To commemorate breast cancer awareness month this October, some facilities are offering free mammograms to women over 40. As commendable as these efforts are, there’s a glitch when it comes to actually getting treatment at the Cancer Diseases Hospital (CDH), the equipment is obsolete and it seems bureaucracy still reigns supreme.

Before we discuss the endless promises for new equipment at Zambia’s only cancer treatment centre, let me first share with you a story of a Lusaka woman who was diagnosed with breast cancer at the age of 31 in 2021. One day, Eunice (not her real name), felt a lump in her breast and casually went to Chilenge Level One Hospital, thinking she would be given some anti-biotics. However, she got referred to CDH and began her rollercoaster battle with cancer.

“I was diagnosed with cancer in 2021, just two weeks after laying my father to rest. It was a huge blow to me, I was like how? Why? To make it worse, I was told we need to do surgery and I was thinking, what? At my age? Cancer? I still have dreams to achieve a family to grow. I waited a week for surgery and thereafter, I was told about chemo and radiation,” she said.

She said the doctors never prepared her for the effects of chemo.

“But, get this, doctors never told me the effects of treatment except for hair loss. It was so hard for my family, it was all new so it just kept everyone running around to keep me breathing. I was fortunate because the chemo drugs were given under NHIMA, buying was expensive, I needed eight cycles and each cost over K1,000,” Eunice said.

“If one is not on NHIMA or any medical scheme, it’s a challenge, cancer is one of the most expensive conditions to manage. It’s really sad nothing is being done about it, not everyone can travel just for proper management. I think eight out of 10 people in Zambia die because of negligence and neglect.”
She said she only found out the radiation machines had been down for some time after finishing her rounds of chemo.

“Get this, in all the time I was on chemo, not one doctor bothered to tell me that the radiation machines have been down for years. I was devastated when I found out and I started asking for help everywhere and anywhere. By God’s grace, I managed to raise enough to travel and have PET SCAN and radiation in India but the CDH doctors did not want to give me a referral letter stating that I am okay, I don’t need radiation. My mother furiously demanded for it. Did I mention I was diagnosed at stage 1? By the time I was starting chemo, it was stage 2(delayed chemo) by the time I was going for radiation, it was stage 3 because of delays on referral letter, they only gave it to me after two months when you are supposed to do it after two weeks at least,” Eunice said.

“When I got to India I was heartbroken to learn that even ministers travel to India for better treatment while the average Zambian suffers. Tax payers’ money working for their personal benefits, but the rest of us suffer.”

She lamented that her cancer journey has left her in so much debt.

“My cancer journey left me in so much debt. Even up to now, we live from hand to mouth because of debt. I am supposed to travel in January for annual PET SCAN, again I am out here asking for help from well-wishers, even you mama if you have anything I’ll be grateful. We have pleaded with government to fix those machines, we need them. How are they managing diabetes, HIV, etc? Why can’t cancer be managed the same? It’s as deadly as those I’ve mentioned right? Government should please listen to the cry of a cancer fighter,” said Eunice.

Eunice’s story is not unique. There are hundreds, if not thousands of other patients going through the same struggles. The last communication we got from the Ministry of Health regarding new equipment for CDH was last month when Honourable Sylvia Masebo said government was working on procuring cancer radiotherapy equipment for the hospital. Masebo disclosed, during a bilateral meeting held with Siemens on the sidelines of the United Nations General Assembly in New York, that Siemens had been identified as a key supplier of medical equipment to support cancer services.

According to a statement issued by First Secretary for Press and Public Relations at Zambia’s Permanent Mission to the United Nations Namatama Njekwa, Siemens and government were expected to sign a Memorandum of Understanding in order for the German firm to provide X-ray and ultrasound machines, CT Scan machines and MRI units for the whole country. While this news sounds progressive, it broke my heart because I don’t understand why we have to move at a snail’s pace when it comes to procuring these vital machines.

The radiotherapy machine has been faulty since 2021 and it has been completely down for over a year now, just as other vital equipment, but all we keep hearing are promises and planning sessions from our leaders. Meanwhile, those who cannot afford to mobilise resources to seek treatment abroad are dying extremely painful deaths. We can do better than this. We have the capacity to do better.

At the moment, cancer cases are on the rise. The 2020 Globocan report estimated that there were 13,831 new cancer cases. This increased from 12,052 in 2018. And to make matters worse, Honourable Masebo told Parliament that the majority, of these new cases, approximately 63 per cent die from the disease

“The highest burden of cancer comes from cervical cancer with 3,161 new cases, Kaposi Sarcoma with 2,210, Prostate cancer 1,546, breast cancer 972 and oesophagus cancer 506 cases. These increased from the 2018 figures of cervical cancer which were at 2,994 new cases with Kaposi Sarcoma 1,690 previously, Prostate cancer 1,230, breast cancer 888 and oesophagus cancer 389, respectively,” said Masebo.

With such statistics, we cannot be taking chances when it comes to equipping our hospitals. I think by now, even some doctors are depressed because people keep going to them for help when they can’t do anything in most instances because they are handicapped by the system. I can’t imagine being in their position, having to watch people who might have beat cancer deteriorate and die over and over again.

But what is to blame for the fact that this equipment hasn’t yet been procured? I think President Hakainde Hichilema hit the nail on the head when he lamented about how slow government processes move, saying he found it offensive that people valued processes more than outcomes.

“What I propose to do is to create a small team from your office, from the Cabinet Office which will utilise the existing structures in the Judiciary, including advisory committees and checklist the things we need to do so we can improve service delivery for those who put us in office. That small working team does not take away powers. I want to confess, one of the challenges I’m having in managing this country, every time you try an initiative towards a solution, there’s a perception that you are diluting the power of those who have been enjoying that power for years. The quickest reaction is that ‘HH we don’t do things like this in government’. I say ‘really, how do you do it?’ They say ‘we do it this way, a memo there, a meeting in the office, if the environment is not conducive, let’s go to Chaminuka, we will think better there at Chaminuka’. I’m confessing today and I find that quite offensive inside but many times, I don’t show it but I find it offensive that processes are valued more than outcomes. You don’t deliver change like that, you have to upset the status quo in order to deliver change and service to the people,” said President Hichilema during the celebrations of the Supreme Court’s 50 years of existence.

One of the sectors which is desperately craving some change in this country is the health sector. This is a sector where procurement systems need to be shifted around in order to meet the demands of the moment. It is not enough for President Hichilema and other leaders to keep complaining about bureaucracy, when are we going to see some actual changes being made? For the health sector, everything is a matter of life and death and I hope that this will start being reflected in the decisions which they make. And to everyone reading this, do all you can in your personal capacity to stay healthy because our healthcare system is stressed.