Cancer cases soar as Dar’s largest hospital overwhelmed

01May 2016
Lucas Liganga
Guardian On Sunday
Cancer cases soar as Dar’s largest hospital overwhelmed

TANZANIA’S largest cancer hospital, Ocean Road Cancer Institute (ORCI) in Dar es Salaam, is overwhelmed by cancer patients, with last year alone diagnosing 5,700 patients, The Guardian on Sunday has learnt.

The Ocean Road Cancer Institute in Dar es Salaam.

ORCI has been overwhelmed by new cancer cases since 2011 when it started to diagnose more than 5,000 cancer patients a year.

The hospital’s most prevalent cancers diagnosed include cervical, Kaposis sarcoma, breast, esophageal, head and neck and lymphomas.

Dr Julius Mwaiselage, ORCI acting Director General, says the hospital has only 260 beds to accommodate the increasing number of cancer patients, meaning that only those who do not have relatives in Dar es Salaam or those who are seriously sick are permitted admission.

“In most cases, cancer patients are not seriously sick until the disease reaches very advanced stages. We see around 450 new cancer patients per month and not all are admitted,” says Dr Mwaiselage, a public health specialist and epidemiologist.

“Yes, it is overwhelming to the institute but you should know that each year there are about 40,000 new cancer patients all over Tanzania, but only those (5,000) can reach ORCI,” he says.

Dr Mark Mseti, a consultant clinical oncologist, concurs with Dr Mwaiselage, saying ORCI is overwhelmed by cancer patients both in terms of capacity to serve them as in-patients due to lack of enough space, as well as in terms of medicines and medical supplies to match with the increasing number of patients.

“Our bed capacity is 260, we have only two external beam radiotherapy machines, the third one is for skin cancers only, which has very few patients to deal with, and only two brachytherapy (intracavitary) radiotherapy machines,” says Dr Mseti, who is also ORCI clinical services manager.

He explains that brachytherapy radiotherapy machines are used for intracavitary radiotherapy treatment in cervical cancer patients.

“We have two external beam radiotherapy machines with capacities to treat 50 patients each per day, but they are instead treating up to 80 patients each per day” he says.

Radiotherapy machines are used to treat out-patients from 6am to 4pm daily, and from 4pm to midnight they are used to treat in-patients, according to the oncologist.

“In this case, the machines are placed on break for six hours only. They are hence being overused,” he says.

According to him, international cancer treatment standards require one radiation machine for every two million population, and in such a case the country needs about 20 radiation machines.

However, the oncologist says there is light at the end of the tunnel with regard to government efforts in educating cancer specialists.

“ORCI, for instance, had only five cancer specialists before 2012 and four of them have now retired. But today the institute boasts 22 oncologists,” says Dr Mseti.

Commenting on reports of increased cancer cases in Lake Zone regions, Dr Mseti says it is probably because of the huge population in the area.

He adds that the availability of diagnostic services at the Bugando Medical Centre and financial constraints to access medical services could be among reasons accounting for the reported increase in cases of cancer.
“Research needs to be done to be sure,” he adds.

He says currently Bugando is treating cancer patients using chemotherapy but will in the near future begin using radiotherapy.

Sr. Jesca Kawegere, ORCI cancer screening and public education manager, says the hospital commenced cervix and breast cancer screening in 2002.

“We screen between 25 and 30 women a day, out of which three to four of them are detected with precarious lesions (suspicious of cancer)” says Sr. Kawegere.

“Awareness of the disease could be the reason behind the increased number of cancer patients. People are nowadays willing to undergo cancer tests.” Sr. Kawegere says.

Dr Mwaiselage is however optimistic that things will improve for the better following completion of construction of the Sh7.5bn new building by the government between 2011 and 2013.

He says the new building does not have wards but it has treatment rooms, planning rooms, control rooms and offices.

He says the new building will have two linear accelerator radiotherapy machines which will improve treatment for patients.

“These are new modern radiotherapy machines which have high precision compared to the current ones,” says Dr Mwaiselage, who also teaches master’s degree students in medicine in clinical oncology at Muhimbili University of Health and Allied Sciences (MUHAS).

He says: “The machines will be procured as soon as we get additional funds from the government. Already we have 4billion/- in our account; and the cost of one machine is about 8billion/-.”

The acting director adds that the machines will be procured through laid down procedures of the Public Procurement Regulatory Authority (PPRA).

“We will start by procuring one machine and in the next financial year we will procure another machine,” he says.

Reacting to the ORCI situation, Minister for Health, Community Development, Gender, Elderly and Children Ms Ummy Mwalimu admitted to an increased number of cancer patients in the country, saying recent forecasts suggest a 50 per cent patient increase by 2020.

“At present 35,000 people develop cancer each year and recent forecasts suggest that by 2020 this number will increase by 50 per cent,” she says in an email to The Guardian on Sunday.

She says the indicated number of cases may however not depict the actual situation in the country due to the fact that about 80 to 90 per cent of cancer patients are still unable to access diagnostic and treatment facilities.

Ms Mwalimu says it is also a matter of concern that about 75-80 per cent of patients attend hospital when the cancers are at an advanced stage when they are not amenable to cure.

She says her ministry is taking a number of measures aimed at fighting against cancer, including integrating cancer control services into all levels of existing health care delivery system in order to increase access to diagnosis and treatment.
The minister says previously it was only ORCI which provided services for cancer patients, but currently Bugando Medical Centre in Mwanza region had started providing the services.

Ms Mwalimu mentions other measures as doing more preventive work including health education at the community level and in health facilities, and conducting cancer screening campaigns countrywide and community sensitization programmes.

“We are also focusing on the provision of diagnostic equipment; free supplies and medication to government health facilities, even though there are still some challenges on this,” she says.

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