Malawi is recording an average of 52 new cases of cancer patients per week or over 204 new cancer cases per month, a development the health sector cannot cope with, authorities have disclosed.
Kamuzu Central Hospital (KCH) head of Cancer Department Dr Richard Nyasosela said in an interview on Tuesday, the facility-which covers the Centre and North-is recording over 30 new cases every week.
On his part, Malawi Cancer Registry statistician Steady Chasimpha said in an interview yesterday that Queen Elizabeth Central Hospital (QECH) in Blantyre records an average of 18 to 22 cases per week, translating into an average of 72 to 84 cases per month.
Said Nyasosela: “On average, we register 30 or more cases per week.”
He said the huge numbers of cancer cases are overwhelming and outstretching the facility, which generally suffers inadequate human and medical resources. The development, according to Nyasosela, compromises care to the patients.
Some of the challenges we are facing are that, as a country, we don’t have a radiotherapy centre to enable us to provide comprehensive cancer care-surgery and chemotherapy.”
The development comes against the background of a study by the University of North Carolina (UNC) Project, which outlines a number of challenges hindering people from accessing cancer screening services in the country.
“As you may be aware there are only two cancer units in the country, one at Queens and the other at Kamuzu Central Hospital. KCH caters for both the Central and Northern region. So the number you may have obtained from KCH includes some of the cases referred from Mzuzu Central Hospital. At the moment, we do not have all the numbers from Mzuzu Central Hospital, but efforts are underway to coordinate this,” he explained.
Nyasosela disclosed that this sometimes forces the facility to refer some patients to India and other countries where government or the patients themselves have to pay huge sums of money to access specialist treatment.
A senior official in the Ministry of Health, who sought anonymity, said the least they spend to refer one case for specialist treatment in India is US$14 000 (K10 million) per case.
“[We refer them] as often as we have financial resources and it’s on a first come first served basis because it’s not only cancer patients that are on the waiting list for specialist treatment. The least we can spend is for chemotherapy and radiotherapy plus air and lodging is $14 000 per case. It sometimes can go up depending on the severity of the disease,” said the source.
Meanwhile, UNC Project clinical research site leader Dr Lameck Chinula disclosed to Weekend Nation in an interview on Monday that long distances to the hospitals and limited as well as lack of awareness continue to hinder women from accessing cervical cancer screening services in the country.
Chinula was speaking on the sidelines of the second annual Malawi Cancer Symposium in Lilongwe.
He warned that although government is offering the services free of charge in its health facilities, a majority of Malawians, especially those living in the rural areas, will continue dying of the disease because of the monetary and time costs incurred involved in the process.
“[You’ll appreciate that] though the cervical cancer screening services are free in public health facilities, women still need to incur transport costs to the nearest facility. In the advent of competing needs, they rather choose to do piecework for money than spend the whole day at a health facility,” he explained.
Chinula, who is also consultant obstetrician and gynecologist at Kamuzu Central Hospital in Lilongwe, added that most health facilities do not provide cervical cancer screening services.
He said there is need to increase cervical cancer awareness among women, men and community leaders with a focus on men since they remain the main decision-makers in homes and that when convinced about its need, they will more likely encourage women to go for screening.
“There is need to make cervical cancer screening services readily available even in rural areas, train more staff and ensure they remain active to give these services in the health facilities. There is need to integrate cervical cancer screening in antiretroviral therapy (ART) as well as family planning clinics so that as ART clinics provide cervical cancer screening, most women will have access to screening services.
“This should be available even to HIV uninfected women and ensure readily available supplies for cervical cancer screening health facilities, including health centres. We also need to incorporate cervical cancer campaigns in communities for the hard-to-reach rural areas at regular intervals,” stressed Chinula.
A recent study by Dr Charles Mabedi and others established that Malawi has the highest cervical cancer incidence and mortality in the world and also the highest proportion of penile cancers in Eastern and Southern Africa, which comprise Kenya, Zambia, Zimbabwe, Tanzania and South Africa, among others.
The study results show that the current age-standardised rate for cervical cancer is 75.9 per 100 000 population while mortality is at 49.8 per 100 000 population.