Τρίτη, 23 Φεβρουαρίου 2010

Uganda battles wave of cancer

Africa has been identified as the continent where the number of cancer sufferers is growing fastest. Susie Emmett has spent time with the staff and patients at the radiation therapy unit at Mulago Hospital in Uganda's capital, Kampala. It is one of the few in Africa which offers cancer treatment. As Dr Baguma invites me to take a seat in his consulting room the air is heavy with floral freshener. "We use the spray," he says, putting the pink can back in a desk drawer, "but it's often not enough." He has just seen a woman aged beyond her years and bent double with the pain of the cervical cancer and associated stinking infection that are devastating her from within. "Too many cases come late," he sighs, rubbing his palm on his forehead. "I'm a doctor and with all my heart I want to heal. But radiation therapy cannot work at such a late stage. "We don't even always have enough morphine to help with the pain." There is a tidal wave of cancer washing over Africa. And a continent wracked by other disease problems is ill-equipped to cope. Weak and worried In Uganda even if, by some small chance, a cancer is diagnosed correctly - let alone in time - then there is only one source of treatment: in the capital. And they come, the weak and the worried, in their hundreds. Not just from all over Uganda but from neighbouring Kenya, Rwanda and even the Democratic Republic of Congo. Compelled by the knowledge that cancer can sometimes be stopped, propelled by the funds of relatives and friends, they arrive at the shabby single-storey radiation therapy unit of the Mulago Hospital in Kampala. "Ah the water feels good." Nurse Elizabeth shuts her eyes to enjoy the flow at her fingertips from the tap at the sink in the corner. "Imagine. We are a hospital and yet for a month we've been without running water." She has the comforting physique of a capable nurse. Wearing a cap like the top tier of a wedding cake she bustles off to her desk in the middle of the throng in the waiting room. Steadily - from first light to midnight - as many as 100 patients a day are given their few moments of radiation. There is just one radiation therapy machine. Within its thick-walled concrete bunker, it is like a giant food mixer, only one which attacks cancer cells with powerful giant gamma rays. Milly Bowenge - with catwalk looks and grace - is the therapist who gets the patients in and lying dead-still for the duration. From outside, looking in by means of a CCTV, while the beeping counter confirms the dose, she tells me how much she enjoys her work - or "keeping hope alive", as she describes it. And then, as so often happens, the machine breaks down. It will be hours until a technician can come - and, at worst, maybe days until it is fixed - and so the rest of the waiting patients are gently told there will be no more treated today. Long journeys Slowly the sick and the aching gather themselves and make their way out under the rain-heavy skies to wherever their temporary home is in the city. For Penina and her mother, who has cervical cancer, their lodging is a lock-up garage in the suburbs. Their distant relative - who has agreed to take them in during the three week course of radiotherapy - works as a cleaner in the capital and welcomes them back, and greets me, before swinging the heavy, rusty metal door shut. They are all from the far, far north of the country - two days' drive away. Penina's mother sinks to the floor and lays on a mat in the corner. Penina tells me how she wishes there were more treatment facilities in Uganda. "But this country has so many health problems," I say, "Malaria, TB, Aids". "I know that," she replies. "She's my mother. She is important to the community because she cares for Aids orphans. I love her and I just want her to live." Committed to Africa Those trained in treating cancer are in demand and any of the doctors and the medical physicist in Kampala could be earning many times more in the richer parts of the world. But they have stayed, committed to curing cancer in Africa. Dr Kigula is head of the team. In 10 years he has seen the incidence of cancer rocket up and is not just hoping for an expanded department but for routine screening to pick up early, easy-to-treat tumours. In a tropical downpour, he takes me to a clinic on the outskirts of the city where he is running an experiment to see how many early breast and cervical cancers can be found. "This is my dream," he announces to the smiles of the nurses setting up their equipment, "to catch cancers when they are very small. It is very satisfying and better than very expensive radiotherapy centres." And through the rainstorm, under bright umbrellas come the young mothers to be checked, to be reassured and taught breast self-examination. Bouncing along rutted roads back into the city, Dr Kigula asks whether my mother is alive and well, and enquires after the health of my aunts and sisters, if I have any. Charming that he is interested in my family? No, he is thinking of my health. "Heredity plays such a part in cancer," he adds, brutally. "You're not so young and have to be aware of these things." He does not add how much better a chance I would have of surviving cancer because of where I live in the world. But it is what I am thinking and how it adds to all other injustices that Africans suffer. So I ask him how, under-resourced and overwhelmed, does he keep going. We are pulling up outside the Mulago Hospital department. The rain is pouring off the roof and there must be more than 70 patients waiting to be seen. "When a patient returns, cured and smiling. That is what gives us all the strength to continue." By Susie Emmett , BBC News, Uganda