A famous person dies of cancer and social media is awash with condolences and opinions followed by politicians with vows to fight cancer by building cancer centers. It’s deja vu, as predictable as a cheap Mexican telenovela.
In a period of 30 days, the media has treated us to the headlines of prominent leaders succumbing to cancer: Former Safaricom CEO Bob Collymore, Kibra MP Ken Okoth and now Bomet Governor Dr. Joyce Labosso who lost the battle to cancer yesterday not to mention the 47,000 Kenyans who die of the vice per year.
We are in another season of promises and everything has gone according to script, but are our leaders really up for the fight against cancer? If we had a cancer center every time a politician promised us one, this country will be crawling with them.
Politicians have made a habit of making roadside proclamations about various issues. Roadside proclamations have two major traits: they are meant as tympanic nourishment for the citizenry and are said before consulting ones grey cells as Hercules Poiroit will put it. So what’s wrong with a cancer centers apart from the fact we have seen very few meant for the public despite the promises?
Merchants of Corruption
A cancer center is basically a tertiary institution by all definitions of the words. A cancer center will just confirm our unending fetish for edifices and machinery. Our solutions to health seem to revolve around new buildings. Controversy at Pumwani? Let’s build a 10-storey building to replace the old one. You want to improve health in Kenya? Let’s provide every county with machines that they don’t need. This buildings and machines provide a conduit for corruption but none really solves the problems at hand.
Apart from cervical cancer, prevention of other cancers is rather difficult. It will not be as easy as the mainstream media and social media doctors will have you believe, given that most of those things mentioned as causative agents are more of risk factors.
Treating late stage cancer is difficult with little chances of success. Thus our only hope is early diagnosis. Despite the media doom and gloom narrative many influential Kenyans have been diagnosed early and successfully treated of various cancers.
No one reports them, they are not sensational enough. Despite an insistent media campaign to paint the Kenyan doctors as incompetent, these diagnoses were made in Kenya by Kenyan doctors. There are cancers that can be picked early and successfully treated; this is our biggest shortcoming as country.
The biggest challenge to early diagnosis is the non-existent public health system. The biggest question in cancer management is not how many cancer centers are there but who sees the patient first.
If the person who initially sees the patient fails to suspect cancer, and the word is suspect not diagnose then the cancers centers will be built to fight losing battles. High index of suspicion will be directly proportional to the academic level of the person seeing the patient.
The lower the health cadre the lower the chances of having the high index of suspicion. A gynecologist is likely to pick Gynecology malignancies more frequently than a medical officer. This is true as we go down the ladder till the remotest of government dispensaries.
So when our grandmothers visit those dispensaries with a persistent ‘sore throat’, is the person seeing them able to think beyond the sore throat and suspect something else and send them for further checkup or will they continue treating the sore throat? That’s where the fight is lost. It’s not lost in the corridors of MTRH and KNH, but in the county hospital.
The fight against cancer will be only be won if more is put towards prevention and early diagnosis rather than in late curative management.
The cancer centers will be eventually needed to reduce disease burden as many Kenyans spend millions abroad trying to care for loved ones but the fight for life will be fought in dispensaries and health centers. The policy makers in both national and county governments have continuously made wrong decisions when it comes to health.
It’s probably time the policy makers made the right choice. Its time they went to the ground and experienced the suffering of Kenyans at the lowest level of health care. I am waiting to see a clear policy on how the ministry will fight the scourge but wait did the Cs Health advise us to avoid meat and take traditional foods to avoid poisoning and staying healthy? Maybe I am putting too much faith in an incompetent leadership.
(The author is a medical doctor with an established hospital.)