Gau wakes up to use the bathroom for what seems like the umpteenth time that night and many others over the past year. It is the planting season and she surely needs the energy after a good night’s rest but her bladder would rather be an alarm clock. The deed isn’t quite relieving either, oh no! What with all the burning and she can’t quite get it all out.
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Getting out of bed in a huff, she reaches for her ‘mulika-mwizi‘ and in a half walk-half bounce swagger, from the pain in her back, she races to the latrine.
“Dama, today you will have to proceed with the seedbed without me, I think I need to see a doctor,” Gau calls in sick. Peering at her from his small eyes behind the big glasses, Dr Kingaru offers the diagnosis, “Looks to me like yet another urinary tract infection (UTI). But, I’ll send you to the County Hospital for a second opinion.”
A few weeks later, Cecilia darkens the doors of their County Hospital and she’s handed the small container that’ll carry her urine for the urinalysis; she knows the drill. She sits there on the cold cement, distraught as people walk past her soundless, blurry and like shadows in the night. What will she do now? The doctor said it, the big C word, the scary one, yes that one.
Something to the tune of bladder cancer that has spread to nearby lymph nodes – stage 3. Surely, all of two years of ‘UTI’? She is angry; angry at the doctors and their antibiotics, at herself for believing them and at the world for existing; she is scared too, for Mama Mbula at home, Dama and all the plans to send her to school – cancer at 21?! A tear breaks bank and streams down her cheek.
For Gau, the next steps were to visit the big city and possibly fundraisers to cover the bill for the medical trip to India.
In Kenya today, patients are being diagnosed with stage 3 and 4 cancers due to a lack of diagnostic capacity for early detection. Gau’s cancer should have been diagnosed earlier. This is unlike developed countries where cancer is diagnosed early and therefore survival rates are high (80% and above compared to less than 30% in Kenya and Africa).
Cancer is a treatable disease with early detection and administration of appropriate treatment early. WHO breaks down comprehensive cancer care into a fivefold process that involves:
- Survivorship and palliative care.
In Africa, the gap is largely at the screening and diagnosis since only South Africa and Egypt have
public Molecular Imaging Centre. It is in a bid to bridge this gap that Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) proposed to build an Integrated Molecular Imaging Centre (IMIC).
The Centre anticipates tackling:
- Early diagnosis and assessment of response to treatment
- Accuracy in diagnosis and treatment of cancer
- Recurrence or metastasis of cancer
- Improved survivorship
- Reduction in waiting time
- Boost Cancer Care efforts of the Government
- Significantly reduce cancer-related mortality
- Attract medical tourism from East, West & Central Africa
- Conserve foreign exchange used by Kenyans travelling abroad for treatment
- Carve out a Centre of Excellence in Oncology research and capacity building.
So, how would KUTRRH get to Gau and others like her?
It needs to bring stakeholders in cancer treatment on board. People like those in the County Hospital that she visited. If only they knew of an IMIC within reach, perhaps Gau’s story would have been less tragic. This idea has led to the creation of a Counties’ Cancer Advisory Team at KUTRRH to look into ways to get this much needed saving grace to the Mashinani.
The implementation of the IMIC calls for joint efforts with the Counties. From installing PET-CTs to streamlining the referral process.
How are the counties managing cancer at the moment?
The Advisory Team came up with a schedule for visitations to the County. On January 11th 2021, all selected champions set out for the important task for phase 1 – to market the Integrated Molecular Imaging Centre to the counties and assess their preparedness for PET CT.
As you can imagine, most Counties had basic Oncology Units and no PET-CTs. A helping hand in improving the situation meant renewed hope for those treating Gau and those like her was a welcome respite.
Their people could be able to receive care right there. The County Governors and Healthcare officials
all expressed excitement from their myriad of questions about the set-up and running of the IMIC project.
KUTRRH lines have been buzzing on end from that first interaction with the Counties. The partnership process is
on course as KUTRRH engages and signs MOUs with the Counties to begin the enactment of the respective areas of collaboration. The plan is to assist the Counties in setting up of PET-CTs, capacity building and acquisition of the consumables for the PET-CT.
This is indeed a new age for Cancer Management in the Country and region. No more outbound medical tourism
– Gau and those like her will receive comprehensive cancer care right at home!
By: Melissa Mwangi – Partnerships, Linkages and Resource Mobilization