IT’S been a year since my mother succumbed to endometrial cancer at the Cancer Diseases Hospital. It was when she was hospitalised that I came to learn, up close, the horrors which cancer patients often face due to the obsolete equipment at CDH. A hospital which was once hailed as a regional hub for cancer treatment is now a shell of its former self and people are dying avoidable deaths every single day because they cannot afford to seek treatment abroad. Last year, Health Minister Sylvia Masebo went to the National Assembly and announced that all Cancer patients who needed radiation would be taken to Tanzania as CDH gets refurbished. She even estimated that government would spend roughly $4,500 on each patient. Sadly, it seems there has been some change of plans and government did not have the decency to inform the people about this.

Hon Masebo on October 26, 2023: “Regarding the issue of patients at the Cancer Diseases Hospital, I’m glad to inform the House that the government, through the Ministry of Health and in particular the Cancer Diseases Hospital has engaged the Tanzanian government through the Cancer Centre in Tanzania as we prepare for the complete replacement of the equipment. To this effect, a memorandum of understanding was signed between the cancer disease centre of Zambia and that of Tanzania where it has been agreed that at the point where we start the replacement of the old machine, the hospital will have to be closed for a period of four to six months.

It is at this period when the hospital will be closed that the machines will be removed and the infrastructure will have to be rehabilitated, taking into account the new machines that will replace the old machines. Once the machines are brought in and the hospital becomes operational, that is the time the patients will be removed from Tanzania back into our hospital…The cost of referring patients to Tanzania as I indicated is a matter that is being negotiated and there is an MoU. An MoU simply means we have agreed but we have not finalised. What comes out of an MoU is an actual contract that will give you now that real figures. Now, that is a procurement matter but off the cuff, I can state that the amount will be around $4,500 per patient and this will cover the cost of transportation to Tanzania, the cost of accommodation for the patient, meals and for a six to seven weeks costs of radiotherapy. So, that will cost around $4,500. But as I indicated, the finality will come out of a signed contract”.

About a month later, Hon Masebo returned to Parliament and furnished the House with more details of government’s deal with Tanzania.

“Government is cognizant of the fact that CDH has nearly 500 patients waiting to receive radiotherapy. As the Government will be rehabilitating the CDH radiotherapy services, there will be no access to radiotherapy during the period. To alleviate this, government has negotiated with the United Republic of Tanzania to assist in the treatment of our patients that require radiotherapy only. The Ocean Road Cancer Institute (ORCI) located in Dar-es-Salaam, is a comprehensive cancer centre providing radiotherapy services in the public sector at a reasonable price. In addition, Ocean Road Cancer Institute has agreed to accommodate an additional 40 patients from Zambia at one setting in addition to what they are treating already. Note that each treatment takes six to seven weeks to complete which means patients will be evacuated every two months till CDH is up and running. At this point there has been no patient sent to Tanzania on government sponsorship as the procurement process is being completed. All patients will go through the ad-hoc committee at University Teaching Hospital for assessment and recommendation for referral to Tanzania in collaboration with CDH.”

But we have now discovered, through an interview, at this attractive deal was scraped off.

MoH Permanent Secretary for administration Christopher Simoonga on February 12, 2024: “Initially, we had negotiated with Ocean Road Cancer Research Centre in Dar es Salaam. We even reached an extent of asking them how much it would cost per patient, and they wanted us to be sending in the batches of 40. And when they gave us the quotation and the mode of payment, we realised that they were more expensive than us sending those patients to India. So, these hospitals that we have a memorandum of understanding with in India, it’s quite a number of them. I think they are about five or four. These MoUs were signed in about 2019 or so. So, these are the hospitals where we send patients in India because we have an MoU. So, when they heard [that] we were trying to send more patients to Dar es Salaam, they came up with a far much better offer than Tanzania which is nearer here. They even offered to buy the tickets. They will pay for the accommodation for the patients. Those were overheads which we as the government were going to meet. They offered a far much better offer than the cost of sending patients in Tanzania…the Cancer Diseases Hospital (CDH) is still treating a good number of patients who do not need what we call radiation therapy. So, a number of other cancer diseases are still being managed well at our hospital. The one thing we are not able to do is radiation therapy because the equipment that has been able to provide that service has become obsolete. In terms of cancer management, we are still doing chemotherapy, surgical intervention where we can intervene early, and we are still doing a number of things as a country. We just need radiotherapy and for that we refer to India.”

I would like to believe that before any minister goes to the National Assembly to layout a roadmap on how government intends to handle any challenge, all the bases would have already been covered; at that point, the expectation is all the pros and cons would have been weighed and all budget questions figured out. But it appears that this was not the case in this scenario. I get the feeling the public had exerted too much pressure on the government and they quickly came up with a statement in an attempt to put out the fire even when there was nothing concrete at the time – and this is very unfair. In my opinion, it amounts to playing with cancer patients’ emotions and this needs to be stopped.

You see, cancer is a condition which makes people feel so helpless and I have heard several patients and survivors say that it strips you of some dignity. Having no radiotherapy equipment at CDH is bad enough; it means patients who need such kind of treatment understand that it is either they mobilise resources to go abroad, or simply wait for the Lord’s call. So, when government comes up with an attractive statement that such patients will be taken elsewhere for treatment, it reignites the hope of those who have no means to make some private arrangements. Imagine just how devastating news of a U-turn is to the patients and their families.

Now, I know government is saying they have replaced it with another deal with India. But when you look at the few details we’ve been given about it, since December, government has only managed to send 39 patients to India. 39! This raises some questions; what is the selection criteria? How does a cancer patient get to find themselves on that narrow list? How many patients will they manage to send to India before new equipment is installed at UTH? The math is simply not mathing. I think the ministry must issue a more in-depth statement on this matter and respond to those questions. Such a stark U-turn cannot be done silently; the patients and their families need to be made aware of all the changes as they unfold. Communication is very important, even if the news is terrible.