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A Long Wait Ends

New cancer hospital in Zambia brings hope to patients.

Waiting can be hell. Just ask Helen Moto-Moto. Diagnosed with cervical cancer in 2005, Helen was placed on a list of patients to be sent abroad for treatment because her native Zambia had no radiotherapy facilities. Two years on, like thousands of others, the 47-year old housewife was still waiting to go. Meanwhile, her cancer was spreading.


"The waiting was dreadful," Helen remembers. "I really needed treatment but every time I called the Ministry of Health for news, I was told the same thing: we haven’t got the money to send you."

Radiotherapy is a powerful weapon in the fight against cancer. But it cost this low-income country about US$10,000 to send a patient to neighbouring Zimbabwe or South Africa for treatment. According to Zambian President Levy P. Mwanawasa, in the years 1995-2004 only 350 out of thousands of cancer patients needing radiotherapy were sent abroad. "The rest were left to endure the pain while the disease ravaged their bodies relentlessly until they died," he says.

Today Helen sits in the bright, airy lobby of the newly-opened Cancer Diseases Hospital (CDH) in the Zambian capital, Lusaka, waiting for her treatment session. As one of the first batch of patients to be seen at the US$8 million cancer facility, she is undergoing an intensive seven-week course of radiotherapy which she hopes will ease her symptoms and eventually destroy the cancer cells in her body.

Cancer of the cervix is the most commonly seen cancer in Zambia, striking 54 of every 100,000 women. (In Australia, for example, the figure is 7 per 100,000.) And in Zambia, as in most developing countries, it is usually diagnosed at an advanced stage, making it very difficult to treat. Yet with screening, early detection and treatment, this form of the disease is usually preventable and curable.

Experts say that cancer is increasing across the developing world because people are living longer and their lifestyles are changing. Many cancers are also infection-related. In Zambia’s population of 11 million, HIV (Human Immunodeficiency Virus) prevalence is 20%, resulting in high rates of Kaposi’s Sarcoma, an HIV-related skin cancer. At the same time, widespread HPV (Human Papilloma Virus) has caused a surge in cervical cancer in women.  Methods of collecting data are flawed in Zambia but health professionals estimate they will soon be seeing as many as 7000 new cancer cases each year. Referring to the cancer crisis facing Zambia, Health Minister Brian Chituwo hailed the opening of the CDH as “A watershed event, not only in the history of our country but that of the developing world."

Human health has long been an area of collaboration between the IAEA’s Department of Technical Cooperation (TC) and its Member States. Zambia’s CDH is a prime example of these synergies at work. In 2002, the Agency helped Zambia prepare the CDH project proposal which secured a US$5.6 million loan from the OPEC Fund for International Development (OFID). IAEA experts provided guidance and advice through the years of planning, constructing and equipping the hospital. And TC funds of more than $500,000 went towards training CDH staff in key areas such as medical physics, radiotherapy and equipment maintenance.

"Commissioning a state-of-the-art cancer facility in Zambia presented huge financial challenges. For the first time, therefore, a tri-partite model was established, using funds obtained from government, donors and the IAEA,” says Muhammed Lameen Abdul-Malik, the IAEA’s programme management officer. “The idea was to use this as a prototype for other African countries."

Up to 100 patients a day will receive radiotherapy once the CDH is fully operational. Treatment is on a cost-sharing basis with each patient required to contribute roughly $600. That sum is beyond the reach of large numbers of Zambians and the government acknowledges it will have to treat many patients free of charge. Still, private patients are expected to pay $1000 and those from abroad $1200 for each course of treatment. These funds, together with money saved from the budgeted allocation for treatment abroad, will be ploughed back into the hospital to help develop sustainability.

Early each morning, Helen travels by public transport from her home in Kafue, 70 kilometers south of Lusaka, for her treatment at the CDH. She says she finds the journey exhausting and expensive, but knows that she is one of the lucky few. “There are many women, especially in rural areas, with no money, no relatives, no way of getting to Lusaka,” she says. “They stay in their villages but are outcasts from society. This cancer takes away your dignity: you bleed, you smell, you’re in pain.”

Today there are a couple of women ahead of Helen in the waiting room, but she doesn’t mind. At last she is getting the treatment she knows she needs. While she sits and waits, Helen is planning her future.

 

Responsible/Contact: Department of Technical Cooperation | Last update: 13 Feb, 2013

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