Belize, a country of just 330,000 inhabitants and limited resources, is bringing cancer care to the fore. In the run up to World Cancer Day —taking place on 4 February 2017— First Lady Kim Simplis Barrow is speaking up for change and is campaigning to increase access to cancer care, based on recommendations from the IAEA.
“I am a cancer survivor because I was one of the lucky ones,” Simplis Barrow said. “For many in Belize, this is not the case.” In October 2011, Simplis Barrow found out she had breast cancer and managed to receive treatment abroad.
Cancer patients in Belize who do not have the means to be treated in another country have little hope, Simplis Barrow said. Even many of those who manage to find treatment abroad do not survive because their diagnoses are given too late or because there is no follow up treatment available locally. Her aim is to make sure Belize establishes a cancer care facility where Belizeans can be treated.
Last December, a team of international experts led by the IAEA assessed the country’s cancer control capacity. After the mission, known as imPACT review, the experts presented the government with priority recommendations.
The experts —nominated by the IAEA, the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC)— recommended the establishment of a cancer control unit in the Ministry of Health and a national cancer registry to collect and analyse cancer data. These are important first steps that help policymakers decide on future interventions and investments for cancer patients in Belize. Ultimately, they will facilitate moving towards the long-term goal of providing closely integrated services to reduce cancer risks, detect cases early and treat patients.
Work on the establishment of a national cancer centre, which would provide various treatment services, could start soon, the experts said.
“Any country committed to introduce radiotherapy is embarking on a long and challenging journey,” said Beatrix Lahoupe, Section Head at the IAEA’s Programme of Action for Cancer Therapy (PACT). “It needs qualified staff, adequate buildings, the right equipment, the necessary radiation safety infrastructure and a plan for sustaining it all.”
The imPACT team recommended that Belizean health authorities —while deciding on the best course of action— establish agreements with cancer centres in neighbouring countries to which doctors can refer patients in need of radiotherapy and other treatment options not currently available locally.
Introducing nuclear medicine
Belizean health authorities also aim to improve the country’s diagnostic imaging infrastructure with the support of the IAEA — and use modern equipment to diagnose not only cancer but also various non-communicable diseases, such as cardiovascular diseases and diabetes, which have a high prevalence in the country.
“The appropriate use of diagnostic imaging can help Belizean doctors improve the management of patients with a myriad of health conditions, including cancer,” said Diana Paez, Head at the IAEA's Division of Human Health. “Belize has a lot of potential and the IAEA will help the country live up to it.”
Through a technical cooperation project, the IAEA will train Belizean health professionals in the use of imaging techniques such as X rays and ultrasound images, support the set-up of the adequate infrastructure and equipment, and guide authorities on radiation safety.
Health with safety
Protecting patients from the harmful effects of ionizing radiation is another area in which the IAEA supports countries such as Belize that are working to introduce radiotherapy and nuclear medicine.
“We need radiation to help cure our people, but for that we also need to ensure that the radiation is used safely,” said Randall Sheppard, legal expert at the Government of Belize. “The application of the IAEA safety standards will ensure the safety of our workers, our patients, the public and the environment.”
In 2010 and 2012, IAEA safety experts visited Belize to evaluate its radiation safety regulatory status and recommend steps to take. Subsequently, Belize’s government has expressed its commitment to follow the Code of Conduct on the Safety and Security of Radioactive Sources. In January, IAEA experts trained a group of technical and legal personnel from CARICOM countries, including Sheppard, on drafting radiation safety regulations. National radiation safety law is also under development. Following IAEA standards, the government will establish a regulatory body for radiation safety in accordance with the national law.
The law and regulations will provide a framework for the safe use of radiation technologies. The corresponding regulatory control will ensure delivering proper doses to patients and protecting workers, using well-functioning equipment, training qualified personnel and empowering a regulatory body to control all activities involving radiation.
“Our work involves people’s lives, so we have no time to lose,” First Lady Simplis Barrow said. “We must act now.”
To commemorate World Cancer Day 2017, First Lady of Belize Simplis Barrow participated in a high-level discussion on “Global Action – National Needs” taking place at IAEA Headquarters in Vienna, Austria, on 3 February.