UGANDA: Cancer Patients Go Home To Die

BY ZURAH NAKABUGO AND RACHEAL NINSIIMA

THE OBSERVER (KAMPALA)/ALL AFRICA, APRIL 12, 2016

What next for radiotherapy patients?

The aftermath of the breakdown of radiotherapy services has shined a bright light on the poor state of Uganda's health care system.

On a sizzling Friday afternoon, the normally-crowded and noisy waiting room of the radiotherapy department at Mulago national referral hospital was unusually-quiet.

What stood out most to a visitor were empty plastic chairs arranged in repetitive rows. In front of the chairs was an imposing Coca-Cola fridge teeming with soft drinks. At the back was Naomi Walulumba, a lone patient who needed radiotherapy services. She is suffering from cervical cancer and sat waiting to be called in by a doctor.

Usually, this room is inundated by tens and even hundreds of patients waiting for radiotherapy treatment from the country's only Cobalt-60 radiation machine.

However, there were no patients. Why? The radiation machine broke down three weeks ago. The out-of-service machine, according to sources, costs about $1.8m.

"I have been coming to the department for a week now to receive radiotherapy but all in vain. I do not know when it will be up and running again but all I know is that I need it desperately," Walulumba, with a despondent look, told The Observer.

During the interview, she intermittently slumps her body backwards in the chair, complaining of severe chest pain. This was her second time to seek radiotherapy since 2013 when she was diagnosed with cancer. However, it was also the second time she couldn't be attended to due to the machine's inefficiency.

"When I first came here after my diagnosis in 2013, I had to wait two days for the machine to be worked on after it experienced technical challenges," she recalled.

DIRE CONSEQUENCES

This time round, Walulumba will have to wait even longer. Official sources said assembling a new machine would take between three to six months. It also implies that hundreds of patients who depend on the machine for free treatment will have to seek alternative cancer treatments such as chemotherapy and surgery or pay millions to access radiotherapy in other countries.

Mulago is the only hospital in East Africa that offers radiotherapy free of charge. The International Atomic Energy Agency (IAEA) donated the machine to Mulago in 1995.

"The machine will cost $1.8m (Shs 5.9bn) if the government invests some money in its reconstruction by IAEA. IAEA manufactures and repairs this machine on request. But this time round this old machine is beyond repair since the radiation sources have fallen down," sources said.

Therefore, one would need at least Shs 14m to access the same kind of services in Nairobi. The machine has not only been used on Ugandan patients but also those who seek free cancer treatment at the Uganda Cancer Institute (UCI) from neighboring South Sudan, DR Congo, Kenya, Rwanda and Tanzania.

Christine Namulindwa, the institute's spokesperson, said Mulago needs four machines of its kind to operate optimally because of the increased number of cancer patients.

"On average the machine has been treating 27,648 cancer patients annually. But since it has broken down, they [patients] have been referred to Nairobi and India," she said.