Cancer is the new Aids but our State not ready to deal with it

Cancer is a killer like no other. In Kenya, the public believes – although the state hasn’t collected, or disclosed, any reliable statistics – that there’s a cancer epidemic in the country. I don’t have current reliable numbers but anecdotal evidence suggests that either more people are publicly reporting cancer cases, or the deadly disease is ravaging the country like never before.

DISCOURAGING

We know this for sure – something very bad is happening to our people. I remember the first reporting on a “mysterious gay disease” in the early 1980s in America. Later, that disease turned out to be HIV/Aids, an epidemic that in the US initially disproportionately hit homosexuals. In Africa, HIV/Aids largely ravaged heterosexuals. Is cancer the new Aids?

I don’t want to create public alarm and hysteria. But remember at the height of the Aids epidemic, Kenyan towns, villages and hamlets were every weekend turned into giant funeral homes. I recall a friend attending six funerals of Aids victims in a single day in one village.

Entire regions and ethnic groups were severely depopulated. Aids orphans became a national catchphrase. It was not until behaviours began to change – fewer and less indiscriminate sexual partners and the use of the now ubiquitous condom – that the Aids menace receded. Are “cancer” cases we see now a manifestation of something as sinister as Aids? As I said, we don’t have reliable cancer statistics in Kenya.

The numbers I have are outdated. But even that is very discouraging. They suggest that cancer is the third leading cause of death after infectious diseases and cardiovascular ailments. More than 39,000 new cases and 27,000 deaths are reported annually. This accounts for seven per cent of deaths annually. For women, 34 per cent of the cancers attack the breast while 25 per cent are cervical. For men, 17 per cent of the cancers are prostate while 9 per cent are oesophageal. The terrible news is that 60 per cent of the cancers afflict people under 70. Shockingly because of lack of medical facilities and impoverishment, 80 per cent of the cancers are diagnosed in the latter, virtually fatal, stages.

EMERGENCY

Kenya isn’t equipped to deal with cancer. The State has been asleep at the switch. Our universities aren’t training enough doctors and health professionals. There are less than six radiation facilities in Kenya – all in Nairobi. There are equally few treatment facilities, again all in Nairobi or large metros. Even more stunning, we have a smattering of oncologists. Bottom line – you will most probably die if you are diagnosed with cancer in Kenya.

But this doesn’t have to be our fate. We need to treat cancer as a national emergency and hit the problem with resources. That’s what other more serious states have done, and seen promising results from dire situations.

 Let’s put cancer in a global context. In 2018, there were 17 million new cancer cases and 9.5 million deaths. Seventy per cent of the cancer burden is on low and middle income countries like Kenya. These are the countries least able to confront the challenge. There are many causes of cancer but in 2016, seven million smokers died of cancer while another 884,000 non-smokers perished from exposure to second-hand smoke.

CARCINOGENIC

In the US, 1.9 million new cases of cancer will be diagnosed in 2019 and 606,880 of those will die of the disease this year. Poor people of all races, African-Americans, and Hispanics are disparately impacted by cancer and cancer deaths. But cancer survival rates have generally increased among all groups.   The causes of cancer in the US are many – smoking, obesity, physical inactivity, alcohol consumption, poor nutrition, and cancer-causing agents like carcinogens, pesticides and other environmental factors.

Early detection is key to treatment and survival. This is where Kenya falls flat on its face. Most cancer sufferers are sentenced to a certain death because the disease isn’t diagnosed until the end stage. But what are the causes of cancer in Kenya? We need to ask which type of cancers afflict Kenyans, and whether they are concentrated in particular parts of the country. We can determine whether the culprits are largely environmental, or lifestyle-related. Is there a spike in the numbers? This requires impeccable statistics to craft prevention strategies.

The country has been on edge about cancer since the high-profile deaths. But most cancer victims will die anonymously out of the media’s eye. We need to ask hard questions. Was Kenya ever a dumping ground for hazardous or nuclear waste for storage or disposal like some impoverished nations? Is Kenya importing contraband toxic cancer-causing foods, or using carcinogenic chemicals to process foods? Or feeding livestock and growing vegetables with cancer-causing agents? Are there toxins in rivers, reservoirs, and our drinking water? These could be killers. Let’s interrogate everything.

Makau Mutua is SUNY Distinguished Professor at SUNY Buffalo Law School and Chair of KHRC. @makaumutua.