HARARE, Zimbabwe
Senior health and government officials gathered at a hotel in Harare, Zimbabwe's capital, to discuss issues and problems related to cancer treatment in the country as it faces a critical shortage of radiotherapy and chemotherapy equipment.
"Cancer treatment services in the country are highly unreliable," said Dr. Nothando Mutizira, a cancer specialist at Parirenyatwa Hospital, one of Zimbabwe's largest referral facilities.
On the eve of World Cancer Day, observed around the world on Feb. 4, Mutizira indicated that services are frequently interrupted, owing to machine breakdown.
"Sometimes it is also because the cancer patient data base system does not work properly. In most of 2020, Zimbabwe did not offer any radiation (therapy) at all," Mutizira said during a World Health Organization (WHO) webinar.
She said that in 2021, there was only one working radiotherapy machine in the country, with patients coming from all over getting in line as early as 2 a.m. for treatment.
"Even if they had done so, we still had in excess of up to 200 patients that we could not put on the machine each day.
"We were short-staffed and had just one nurse. We can't as a whole country be sustained by one radiotherapy machine," she added.
"The number of cancer patients who have been treated at Parirenyatwa has gone down in the past four years, owing partly to COVID-19. They're delaying seeking more help because of the pandemic."
A nurse who spoke on condition of anonymity revealed that it was not just about the machines, as cancer drugs are also unavailable.
"There aren't enough morphine supplies, chemotherapy drugs, or radiotherapy machines. While the International Atomic Energy Agency (IAEA) recommends one or two machines per million (people), we have six (in total), and only one works sometimes," she said. Zimbabwe has a population of about 15 million.
Early screening and beliefs
Health experts have advised that some types of cancer, like cervical cancer, are preventable and easy to treat if diagnosed early.
"In developed countries, incidences of cervical cancer have gone down to a minimum level, such that when they get those few patients, the available resources would be enough," said Dr. Anna Nyakabau, an oncologist based in the capital Harare.
"Whereas with us, since we are not yet there, we could have several patients but with limited resources."
"Sometimes, you don't present symptoms, but just a lump," said the doctor, adding that it would have taken "a long time" for the tumor to get to that stage.
"This is what makes cancer enigmatic, because many people would be thinking they don't have cancer when in fact, they are harboring it until they start getting symptoms," added Nyakabau.
Survivors' account
Due to the challenges, many cancer patients seek treatment in private hospitals.
Keretia Chikowe from Harare was diagnosed with stage-three colon cancer in 2017 and had been unwell for a long time.
She sought chemotherapy at a private hospital.
"It wasn't easy," she said, adding: "But, it was costly."
"We have problems at our public hospitals. Sometimes the machines don't work. I know there are limitations here and there."
Keretia urged Zimbabweans to have a healthy lifestyle and seek treatment early.
Another survivor, Charity Makawa, suffered breast cancer twice, as well as colon cancer.
"I was diagnosed with breast cancer in June 2014 at (age) 27. I had a recurrence of the breast cancer in January 2017, and that same year in June, I was diagnosed with colon cancer," Charity said.
"I was fortunate enough to have private medical aid through my employer, who was also very supportive financially. I had access to medication locally, though it was expensive. At the time, I needed radiation (therapy), but the machine wasn't working. So, I had to seek treatment in South Africa."
Charity explained that mis-diagnosis was also common when dealing with cancer in Zimbabwe, leading to the deaths of many patients.
"Will Zimbabwe overcome the gap between screening and treatment?" she asked, referring to the motto of the World Cancer Day commemorations in the country: Covering the Gap.
Zimbabwe has a population of 4.59 million women aged 15 and older who are at risk of developing cervical cancer.
Current estimates indicate that every year, 3,043 women are diagnosed with cervical cancer and more than 50% die from the disease.
Though there are no statistics on how the Human Papilloma Virus (HPV) is linked to cervical cancer in Zimbabwe, an HPV vaccine has been given to girls since 2018.
According to the World Health Organization, HPV causes cancer in the majority of HIV-positive people.
Cervical, prostate, and breast cancers account for 66% of the total cancer burden in Zimbabwe, as well as 61% of total cancer fatalities, according to Ministry of Health statistics from last year.
