It was not too long ago when our home's best civil engineer died of stomach cancer. He had no formal education but demonstrated a level of integrity I have cherished for years. I came to know him at the age of 6 when he was, with other local engineers, building our home's fence. It has been 19 years and the fence is standing strong. While it has had to undergo usual maintenance, I can attest that he did not pilfer nails, bags of cement, paints or sand like some other individuals do; an unfortunate reality contributing to infrastructure challenges in Africa. This inadvertently affects Universal Health Coverage, given that there is limited healthcare facility development, and existing facilities are hard to reach due to lack of infrastructure health facilities are few or even hard to reach due to a lack of infrastructure. I am glad, from his experience, I learned about integrity!
Shortly before the COVID19 pandemic, his daughter reached out to me to ask if I would support her dad in getting quick access to services anytime he came for chemotherapy for cancer that was previously misidentified to be stomach inflammation. At that moment, I was working on my research on breast cancer early detection in Rwanda. I am glad Rwanda has made some progress with cancer early detection and treatment, but we can do more than we have, and I hope for that. We need to do more to help people get to hospitals for treatment, especially when they have a long distance to travel. Because, for instance, the patient and companion travelled up to 267.7 kilometres going for periodic chemotherapy. You can imagine the psychological and emotional support they needed periodically, plus financial support for transport and diet needed to supplement chemotherapy treatment. If you can understand how hard it was, with such experience, could you also imagine how early cancer should have been identified and treated if health providers in his nearest health facilities were able to identify the disease at an early stage or if sought for service early due to community awareness on cancer?
A focus on early detection of cancer is important but should coincide with holistic psychosocial and financial support for the cancer patients and their families. With my growing experience, knowledge, and research on cancer, I will admit that my local community members consider me an advocate, researcher, and educator on cancer. It has gone beyond that since October 2020 when I reconnected, on a phone call, with someone who once was our neighbor in the year 2008. She left the neighborhood like everyone does, either for education or work, for self-development and growth. At this time, she returned home. Reconnecting, she wanted to know if she could go to confirm her suspected skin cancer at the Butaro Cancer Center of Excellence, travelling 267.7 kilometers. “Yes, to be sure, you must look for a transfer and travel to get a biopsy done”, I replied.
I have been following up with this skin cancer patient and her experience with treatment, and it made me reflect on success stories we have from the global AIDS movement. The global AIDS movement has been achieving a satisfactory progress 90-90-90 target (90% of all people living with HIV knowing their HIV status, 90% receiving sustained antiretroviral therapy & 90% with viral suppression), despite the COVID-19 pandemic challenges. It has left a good impression on me that infectious diseases have a high level of attention and investment to reduce the burden, and I long for more interventions fighting for the silent killers, non-communicable diseases, including cancer. If we could put our efforts together, this patient, like others, could avoid missing some scheduled chemotherapy treatment sessions due to lack of transport. Or, the patient could not be returned home to go and eat fruits and other nutrients, which she hardly gets, to increase antibody levels in her body to avoid being affected by chemotherapy medications. Also, patients can be distressed by the fact that their family members are not emotionally and financially able to accompany them throughout the journey.
May World Cancer Day 2022 bring hope to patients and families that are thriving and fighting cancer disease. A great appreciation to the oncology nurses, doctors, and social workers who are scouting cancer patients in their treatment and healing journey. To all generous donors, funders, policymakers, and advocates who are contributing in your ways, may you find more opportunities to leverage your work and improve cancer early detection, treatment, research, and advocacy interventions to fight the burden. To anyone who can still join the movement, you can do it in your best capacity! #IAmAndIWill! Join me!
About the Author:
Aimable Uwimana, BA, MSc is a non-communicable disease advocate and researcher. He investigated and co-investigated population health research projects on breast cancer early detection and Covid-19 mental health impact in Rwanda. In his free time, he explores the connections between arts and health, particularly mental health and one health, through music and nature photography