AGFAX Resource - Fighting Cancer in Africa - Voices of doctors and patients (IAEA) April 2006

In Uganda cancer is on the increase. While this may be partly explained by an increasing population, Dr Joseph Kigula, Senior Consultant Radiotherapist at Mulago Hospital in Kampala explains that the incidence of breast cancer has doubled over the last 20 years and women who are developing cancer of the cervix are increasingly younger and suffering more aggressive forms. With only one treatment unit in Uganda, he estimates that there are 20,000 cancer suffers who could be diagnosed and treated if Uganda had more equipment and treatment units.

Once cancer is diagnosed and deemed treatable, it is the job of a medical physicist to plan the patient's radiation treatment. In the case of breast cancer, the objective is to maximise radiation to the tumour in the breast, but minimise radiation to surrounding areas, such as the lung. Kavuma Awosi, medical physicist at Mulago Hospital uses machines to measure the tumours from every angle so he can pinpoint where radiation should be targeted and calculate how much radiation should be allowed to hit the body and for how long.

Dr Joseph Kigula, Senior Consultant Radiotherapist, dreams about being able to detect cancer early. Cancer of the cervix and breast are among the most common cancers for women in Africa, however the earlier the cancer is diagnosed, the more likely that treatment will be successful. At Kawenpe Health Centre, Susie Emmett meets Nurse Beatrice Chivero who is screening women for cervical cancer and teaching them how to examine themselves for the signs of breast cancer. It is this early detection that Dr Kigula believes is the best and most cost-effective way of managing cancer in Uganda.

With 60 to 80 patients to look after each day in the cancer treatment unit at Mulago hospital, Nurse Elizabeth Nagudi is very busy. As well as dispensing drugs and monitoring treatment, the nurses also counsel and reassure their patients. Helping to make a patient feel better gives great satisfaction to Elizabeth, and she hopes with better screening methods, more of her patients will get the treatment they need early.

Doctor Ponsiano Baguma's job is to diagnose, assess and then send his cancer patients for treatment. It is difficult to tell someone they have cancer and explain what radiation therapy is, so he has to choose his words carefully. Dr Baguma was trained to preserve life and so is demoralised when most of his patients don't survive more than a few years because they came late for treatment. However when radiation works and someone improves, he is given strength to continue.

After a patient's treatment plan has been prepared, it is the radiation therapist who delivers the radiation. Giving her patients hope makes Milly Bowenge's job worthwhile but she is frustrated when the machine breaks down and she is unable to give treatment. With one machine in Uganda and cancer on the increase, she hopes that soon there will be more machines and more treatment centres to fight cancer in Africa.

Lamunu Penina has travelled a long way from home to get treatment for her mother who has cancer of the cervix. Lamunu cares for her mother and provides all the support she can. She has seen much improvement in her mother's health since she began radiation therapy. Lamunu wishes that the government of Uganda would support the unit to ensure that it continues to operate and treat the sick.

With a cancerous tumour in his knee, Francis Musutwa, a 25 year old electrician, faced the prospect of amputation. However after discussions with his doctors they decided on surgery to remove the tumour followed by a course of radiation therapy. Francis explains how friendly the doctors are and what his radiation treatment is like.

After being diagnosed with breast cancer, Harriet Namudde lost all hope and thought of death. The operation to remove her breast and the radiation treatment she received afterwards to kill the remaining cancer cells frightened her and was very stressful. Harriet has now recovered and returned to work as a nurse at Mulago Hospital, where she uses her experience to offer hope to other cancer sufferers.