Tanzania's cancer centre works to save lives

Published Date: 21 June 2007

© The Ocean Road Cancer Institute (ORCI) is Tanzania's only specialised cancer treatment and radiotherapy centre. Every year ORCI handles some 3000 new cancer patients and up to 10,000 follow-up cases. That's only a small portion of Tanzania's cancer burden--estimated at 35,000 new cases a year--but a huge workload for this hospital of just 112 beds and 200 staff For many patients from poor, rural areas of Tanzania, this sign represents the end of a long and uncomfortable journey. It also marks the beginning of another journey, as they embark upon treatment for their disease. ORCI is housed in a handsome white building dating back to the 19th century and German colonial rule in Tanzania. On the upper floors its colonnaded corridors and many windows permit the circulation of cool breezes from the nearby Indian Ocean. Up to 20% of ORCI's patients are children. The most commonly found childhood cancers in Tanzania are Burkitt's Lymphoma and cancers of the head and neck. At ORCI children are treated with both chemotherapy and radiotherapy. Childhood cancer is relatively rare and the survival rate in the developed world has improved to more than 75%. Sadly that is not the case in developing nations where the survival rate is less than 50%, usually because the cancer is diagnosed too late. The Paediatric Ward (Ward 3) has 18 beds but usually houses as many as twice that number. Parents are allowed to stay for the duration of their child's cancer treatment. Due to space constraints at ORCI, chemotherapy is administered to the children in a cramped area at the end of the ward. Hair loss is a common side-effect of chemotherapy, which is widely used in the treatment of cancer-either alone or in combination with radiotherapy. Once the chemotherapy treatment is completed, the hair will grow back. Between treatments at ORCI, the children often gather together on the stoop outside the paediatric ward. With no play area, entertainment is improvised-this pole makes an effective swing. Given Frank Kamindu was just two years old when diagnosed with Retinoblastoma, a cancer of the retina. His left eye had to be surgically removed (a procedure called enucleation) because the cancer had spread to surrounding tissue. But Given is responding very well to radiotherapy treatment at ORCI and he and his father hope to go home soon. Given's father Frank Kamindu, 38, a Tanzanian farmer, had to sell his two goats and borrow money from a friend to make the 900 Kilometer journey to Dar es Salaam so that his son's cancer could be treated at ORCI. Given is now undergoing the second of two cycles of radiation therapy. The radiotherapy machine, a MDS Nordion Equinox 100, was provided by the IAEA in July 2006. Albinism is a genetic condition causing people to be born with little or no pigment in their skin, hair or eyes. Under Tanzania's fierce sun, Albinos are particularly at risk of getting skin cancer. It has been estimated that 17,000 Tanzanian Albinos are threatened. Skin cancer is avoidable if the skin is protected with sun-blocks or beta carotene supplements, but these are beyond the financial means of most of the country's Albinos. Kibibi Stambuli, 43, from Tanga in northern Tanzania is undergoing chemotherapy and radiotherapy for cancer of the oesophagus. Tima Omary, 56, travelled to Dar es Salaam with Kibibi in mid-April. She has been living for two months in the round, open-sided Pavilion in ORCI's grounds, along with scores of other relatives. Tima helps to cook and care for her sister. The round, open-sided Pavilion in the hospital grounds is temporary home to scores of relatives and friends who travel with cancer patients to ORCI and who have nowhere else to stay. The women cook on small portable stoves and spread their washing over nearby lawns. At night men, women and children sleep on the Pavilion's hard stone floor. ORCI's Vision is to become an institute of excellence for the treatment of cancers in Africa. PACT is bringing partners together to guide and support ORCI as it develops into a centre from which regional hospitals in Tanzania may learn and draw inspiration. ORCI is a regional resource centre for all aspects of screening and treating cervical cancer. ORCI also collaborates with PACT partners IARC and INCTR in a joint cervical screening project. Waiting rooms at ORCI are usually crowded with day patients. As many as 180 people a day receive radiation treatment at the Institute, an increase of 300% in recent years. ORCI has only three radiotherapy machines and a ratio of one radiation oncologist to every 1000 patients. Medical Records at ORCI are a reminder of the pre-electronic data age. Records from the year 2000 are also kept on a computer database but hard copies are safer in Tanzania, where power supplies can be unreliable. Dr. Twalib Ngoma (left), Exective Director of ORCI, together with Dr. Deo Mtasiwa, Chief Medical Officer of the Tanzanian Ministry of Health and Social Welfare. The Tanzanian government is committed to establishing a National Cancer Control Plan, in collaboration with ORCI, IAEA/PACT and other international partners.