Cancer Day: Cancer treatment: Beating the long waiting time

21 years after her cancer diagnosis, 36-year-old Elimina Ndunguru, resident of Ruvuma, recalls the first time she visited the Ocean Road Cancer Institute (ORCI). It was in 1997 when she first saw the stumpy white structure facing the Indian Ocean.

But once Elimina was inside, the hospital took on a different atmosphere. She tells Your Health, “It was crowded, there was no place to sit and I waited more than three hours to just see a specialist, let alone the treatment process.”

In the last three years, the Dar es Salaam based- institute used to be overwhelmed by cancer patients from all the regions across the country, including patients from cross-border countries like Malawi and Kenya.

A recent database showed that at least 5,529 cancer cases were recorded at the institute in 2016, Dar es Salaam region carrying the biggest burden of cancer compared to any other regions in the country.

Due to the burden, long patient waiting times are a big problem in healthcare in Tanzania especially in public health facilities due to the notion that they offer treatment at a lower cost compared to private hospitals.

According to a report published by the World Health Organisation, chronic shortages seemed to be the norm in the hospital [ORCI] with wards being crowded, often 10-12 beds massed together in a small room, there is no air conditioning, and some of the narrow beds are occupied by two patients. It further said, “Certain critical drugs for chemotherapy were missing at the time of the visit, and where the only two radiotherapy machines are working over-time; according to one of the radiotherapists, the hospital would need six machines to cover actual demand. The machines also break down often, making treatment all the more difficult.

On the positive side, the hospital does employ a bio-engineer to maintain and fix the machines when there are technical problems.”

In spite of the emergence of cancer as a serious public health issue, the country has only two cancer hospitals - a large population of this relying on ORCI.

Things are different now. What changed?

Cancer is on the rise, globally, with 9.6 million people worldwide are estimated to die from cancer in 2018. Tanzania is not an exception. According Dr Crispin Kahesa, ORCI’s Cancer Prevention Services director, the number of cancer patients they receive in the hospital has risen from over 4,500 recorded in the last three years to 7,300 in 2018.

Out of those cases, one of them was Elimina’s. During the visit [to ORCI] three days ahead of World Cancer Day that falls today, Elimina was there for her routine treatment.

When she was discharged in 1998, she was told to visit ORCI yearly for consultation and treatment.

But things seemed a little different during the recent visit than what Elimina had recalled. People were seated on benches waiting for their turn, it was not crowded and importantly there were no queues.

Walking up to Elimina, the hospital was decorated with pink and white balloons to commemorate the big day ahead. The ward beds were spaced with each patient having their own bed.

Elimina is smiling. “I’m a cervical cancer patient and have been visiting the hospital for my radiation therapy sessions yearly. Things have changed so much, from waiting just minutes or an hour to see my specialist to the not-so long waiting time for the treatment,” Elimina confesses.

Things took a different turn last year.

Due to the growing demand, Minister for Health, Community Development, Gender, Elderly & Children Hon. Ummy Mwalimu, last year, heightened to speed up installation of radiation therapy machines at ORCI with a view to enhancing treatment services. Published in The Citizen last year, Dr Julius Mwaiselage, hospital’s executive director was quoted saying, “We will be installing two linear accelerators and one CT stimulator.”

Dr Kahesa further adds on to this that they can now attend to about 100 chemotherapy patients per day from 40 and about 220 radiation therapy patients per day from 160.

“Availability of medicine and other essential basic needs like food and accommodation have improved here. Many thanks to the government,” says Elimina, as she prepares herself for her radiation therapy session.

Reaching to many cancer patients

Dr Kahesa says, advances in imaging technology has made it possible for the institute to offer cancer treatment more precisely reaching to a bigger number.

Availability of medicines and medical supplies at the institute has improved from 4 per cent in the last three years to 87 per cent in 2018.

The improvement achieved after the government recently increased the budget for the institute from Sh700 million to Sh7 billion, according to the hospital management.

Dr Kahesa explains, “ORCI offers numerous cancer treatment services including diagnostic imaging, chemotherapy, radiotherapy and palliative care services.” Following the advances in imaging technology, the institute was determined to reduce congestion of patients who seek treatment at the institute.

He adds, “Our target is to keep improving cancer treatment to cater for more patients in the country.”

Dr Kahesa further highlighted positive impact of the installation of the equipment in the hospital, saying at least 70 per cent of cancer inpatients and outpatients were currently accessing radiotherapy service.

He also commented that the hospital is currently having at least 25 cancer specialists, citing that in the last three years the institute was hit by shortage of specialists.

Let’s double the efforts

Cervical and breast cancer are still the leading cancer diseases in Tanzania affecting most girls and women. However, the senior cancer specialist, Dr Kahesa expressed optimism saying the newly launched cervical cancer vaccination for girls aged 14 would help to prevent girls from developing the illness.

Dr Kahesa also said doubling of efforts is necessary to educate Tanzanian population on importance of conducting regular medical check-up, insisting that early detection of cancer saves a life.

This year’s Cancer Day celebrations mark the launch of the 3-year ‘I Am and I Will’ campaign aimed at urging for personal commitment and represents the power of individual action taken now to impact the future.

This includes making healthy lifestyle choices that include avoid using tobacco products, getting plenty of physical activity, eating a healthy diet, limiting alcohol, and staying safe in the sun.

And also, know about signs and symptoms of cancer and early detection guidelines because finding cancer early often makes it easier to treat.

As part of the celebrations, the organisation and people in the world unite to raise awareness about cancer and work to make it a global health priority.