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Declaring cancer a national disaster is not the magic wand

Thursday August 1 2019

Bomet Governor Joyce Laboso, Kibra MP Ken Okoth

Bomet Governor Joyce Laboso, Kibra MP Ken Okoth and Safaricom CEO Bob Collymore died of cancer in the month of July 2019. PHOTOS | NATION MEDIA GROUP 

ELIZABETH MERAB
By ELIZABETH MERAB
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NASIBO KABALE
By NASIBO KABALE
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Kenya may be unable to deal with cancer even if the government decides to declare the disease a national disaster.

This is because the country has neither enough cancer specialists nor diagnostic and treatment equipment, experts from a professional association of cancer specialists have said.

DATA INSUFFICIENT

And the government is yet to be sufficiently convinced that the crisis is of national disaster proportion. According to Health Cabinet Secretary Sicily Kariuki, the data available is insufficient to make such a call.

According to Ms Kariuki, for the country to reach a point of declaring cancer a national disaster, there has to be sufficient, scientific and solid data built over a period time.

“I have sat with my teams including the experts and it is not that I am not sensitive and for us to be able to reach that point there are several things that need to be looked into,” she said.

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Whereas the country’s capacity to detect and treat cancer has significantly improved, there is still much that needs to be done.

The Kenya Society of Haematology and Oncology (Kesho) says there are only 45 oncologists in the country against a population of 50 million, and even if one was to be taken to every county, two counties would still lack a specialist given the soaring number of cancer patients.

“Even if we had one oncologist for every 100,000 patients that would be great but at the moment 80 per cent of the oncologists are in Nairobi, a few in Eldoret, Mombasa, and Kisumu,” said Dr David Makumi the chairman, Kenya Network of Cancer Organisations (Kenco) adding that the number of oncologists falls far below the ideal ratio.

But Ms Kariuki says the government is more than able to handle the cases. So far, she says, the government has allocated more than Sh4 billion to various sectors that handle the disease.

“For operationalisation of the Kenyatta University Cancer Centre, we have allocated Sh1.5 billion. For the construction of three new radiotherapy and chemotherapy centres the ministry allocated Sh2 billion. Sh350 million has been set aside for equipping Moi Teaching and Referral Hospital with radiotherapy equipment,” the CS said.

DETECTED CASES

On human resource, she said there are enough specialised doctors to handle cancer detected cases.

“Currently, we have 45 oncologists, 36 oncology nurses, 10 clinical oncology officers and 20 more who are yet to graduate. These specialists are rotating in hospitals within the counties giving services to Kenyans. There is no crisis,” Ms Kariuki said.

But cancer experts decried the fact that resources channelled towards cancer management are inadequate and overstretched.

“The distribution flow is based on the availability of resources. Certain specialists like radiation oncologists can only be at the Moi Teaching and Referral Hospital and the Kenyatta National Hospital where we have radiotherapy services,” he said.

With only one radiotherapy centre at KNH, the country’s cancer management is limping.

Kenya boasts of 12 radiotherapy machines in total, of which KNH has three while the rest are in private hospitals. However, the equipment at KNH is prone to frequent breakdowns.

Kesho secretary Andrew Odhiambo said that many health facilities are unable to diagnose patients at an early stage as the country’s health system is not responsive.

ADVANCED STAGES

“Cancer does not fit into one shoe. It presents similar symptoms as many other diseases. The repeated visits to hospital, or any health facility by a patient with the same symptoms is what the health system should be able to pick up as an oddity because it could be cancer,” explained Dr Odhiambo.

National Cancer Institute (NCI) in a report presented before a parliamentary committee indicates that 65 per cent of all cancer cases are diagnosed at advanced stages of either stage three or four.

In this year’s budget Treasury indicated that Sh400 million was allocated for construction of chemotherapy centres that will be phased over coming years.

The Ministry of Health said that as a start, the centres will start administering chemotherapy and be scaled up later to provide radiotherapy services.

The centres are aimed at cutting travel costs to referral facilities and ease congestion in hospitals such as KNH at a time when cancer has emerged as a top killer disease.

Dr Sitna Mwanzi, a consultant oncologist and chairperson of Kesho, said that an increase in specialists would mean early detection of cancer, proper screening and quality palliative care for the patients.

She added that besides the fact that Kenya lacks cancer specialists to tackle the disease the country also does not have well-equipped cancer centres despite a promise to build six.