. I have once dealt with a case that required close to K20 million.
“It is sad that as a country, after a lot of years of seeing such cases, we do not have our own centre. However, Malawians deserve a pat on the back because of the unity that is there among us. But to be honest with you, cancer treatment is no mere treatment; it is expensive and government should take keen interest. A lot of lives will be saved,” said the source.
Director of Non-Communicable Diseases in the Ministry of Health who is also responsible for referrals, Jonathan Chiwanda, asked for more time when asked to provide records of how many people government supports for treatment outside the country.
Patients requiring radiotherapy, complicated cancer surgeries and intensive chemotherapy are often referred to India, Zambia and Tanzania.
According to the National Cancer Control Strategic Plan, in Malawi cancer is a growing concern, causing significant morbidity and mortality due to lack of comprehensive cancer prevention, early detection, treatment and palliative care services.
It estimates that the total annual new cancer cases stands at 15,349, with 5,966 cases among men and 9,383 in women.
It says Malawi has the highest age standardized incidence rate (75.9/100,000 women) of cervical cancer in the world, with the risk of one out of 14 Malawian women developing cervical cancer in her life time.
“The projected cancer burden might be underestimated due to inadequate cancer diagnostic services and underreporting of clinically diagnosed cases given that only 18 percent of all reported cancers had pathological confirmation,” reads the plan.