New cancer unit lights up patients

Each day, about 200 people report to the Uganda Cancer Institute (UCI) in Mulago for treatment, checkups and counseling about the devastating malignancy. Some of them travel miles from the Democratic Republic of Congo (DRC), Burundi and Tanzania because UCI is the only national and regional free cancer referral centre.

Outside the outpatient department, tens of patients try to find sits, floor space and tree shades to rest and wait because wards are full. When the sun sets, patients who cannot afford transport fare back home saunter into the wards to sleep. Christine Namulindwa, the institute’s publicist, says the prohibitive cost of cancer treatment in private facilities has led many to seek free treatment at the institute. The high cost of equipment and drugs explain the exorbitant cost of treatment.

“The cheapest cancer treatment is about Shs 14 million and majority of the patients cannot afford it, which explains the overcrowding here. However, we are also met with the challenge of limited skilled personnel as there are only 12 oncologists,” Namulindwa says.

Children afflicted with cancer find rest-Photo Credit/Nicholas Bamulanzeki

In the past few years, UCI has reported a spike in cancer incidence, particularly infection related cancers such as Kaposi Sarcoma, sending a wakeup call to government. Although there is no nationwide data, estimates obtained from UCI’s registry indicate that some 300,000 Ugandans develop invasive (advanced stage) cancers and over 10,000 of these die annually.

NEW PREMISES

In 2011, government invested Shs 10.4 billion to construct a new, modern cancer unit. Currently, some of the wards on this six-floor unit are up and running. For now, mainly children, patients admitted to the private wing and those going to be operated are using the facility. Majority of patients are still using the old block as the new block is short of medical equipment.  

The new cancer block-Photo credit/Nicholas Bamulanzeki

Inside the children’s ward on level four, hued caricatures painted across the walls are a fresh face to the children’s treatment. Accordingly, these play a role in keeping the little ones in high spirits. Six year old Jordan Kibirige from Mukono was admitted here one week ago.

He is battling Burkitt’s lymphoma, a potentially fatal cancer that has left him with a painful swelling on the left side of his face. The lymphoma, associated with malaria, is known to grow rapidly such that the tumours double their size in five days.

“So far, we have been able to get quick treatment and bed space at this new facility. I hope my boy will soon recover,” Kibirige’s mother forlornly says.

At least one doctor and nurses are on duty here throughout the day, a sign of relief to the over 20 patients here.

So far the journey is comfortable; clean toilets, lifts, regular electric power, piped water and free lunch. The theatre, on level two, is operational and Namulindwa says it has greatly reduced congestion at Mulago hospital’s general theatre. The building also has a mortuary, intensive care unit, private wing and an imaging and nuclear medicine department.

Inside the children's ward

However, Namulindwa expresses fear that with the swelling number of patients, this facility will soon be overwhelmed.

“The new centre is expected to accommodate 100 patients but we’ll be seeing more than these,” she said.

The new facility will officially open mid this year.

MORE DEVELOPMENTS

A comprehensive state-of-the-art research, training and outpatient cancer centre is currently in the final stages of construction. The Hutchinson Cancer Research Institute- Uganda sits on 25,000 square feet and will include an outpatient clinic, chemotherapy infusion rooms, research laboratories, molecular diagnostic labs, a training center and data centre among others.

This facility seeks to ensure the availability of medical care, overcome the social and economic barriers to completing treatment and improve capacity of the medical infrastructure to diagnose and care for patients. With the new premises, it is hoped that the five-year survival rate of cancers such as leukemia which is less than 40 per cent will be improved.

The centre, whose construction began in April 2013, is slated to officially open in May this year. It is supported in part by the United States Agency for International Development, American Schools and Hospitals Abroad Programme.

Namulindwa also told The Observer that plans are underway to construct a Radiotherapy and Nuclear Medicine Centre.

In spite of these developments, challenges of limited beds and equipment, medical personnel brain drain and forbiddingly expensive drugs are rife.

“Diagnosis equipment for examining biopsies is only available at Mulago Referral hospital and because of the limited number of pathologists, results take up to two weeks to return,” Margaret Okello, a volunteer counselor at UCI, notes adding that there is only one radiotherapy machine in the entire referral hospital.

Moreover, because of the limited number of oncology personnel, nurses have had to be trained on the job in order to administer drugs.

Okello and Namulindwa urge government to subsidize pharmaceutical companies that supply drugs in order to make them more affordable and available.

“We also appeal to government to adequately remunerate skilled personnel and invest in the purchase of modern equipment such as a magnetic resonance imaging machine,” Namulindwa says. 

This article first appeared in The Observer.