October is World Cancer month. Wear your pink ribbon.
Throughout this month, Corporate Social Responsibility activities are flooding Uganda. Cancer screenings and marathons and fundraising campaigns paint Kampala (notice the scope?).
CandeIndex Statistics show that out of 31.6million Ugandans (2008 Census), 27,000 people are diagnosed with a form of cancer per year (excluding NMSC); 17% of the people are at the risk of getting cancer before making 75years and about 21,300 people die from cancer in a year.
These statistics are worrisome.
In Uganda, cancer health practitioners are from both the government and private health service providers. Of the few, one main service they offer is palliative care. Examples of palliative care service providers include: Palliative Care Association of Uganda, Uganda Cancer Institute, Uganda Child Cancer Foundation, Uganda Women’s Cancer Support Organisation, etc.
The best wonder drug in palliative care is morphine. Previously used during war on wounded soldiers, morphine exhibits strong elements that reduce severe pain, leaving the user with a little ease on the pain. Only palliative care and health service providers have authority to administer medical morphine because the drug is addictive and dangerous, if not regularized.
But are we on the right track on palliative care and health policy?
Palliative Care is specialized treatment and care for terminally ill patients and their families. Terminal illnesses are many but cancer stands out thus this concise article.
Many countries, especially in developing spheres had not anticipated the attention cancer would receive. They were thrown off-guard by the increasing numbers of cancer patients and the cost of treatment for an ordinary citizen. Unfortunately, the wave of cancers has brought with it another tide of extortionists and unprofessional service providers as if the poverty level of majority citizens is not concern enough.
This writer confesses that not until 2015, during a Palliative Care Training, she had limited knowledge on palliative care and the wonder “military” drug, morphine.
How cancers develop
Cancers emerge when abnormal cells grow in one part and spread quickly to other parts of the body. In some cancers like pancreatic cancer, the cancerous cells spread fast and undetected but wait to present symptoms which the patient might ignore. When these cancerous cells spread to organs like the spinal vertebrae, liver and lymph nodes, the symptoms become severe and often the cancer stage is advanced that little can be done to thwart the disease.
In the cancer world, words like mass, lesions, diagnosis, benign, malignant and several other complex terms emerge without one’s forecast of the diction.
Cancers may begin like tumors. When tumors manifest in any form, they are either benign or malignant. Benign tumors are said to be less harmful and easy to treat while malignant tumors are serious and harmful. Malignant tumors get the doctors nervous.
When somebody experiences sudden unintended weight loss, constipation, fatigue, abdominal pain, painless lumps, skin lesions, protruding body parts, etc, he/she must seek a doctor’s advice on the condition. Without a doctor’s opinion, it is difficult to tell if these signs may be signs of a cancer. Although not conclusive, these little signs can help you know what body changes you are undergoing and whether they are cancer related or not.
Scientists and especially, oncologists have categorised cancers in different stages. Each stage poses its own dangers, effects and level of treatment. While the initial stages can be fully cured, if detected early, the last stages are characterized with pain, weakness and death. Since the magnitude of the cancer cells movement is greater in the whole body, the body loses its will to fight back against the cancerous cells. This is where palliative care specialists increase their attention.
Chemotherapy requires that the patient to receives several doses before starting full treatment. Although painful and nerve wrecking, chemotherapy is more costly than the thought of treatment and that is why it is important to talk about an effective health policy or a health insurance policy.
The International Abuja Declaration & Health Policy
The International Abuja Declaration law provides that states should spend at least 10% of their national budgets on health services but hardly any State exhausts the health policy logistics.
Health insurance policy providers are also faced with several challenges that their rates do not favour the ordinary peasant to open up and save with one. Notwithstanding their importance, health insurance coverage is concentrated in the elite class of society whilst the remote area dwellers stick to government facilities. That is why the challenges of the law and the policy must be undertaken head on with concerted efforts.
- Of the many policies touching on health, a limited number of them succeed or even last. Despite their touchy nature, a peasant family earning a daily income of Ushs.10,000/= may not afford services like having a Healthy Policy. In Uganda, a patient may need approximately UShs.2,000,000/= for each dose of chemotherapy, not counting the cost of other daily needs and services for a suitable healing process.
- The scarcity of service providers with a palliative care and suitable/affordable health care insurance policy in remote areas worsens the situation. Many health centres in remote areas lack diagnostic centres and specialized treatment, if not oncologists.
- Decisions in the legislature take time. Majority of law makers require special education even on minor theories. The government spends more finances educating a team of law makers without knowing whether they will consent to or reject the policy at hand. In a bid to not act on an impulse, Parliament may require an incentive to overlook the procedure.
- Sustaining a government decision on health policy can be challenging, thanks to a multi-political system checked by a fairly performing authority. Ordinarily, subjecting most health related issues to law makers may be detrimental to the program.
- Clinical research, association and funding as awarded by government and donors is limited and seldom utilized. Cancer has proved difficult to cure but possible. Unfortunately, a meager capital and an ignorant public make the efforts futile. Oncologists study specialized systems which take time to grasp. In the meantime, more infections occur.
- Tumors, mostly cancerous, only respond to heavy medication. Sometimes they are too strong to contain, hence the many deaths. Heavy duty machinery is expensive to acquire and maintain in workable condition. The unreliable power supply, a limited number of specialists and low morphine productions add to the burden.
NB: However, the medical fraternity has made successful research and cures for cancer despite the costs.
- More government support to research and scientific experiments is needed especially in private sectors where the motivating factor is to produce effective medication and mass production of generic drugs in the health sector.
- Also, privately sponsored facilities deserve tax holidays subject to viable results and subsidized costs of treatment.
- More support on sensitization of masses about the importance of a health insurance policy under the NSSF and Pension schemes are required.
- Subsidized health policies to ensure limited rates of treatment failure due to incomplete dosages must be established.
The right to health is not just a statutory requirement but a human entitlement. Whether provided by the government as a mandate or by a private facility as an alternative caregiver, palliative care and health policies need improvement.
It is difficult to put a price tag on each patient because “All cancers matter”.
BY ATUHAIRWE AGRACE
This article appears in our weekly law digital magazine, The Deuteronomy Vol 7, Issue 3 of October 21st, 2016
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