TPBRC targets affordable MRI, CT scans to improve boxer safety

An investigation by The Citizenfound that many professional boxers in Tanzania are unable to afford MRI and CT Scan examinations, leaving them vulnerable to severe injuries, disabilities and, in some cases, death.

Stakeholders in the sport say some fighters enter the ring with undetected head injuries and other medical conditions that only become apparent after they have suffered blows during a fight.

They have urged the government, sponsors and boxing authorities to lower the cost of the tests, improve access to health insurance and strengthen medical screening systems to safeguard the lives of fighters.

The concerns have emerged despite the existence of regulations that require professional boxers to undergo medical examinations before and after bouts.

The 2024 TPBRC regulations emphasise the importance of medical screening but stop short of making MRI and CT Scan examinations mandatory for every contest. Regulation 4.1.2 states that every professional boxer must undergo a medical examination by a commission-licensed doctor recognised by the Tanzania Sports Medicine Association (TASMA) at least 14 days before participating in a professional bout.

Based on the results, the doctor determines whether the boxer is fit to compete. However, the regulations do not specifically require MRI or CT Scan examinations before every fight.

This approach is consistent with international boxing regulations, which generally require medical assessments but reserve brain MRI and CT Scan examinations for specific circumstances or at intervals determined by federations and relevant authorities.

For example, the International Boxing Association (IBA), formerly known as AIBA, recommends MRI and CT Scan examinations before major competitions, including world championships. The examinations are also required when a boxer suffers a knockout (KO) or technical knockout (TKO).

TPBRC vice-chairman Jacob Mbuya said the commission recognises the challenges facing boxers and has already started taking steps to address them.

He said TPBRC has entered into a sponsorship arrangement with Hitech Sai Hospital in Upanga, Dar es Salaam, to make the examinations more accessible. According to Mbuya, four boxers have already undergone MRI and CT Scan examinations under the arrangement after doctors advised that they needed the tests.

"The previous leadership initiated discussions with the hospital and we continued from where they left off to ensure that we begin working together," he said."Going forward, any boxer who suffers a knockout will undergo MRI or CT Scan examinations. In the past, many boxers did not undergo these tests because they simply could not afford them."

He said the commission had decided to seek sponsorship after realising that the problem was affecting a large number of fighters.

Mbuya added that TPBRC hopes to expand its medical support system in the future by establishing gym facilities equipped to conduct medical examinations before and after fights.

"Our long-term vision is to have gyms that can conduct these examinations so that fighters can be screened before and after bouts. However, given the current situation, this remains difficult to achieve immediately," he said.

Former TPBRC president Chaurembo Palasa said his administration did not place direct emphasis on MRI and CT Scan examinations because of their high cost.

However, he stressed that any boxer who suffers a knockout must remain out of competition for between two and three months, depending on the severity of the incident.

Before returning to the ring, the boxer must undergo MRI or CT Scan examinations to confirm that there is no serious damage to the head.

"We did not insist on these examinations in our regulations because of the high cost involved.

However, a boxer who suffers a knockout must rest and undergo these tests before being allowed to compete again," he said.

"In boxing, health and fitness are extremely important. That is why fighters undergo regular screening for HIV, liver diseases and other medical conditions."

Palasa said that during his tenure, he had not witnessed cases of boxers developing severe mental complications directly linked to professional competition, although there had been isolated deaths and other health problems.

He attributed many of the complications to unregulated fights in informal settings where fighters often compete without undergoing proper medical examinations.

"Many of these problems occur because some boxers participate in unregulated fights without medical screening. When they later enter sanctioned competitions, previous injuries become serious problems," he said.

Palasa also called for the establishment of a government-backed boxing board with stronger legal authority to oversee the sport.

He said a statutory body similar to the country's film board would help improve regulation and ensure that safety standards are properly enforced.

"The existence of such a board would contribute significantly to making boxing safer," he said. He also expressed optimism that proposed constitutional changes within TPBRC would strengthen measures aimed at protecting boxers.

The proposed amendments have already been submitted to the National Sports Council (NSC) for legal review.

Boxing physician Dr Khadija Khamis said not every collapse in the ring should be considered a sudden event because many cases are associated with pre-existing conditions.

"Very often, when a boxer receives a punch and collapses, examinations reveal scars from previous injuries. If fresh signs of trauma are also found inside the head, it may indicate that the punch was particularly severe," she said.

She noted that head injuries can result from circumstances unrelated to boxing.

"There are many situations outside boxing that can cause bleeding or injuries in the brain. A boxer may suffer a blow elsewhere, take painkillers and feel better.

However, when he later enters the ring after undergoing routine tests that cannot detect internal injuries, even a light punch can cause him to lose consciousness," she said.

Dr Khamis said MRI examinations cost approximately Sh800,000 in public hospitals and up to Sh1.5 million in private facilities.

For many professional boxers, particularly those competing at lower levels, such amounts are beyond their means.  Through the proposed sponsorship arrangement, however, she said the cost of an MRI examination could fall dramatically.

"If everything proceeds as planned, the agreement with the hospital could reduce the cost of an MRI examination from Sh1.5 million to Sh250,000. That would make the tests affordable for many boxers," she said.

Dr Khamis said the commission also plans to conduct educational visits to boxing gyms across the country to raise awareness about health issues among coaches, promoters and fighters.

She said some fighters ignore symptoms such as persistent headaches and instead rely on painkillers.

"If a boxer complains of headaches, he should be examined rather than simply taking painkillers. There may be a serious underlying problem related to boxing or even to his personal life," she said.

"We are educating boxers about nutrition, proper meal planning, sleeping conditions and the responsibilities of coaches in protecting athletes' health.

All these measures are aimed at safeguarding their wellbeing." Dr Khamis appealed to President Samia Suluhu Hassan to consider introducing health insurance coverage for boxers to help reduce the financial burden of medical care.

Sports physician Abel Shindika said he had previously treated two boxers who required MRI and CT Scan examinations but were unable to afford them. "

The tests are important because they help doctors identify where the problem is and determine the appropriate treatment. Unfortunately, cost remains the major challenge," he said.

"The boxers I attended complained of headaches and their symptoms clearly indicated the need for CT Scan examinations. However, they did not have the money and only requested pain-relieving injections.

I advised them to look for funds so that they could undergo proper examinations."

Through TASMA, he said, sports doctors have repeatedly appealed for the cost of the examinations to be reduced.

"We do not have the resources to treat every athlete because they are many and each doctor works within his or her own institution. I have seen boxers abandon the sport because they cannot afford treatment, while some sponsors also lack the financial capacity to support them," he said.