The oncology ward in Zambia's main hospital in Lusaka is an untold story. Within its bare halls, people in pain stream in daily, seeking cancer treatment that is out of reach.
"It is a very sad situation. People wait for treatment that may never come. You see women suffering - rates of cervical cancer are high. They're in a lot of pain and there is not a lot health workers can do. We do not have the diagnostic and treatment facilities," says Mr. Nicholas Chikwenya from the Zambian Health Department.
But that will change. Zambia is about to start building its first national cancer treatment centre, capable of delivering megadose radiation therapy. Once this new facility is fully operational, about 1200 new patients per year could be treated. Potentially, this might result in saving one life every working day. Even incurable patients would receive substantial pain relief.
The centre will be constructed at the University of Zambia Teaching Hospital in Lusaka. Made possible from a US $5.6 million loan from the OPEC Fund for International Development, with technical support from the IAEA.
At present, access to good cancer treatment in Zambia is a privilege of just a few. Patients needing vital radiotherapy treatment have to travel to South Africa and Zimbabwe. The Zambian Government covers most of the cost but a financial contribution is still needed from the patient - which few can afford. Even for those that can, the waiting period can last from six months to one year. All the while the cancer spreads.
Mr. Chikwenya says the new facility - with its purpose built laboratories, treatment and waiting rooms - will greatly improve people's access to quality cancer diagnosis and treatment. The centre's radiotherapy capabilities will give cancer patients undergoing this treatment a 45% chance of being cured. "It is a project that everyone is waiting for," he says.
None more so than Dr. Mushikita Nkandu. He is the only radiotherapy oncologist working at the Lusaka based hospital. He has been lobbying for such a facility for over 10 years.
"The most common cancer we see is cervical cancer, in around 32% of patients. These patients should be treated with radiotherapy. It is frustrating when the best we can offer them is palliative and supportive care," he said.
In a year's time this situation will be a thing of the past. The new centre will house a cobalt-60 radiotherapy unit, a linear accelerator machine and other diagnosis and therapy equipment. The hope is to start treating the first patients in 2004.
But fighting cancer in Zambia requires more than just supplying buildings and equipment. Most of Zambia's oncologists and radiotherapists have left the country to seek employment elsewhere because of the lack of facilities. New staff must be trained in medical dosimetry to determine the dose of radiation needed for the safe and effective treatment of each patient. The Agency is helping to train medical physicists and radiographers for the new facility and, provide expert advice on the safe and secure use of the equipment.
Zambia is not unique in its battle against cancer. For most of the developing world, the reality is of overstretched health systems, where few cancer patients get screened, diagnosis comes too late or treatment is just not available. Medical experts, such as the IAEA's Dr. Ken Shortt point to the lack of radiotherapy and other effective treatment methods needed to save lives.
"About 2,100 megavoltage radiotherapy machines are installed in developing countries. But at least 5,000 machines are needed. The IAEA is stepping up efforts to help more patients survive cancer through earlier diagnosis and better treatment but more is urgently needed," Dr Shortt said. (See list of IAEA radiotherapy projects. [pdf])
Meanwhile, Zambia's cancer patients continue to wait. For them and their families, the national cancer centre cannot come soon enough. It offers hope and the chance of survival to those who previously had none. And, when it does come and brings the expected benefits, then perhaps the stories in the Lusaka Hospital oncology ward can be told and retold...with a happy ending.