For many Africans, tuberculosis, HIV/AIDS and malaria are no longer the biggest health threats. Instead, cancer is.
Every year, there are thousands of children and adults in Senegal who die from poor health care, but what may surprise you is that they are dying from cancer.
Cancer, diabetes and heart disease are responsible for 30 percent of all deaths in Senegal, and cancer alone kills more Senegalese than malaria, tuberculosis, and HIV/AIDS combined. This problem is not unique to Senegal — according to the World Health Organization, Africa as a whole could be heading into a new medical crisis in the next decade.
Highlighting this problem is a report published by Human Rights Watch, “Abandoned in Agony: Cancer and the Struggle for Pain Treatment in Senegal.” Its research showed that tens of thousands of patients in Senegal are suffering unnecessarily due to restrictive government regulations on drug usage, as well as a lack of resources in palliative care
The 85-page report found that 70,000 Senegalese each year need what is known as palliative care — treatment and prevention of patients’ suffering — to control symptoms related to chronic, life-threatening diseases. With many Senegalese not getting diagnosed or receiving treatment at the early stages of cancer, they are entering the few medical facilities equipped to deal with chemotherapy and cancerous illnesses in the late stages of the disease, when little can be done other than pain management through drugs.
Morphine is an essential and inexpensive medication for treatment of severe pain, but according to the HRW report, Senegal only imports about one kilogram of morphine each year. This amounts to the treatment of about 200 cancer patients in a year. With frequent shortages of medication and poor training of medical staff, the death toll of cancer-related deaths is on the rise. But much of this problem is due to funding.
PRI research reveals that foreign aid for cancer victims in Africa is well below funding for the treatment and prevention of other diseases. In 2008, there were 4.8 billion cancer deaths in low- and middle-income countries, but the amount given in government and charitable aid to support cancer treatment was $168 million. Contrast this with the $6.2 billion spent on HIV/AIDS programs, when a lesser 2.1 million people from the same group of countries died from HIV/AIDS-related deaths.
The problem in Senegal is that its health system has limited funds to treat acute health problems, and very little is dedicated to palliative care. In most acute health problems, a diagnosis is often made late, treatment options are limited and medical care is costly. That leaves a large percentage of patients with chronic, life-threatening illnesses to develop pain and other debilitating symptoms. HRW research shows that as many as 80 percent of patients with advanced cancer, and about 50 percent of those with HIV/AIDS, develop moderate to severe pain.
The WHO has urged countries to take action in policy-making, education and drug availability. While there is some overlap between these three areas, WHO has identified each of them as fundamental to the development of palliative care services. Measures to address these areas would cost little, the organization reports, but can have a significantly positive impact on improving access to care for thousands of Senegalese.
For patients like Bineta, a 12-year-old girl with stomach cancer, this amounts to too little, too late. Referenced in the HRW report, her story highlights the barriers that many Senegalese face in seeking treatment.
Bineta’s parents had to save up money to travel the two days it takes to get to the capital, Dakar, for treatment. After a course of chemotherapy, Bineta’s parents ran out of money and could not afford to continue the drug treatment she needed.
Bineta died in March this year. Unfortunately, Bineta’s story is becoming all too common in Senegal.