A tale of child cancer

Cancer remains a silent killer of thousands in the country. Children have not been spared. As the country gears to commemorate World Cancer Day this Saturday, where does Malawi stands on diagnosis, treatment and cure of child cancer? EPHRAIM NYONDO explores.

The Sobo Oncology Ward at Queen Elizabeth Central Hospital (QECH) in Blantyre, appears quite a pleasant room. Its floors are sparkling clean, the neatly dressed nurses’ smile with warmth, and all around there is a feel of hope.

But the moment you get to the corner of the ward and picture a face of a boy lying on a bed with the entire body covered in a Chiperoni blanket, the very feeling of pleasantness quickly grinds to a halt.

It is a sullen face of an 11-year-old, bedridden and trapped in a body that brings him nothing but suffering.

“He can’t eat at all,” says Beatrice Peter, his mother, sitting by the bed, a baby fastened to her back.

Innocent Peter, the boy’s name, can’t help complaining of aches in the stomach. Although he feels hungry, he can hardly eat. His limbs have withered into twigs, his body looks pale, and his lips are cracked and dry.

The tragedy of the boy began when he was very small.

“He was always complaining of stomach-aches. All these years we had been trying different medications, but they hardly worked,” continues the mother, who comes from Kambwiri, T/A Chiunguza in Salima.

Dazed by their first born son’s tenacious stomach-ache, in 2009, together with her husband, they took the boy to Salima District Hospital.

“After examining him, we were told the problem was beyond their control. As a result, they referred us to Lilongwe [Kamuzu Central Hospital]. We stayed there for two weeks, and then they told us to come to Blantyre,” she says in a low voice.

She continues: “Here at QECH, we stayed for some days. The boy was treated for a tumour in his stomach. After that, we were discharged and told to come back later.”

At that time, it appeared the boy had regained his health. He went back to his Standard Two class. But he did not stay long. The problem returned, worse than before.

“We came back to Blantyre last July. The boy went for an operation to remove the tumour that was giving him sleepless nights and restless days. The operation was successful. We were told to come back six months later,” she says.

But just after four months, the boy started to complain again.

“It was terrible; he could not sleep, not even dare to eat. We were forced to come back before the scheduled time,” she says.

At 11, an age when his peers are either in Standard Seven or Eight, Innocent is bedridden at the Sobo oncology ward.

And it is not just him.

The stories from different parents with cancerous children in the ward are full of sorrow, inviting one to tears.

There is a four-year-old boy jumping up and down, full of child innocence, yet his left eye is covered by a tumour. There is a girl, 14, sitting erect on the bed reading a Standard Four text-book, yet at that age she has received blood for over ten times. And there is another here with a swollen cheek, another there with a stomach tumour.

But despite the fact that these young ones are trapped in cancerous pain, there is a reason for them to smile. At least, they are the privileged few that got diagnosed and managed to secure treatment at the Sobo oncology ward.

But what is the scale of child cancer in the country?

According to Henry Chimbali, spokesperson for the Ministry of Health, a survey was done to establish the extent of cancer in Malawi targetting the period of 1 January 2007 to 30 August 2010.

“Data was collected from main government, Cham and private hospitals as well as histology labs,” he says, adding that the data was extracted from registers (OPD, wards, clinics, labs, theatre, pharmacy, mortuary).

Chimbali says the survey revealed that in the age group 0 to 19, the number of children with cervical cancer is almost zero while that of other types of cancer was less than 100.

“However, Kaposi Sarcoma, which is one of the most common cancers, the number of cases increased by age such that in age group 0 to 4, (49 children) , 5 to 9 (70 children), 10 to 14 (73) and 15 to 19 (95). Within this age group, Kaposi Sarcoma is mostly common in males than in females.”

The figures could be more. The main challenge continues to be diagnosis; there a number of cases that go without diagnosis.

“Cancer is better treated with early diagnosis. We are, therefore, strengthening our diagnosis but also public education to understand the causes which can be prevented,” he says.

But as government strengthens diagnosis, does the country’s health care have the capacity to contain the cases?

Currently, child cancer in the country is only treated at the Sobo oncology ward. Built in 1997 by Southern Bottlers, the ward is currently being supported by Carlsberg Malawi.

“We have been supporting the ward since 1997 when we extended the ward,” says Towers Pilling, Carlsberg Malawi’s corporate communications officer.

She adds: “In 2008, we also refurbished the toilets of the ward. In December last year, we donated bed rests to help the children sit up in bed, medicine cabinets for storage of drugs in the ward and bedside stools. We are also having medicine trolleys and stretchers made for the ward.”

The challenge is that it is the only ward receiving such cases across the country

“We receive new cases almost daily. Sometimes three or four cases a day,” says Agatha Thundu, a veteran nurse who has been treating child cancer since early 1990s.

She adds: “But as awareness infiltrates in the villages, we are seeing more cases sprouting, and this is creating pressure at the ward. We have 25 bed spaces, but we always make sure that we do not send patients back. We put them all over.”

She also disclosed that a single child with cancer costs about K100 000 (about $600) to be fully treated.

Despite that, the ward, too, has its challenges.

“We need more staff. You can imagine that all of us here are under a project. Even worse, most of the properties here come from donations and charitable organisation,” says Thundu.

Surely, as the cases continue to rise, it is evident that the ward would soon be found wanting. This is a call for intervention.

But for the time being, let’s all lock hands and pray for Innocent and fellow young ones in the tidy Sobo oncology ward. They need to live their lives and go back to school.

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