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So near, yet so far away from radiotherapy

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MITHI—It speaks a lot of how we have failed our fellow Malawians

Forty-year-old Petrol Magasa of Mkanja Village in Dedza District is one of the patients who presented themselves at the dispensary at the cancer centre, ready to receive his prescription for cancer the doctors discovered recently.

Magasa has a swollen neck, which also affected his left eye, and, upon screening him, the doctor confirmed the condition to be cancer, one of the non-communicable diseases that are becoming a concern to Ministry of Health officials in the country.

“The doctors have told me that it is cancer. I have just been scanned. I am waiting for results so that I can begin to get the actual treatment,” he said.

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He is one of the patients that are receiving treatment at the centre ever since it became operational partially.

He is, however, unsure about how, moving forward, the whole treatment will turn out.

“l heard that it takes time to get healed from cancer and that, sometimes, it’s a lifetime burden until it takes your life. But I wish there was a way I could get an instant healing. At one point the doctor said I will have to undergo chemotherapy,” he said

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His wife, Selina Samala, said confirmation that her husband has the disease has placed a burden on their lives as they have to be visiting the centre now and then for treatment.

“We don’t have the financial capacity to be visiting the centre for treatment frequently. We have no choice but to be coming here because we need healing,” she said.

In the corridors of the state-of-art facility lay 52-year-old Amos, who had just finished chemotherapy treatment and was catching some breath before leaving for his house in Chinsapo, Lilongwe.

“It has not been easy going through the process. I normally experience severe headache, stomach upset and my body can even tell,” he said.

Hospitals in the country provide cancer treatment of chemotherapy and also conduct surgery by removing the cancerous organ to cancer patients.

The cancer centre, which is partly in operation, only provides chemotherapy and surgery services despite being designed to have its own cancer surgery, radiotherapy, chemotherapy, hormone therapy, palliative care, pathology and allied diagnostic services, medical records and hospital cancer registry services.

Among the three cancer treatments, the centre does not provide radiotherapy services, which was, in the first place, the major aim of having the facility in the country.

The Ministry of Health says, currently, it is constructing a bunker, where radiotherapy equipment is supposed to be housed.

Spokesperson for the ministry, Adrian Chikumbe, acknowledges that there have been some delays to have the radiotherapy facility in place as the initial contractor failed to meet the specified standards as prescribed by the International Atomic Agency.

“We are happy that we are making progress. Once we are done, we should be able to purchase the desired equipment and, maybe, in about a year, we should be able to have the facility operational,” he said.

Chikumbe said the ministry would still have to be monitored at every stage when the bunkers are constructed, hence the longer wait.

The cancer centre project was launched in 2017 as part of the strategy to save financial resources that government spends on referrals who seek treatment abroad.

It was a move towards meeting Universal Health Coverage (UHC) goals, especially as it relates to reducing cancer incidence, mortality and improving cancer down-staging and survival rates in Malawi.

The National Cancer Control Strategic Plan for 2019-29 estimates annual new cancer cases to be at 15,349, with 5,966 cases among men and 9,383 in women as around 2012.

One of the cancer survivors is Chikhulupiliro Ng’ombe, who is also founder of Cancer Survivor Quest.

Ng’ombe said, without the radiotherapy facility, the country faces an uphill battle.

He indicated that chemotherapy is so powerful that, apart from curing some types of cancer, some patients lose their hair, have their internal organs damaged, with others even dying.

“It is very important that we, as a country, should have chemotherapy. Other forms of chemotherapy can be used for cancers that are difficult to treat,” he said

Society of Medical Doctors (SMD) in the country advocates for the presence of radiotherapy services as soon as possible, stressing that some type of cancers are resistant to chemotherapy.

“With some type of cancers, no matter how much chemotherapy you would give, they cannot be cured. It is at this stage that you need radiotherapy. In Malawi, there are some cancers that we cannot treat and you would imagine the burden that people are having.

“Yes we are able to refer some of the patients outside Malawi, but the referral system has proven to be a failure because it is very expensive to many patients. It is also a very tiresome process and, in some cases, by the time the patient has processed everything, the cancer has already spread beyond cure. As such, it is a matter of urgency,” SMD President Victor Mithi said.

Mithi said the country has people that have been trained in cancer treatments but lack necessary equipment.

“We, as a country, are unable to provide these services. It speaks a lot of how we have failed our fellow Malawians and it also adds an extra burden on the families. Much as they may be referred, in most cases it demands that families dig deeper into their pocket to support extra guardians and, in the end, we lose more, than having the patient treated in the country,” he said.

Patients requiring radiotherapy, complicated cancer surgeries and intensive chemotherapy are referred to India and other countries at considerable cost toTreasury. Some patients seek radiotherapy services in Zambia and Tanzania.

The development and operationalisation of the cancer centre is deemed as the most important initiative in the national cancer control programme of Malawi.

Cancer treatment is currently highly fragmented and provided in overextended hospitals with limited infrastructure, consumable supply chain problems and limited skilled and experienced human resources.

With eight years left to meet 2030 Sustainable Development Goals, cancer mortality rates will continue to soar as the citizenry will continue failing to access radiotherapy services within the country against the call for global leaders to reduce deaths associated with non-communicable diseases through prevention and treatment and promote mental health and well-being.

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