Cancer Surge Overwhelming AIDS-Crisis Botswana
Pastor Dale Morgan
Cancer Surge Overwhelming AIDS-Crisis Botswana*
Gaborone, Botswana (AFP) Sep 07, 2006
Doctors in Botswana, already battling one of the highest levels of HIV
per capita in the world, are being overwhelmed by a dramatic rise in
cancer cases as a result of the epidemic.
Incidents of cancer have more than doubled in the last four years, say
the medics who are faced with a severe shortage of trained staff and
equipment in the southern African country whose health budget is already
overstretched.
"We have a cancer crisis in this country caused by HIV which weakens the
body's immune system," said Alexander von Paleske, head of oncology at
Princess Marina, the largest state-owned hospital.
"The outpatient visits we had in 2002 were 2,050 people but last year we
had 5,650 people," von Paleske told AFP.
"As doctors we are seeing about 20 to 30 people a day and we are now
working seven days a week, overtimes and still struggling to cope.
"The chance of getting cancer, in this era of HIV/AIDS is now 10,000
times higher than it was before."
Princess Marina's oncology department has 20 beds, three doctors and
about 18 nurses who work in four shifts. The department does not have a
radiotherapy unit and relies on the nearby Gaborone private hospital.
Von Paleske said a large number of cancer patients admitted were
suffering from Kaposi's Sarcoma, a particularly nasty type of skin
cancer which starts out as spots before multiplying into ulcerous sores
all over the body. It is usually fatal if untreated or diagnosed too late.
He said the cost of treating Kaposi's Sarcoma was an additional burden
on the public service health budget.
"The cost per patient is 350 pula (58 US dollars) per course which is
repeated four to six times. There is also the cost of radiotherapy which
is between 5,000 and 7,000 pula. With other types of cancer, these
amounts increase to 2,000 pula per course," he said.
Von Paleske said often patients suffering from the Kaposi's Sarcoma
cancer came for treatment too late and this necessitated amputation of
the affected limbs. He said the link between HIV and cancer meant that
the majority of patients and victims of this cancer were between 20 and
40 years old.
"I have only four patients who have cancer and are HIV negative and
hundreds more who are positive. There are cancers that are as a result
of HIV and others that become more aggressive because of HIV," he said.
Jeroen Lorist, an official with the Cancer Association of Botswana
(CAB), said his organisation was also struggling to cope with the
upsurge in patients.
The CAB has a 20-bed interim home where patients can recuperate while
receiving treatment from hospital and also provides after-care, support
and counselling services.
"We are now seeing that sometimes we do not have enough beds to
accommodate people and we have to put mattresses on the floor for them,"
he told AFP.
"There is access to treatment in this country and we are proud of that,
but the challenge may be to increase information on cancer to society.
"A lot of times, people do not come when the disease is in its early
stages and this decreases the effectiveness of the treatment."
Last year, the association provided for 90 female and 58 male patients.
It also has a psychologist and social worker volunteering their services
to the patients. Botswana has one the world's highest rates of HIV,
affecting around a quarter of the 1.7 million population, according to
the United Nations.
Von Paleske described the situation as a "challenge of unforeseen
proportions", saying the department could not demand more funds from
government as it was already financing the rollout of Antiretroviral
drugs to combat AIDS.
The Botswana government is currently negotiating with the International
Atomic Energy Agency to establish a radiology unit at Princess Marina.
However, von Paleske said that the biggest challenge would be to secure
experienced staff to run the unit, adding that no one was currently
being trained in radiology.
Source: Agence France-Presse