Transcript
Mugambe
Exactly, that is really what I would dream about. At the moment most of our ladies who come to us with very advanced cancer, stage 3, some of them stage 4.
Emmett
And that is when it is so serious that there is not much that can be done?
Mugambe
That can do done apart from reducing pain, maybe reducing discharge or bleeding but as far as a cure is concerned the chances are very minimal.
Emmett
So the other hope is to spot the cancer very early on when the cancer is small?
Mugambe
Yes. And that is why I have brought you here to Kawempe Health Centre where we are starting a project screening women above the age of 25 years, screening them for two cancers, basically for cancer of the cervix and cancer of the breast. So, in other words you are trying to catch the cancer of the breast early before it becomes big and before it has spread to other parts.
Emmett
Well now I am going to see the cancer screening as its called, in action and go into one of the consulting rooms where Nurse Beatrice Naganda Chibero is at work. May I come in?
Emmett
Fine, oh hello I see you have a lady here?
Beatrice
Welcome. Yes I have a lady.
Emmett
And she had brought her little one with her?
Beatrice
Yes she has brought her baby with her. This is Harriet she has come for her cervical cancer screening as well as breast examination. This is very good to teach a woman how to examine their breast themselves because many women, they can find the lumps which can turn out to be cancerous later in their lives by themselves. So, this has to be done once a month ten days after her menstrual period.
Emmett
So you insist on this time, ten days after the period?
Beatrice
So she stands before the mirror and looks at her breast to see whether there is any kind of swellings. If she has no mirror she can tell her friend to look at her to see if there is any kind of swelling. She looks at her nipple to see if there is any kind of discharge like puss discharge, if there is any watery discharge, if there is any kind of blood discharge. She looks at the skin of the breast to see if it has an orange kind of appearance.
Emmett
So it changes in colour or texture?
Beatrice
Cancer has the tendency of changing it to... like a skin of an orange. So you look at the breast to see if it has that kind of texture. Then after that, uses her three fingers, not the tips, to go around the breast pressing, first of all lightly then to rule out any kind of swellings which are just under the skin.
Emmett
Now the other thing you are going to do is look for cervical cancer. That involves looking inside, up through the vagina to look at the neck of the womb?
Emmett
Is it easy to spot a cancer like that?
Beatrice
Yes it is very easy?
Emmett
Even at an early stage?
Beatrice
At an early stage it is very easy to get it because the lady has to lay on her back. You go into the vagina, it is not painful provided the mother has relaxed. And then, we have aesthetic acid, we apply it on the cervix, if it makes any changes, that shows that there is an early cancer.
Emmett
So this is just tiny marks, tiny abnormalities and you can spot them?
Beatrice
Yes, which can be spotted. We also use Lugol's iodine if there are lesions that are suspected to be cancerous. We have a treatment that we give, it is a cool kind of treatment to kill those cells early enough so that they do not develop into cancer at all.
Emmett
Well, thank you very much indeed for that and Harriet, your patient, is waiting patiently here beside us so I should let you get on with your work.
Beatrice
Thank you very much, Susie.
Emmett
Outside the clinic there are now even more women who have come for screening as its called, testing in this pilot scheme in the Kawempe Health Centre. So Doctor Joseph Kigula as a cancer doctor, as the Head of the Radiation Therapy Department, is this the kind of testing or screening for early stage cancer that you would like to see much more of?
Mugambe
Certainly, this is what I would want. At the moment this is a pilot study, and we are targeting twenty thousand women in about two years. After that, we would want to see, covering the whole city and hopefully going over to cover the whole country. This is the best way, the most cost-effective way of managing cancers. Treat them before they actually become evasive, to catch them when they are very small, it is very satisfying and has real benefits in the long term, than putting up very expensive radiotherapy centres and training radiotherapists rather than nurses who can do this kind of work. End of track
