Kenya: Uasin Gishu MCAs Pass Motion on Mandatory Cancer Screening

It may soon be compulsory for anyone visiting a public health facility in Uasin Gishu County to undergo cancer screening.

The county assembly has approved a motion seeking early and free or affordable screening of non-communicable diseases to tackle rising lifestyle diseases.

The motion by Tarakwa Ward Representative Patrick Bundotich compels the Health department to come up with a policy framework that will allow the devolved unit to subject all patients to cancer early screening so as to boost treatment of the disease.

The MCA decried the high number of cancer cases reported in many health facilities and was optimistic that early detection will help patients start life-saving treatment early.

"Data from county hospitals shows that most of the patients are diagnosed with hypertension, cancer and diabetes, which they discover late in stage three or stage four, when the disease has progressed," he told the assembly.

"We want the county to make screening compulsory when the patient first arrives at hospitals and if it is possible to make this to be free for all patients."

Kiplombe MCA Ramadhan Ali supported the motion, noting that the creation of a policy framework will help address high cases of non-communicable diseases reported in Uasin Gishu.

Mammogram test

"People have lost their loved ones to cancer and lifestyle diseases. Such a policy that seeks to improve screening is a welcome move because early screening will help to ensure that patients get treatment at the appropriate time," he said.

In Kenya, cancer screening costs between Sh9,000 and Sh25,000 per biopsy or mammogram test depending on the type of cancer and hospital, making it out of reach for most families.

"We usually test for specific cancers and most common cancers are cervix and breast. The cost ranges between Sh10,000 and Sh15,000 per test (biopsy and mammogram)... For other cancers we check symptoms for early diagnosis," said Dr Naftali Busakhali, an oncologist at Moi Teaching and Referral Hospital.

The 2019 census put the population of Uasin Gishu at 1.163 million, making the proposal an expensive affair for the county.

But besides the cost of tests, Dr Busakhali said, most health institutions in the county lack the facilities to conduct such tests.

Cancer is Kenya's third leading cause of death after infectious and heart diseases, contributing seven percent of total deaths annually.

More than 28,500 new cases are diagnosed and 22,100 people die, depriving the country of a healthy workforce.

Causes of morbidity

Breast, cervix, throat and colon cancers are the leading types in Kenya, Ministry of Health data shows.

In the North Rift and Western Kenya, efforts to fight the disease have been stepped up, with Moi Teaching and Referral Hospital (MTRH) acquiring new radiation equipment.

MTRH chief executive officer Dr Wilson Aruasa told Nation.Africa recently that the brachytherapy and linear accelerator machines are a game changer in healthcare in the region.

"The health facility serves patients in the whole of the western half of Kenya, Uganda, South Sudan and many other places. We cover comprehensive quality cancer treatment right here in MTRH at affordable costs," he said last month.

With the new machines, cancer patients will no longer have to travel to Uganda or Nairobi for screening and chemotherapy sessions.

In May, a team of oncologists at MTRH, led by Dr Jesse Opakas, conducted the first brachytherapy on a 57-year-old patient diagnosed with cancer of the cervix stage 3B.

Cancer treatment is covered by the National Health Insurance Fund at Sh40,000 a session and session one or two using Iridium-192 Source from Elekta.

Brachytherapy is an intra-cavity (inside) mechanism of radiotherapy for cancers of the cervix (lower part of the womb) and oesophagus (food pipe), two of the more common cancers in Kenya and leading causes of morbidity (sickness) and mortality (death), medical experts say.

"The procedure from planning to delivery of the dose of radiation takes two hours per patient. This particular patient had been waiting for treatment since March... For brachytherapy, only one or a maximum two sessions are required," Dr Aruasa said.

Serving patients

The brachytherapy machine is administered for cancers in hollow (cavitation) body areas like the cervix, oesophagus and prostate.

The new brachytherapy machine, he said, can treat up to 30 patients a day.

MTRH also acquired a linear accelerator radiotherapy machine, one of the latest technologies in the country, and it has since been installed and is serving patients.

Another form of cancer radiotherapy treatment is the external beam that uses a linear accelerator (linac) radiotherapy machine.

MTRH has been conducting diagnoses and treatment since January for leading cancers such as breast and cervical.

Linear accelerator radiotherapy machines can treat between 70 and 100 patients per day.

For curative treatment, between 20 and 30 sessions daily are needed per patient to deliver the required amount of radiation.

MTRH also received other equipment such as a Treatment Planning System, Quality Assurance (QA) machines, and Dosimetry machines, Dr Aruasa said.

Uasin Gishu Governor Jackson Mandago has in the past urged the national government to waive taxes on cancer equipment and drugs so as to make treatment more affordable for Kenyans.

"Since this disease has become a huge burden to most families, the national government needs to waive taxes to make cancer drugs and treatment free... some of the chemicals approved for agricultural use have been banned in developed countries for causing cancer but continue to be used in our country," he said.

"Parliament should come up with a list of these harmful chemicals so that they can also be banned."

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