Cancer in Malawi and the need for urgent action

The American Cancer Society graciously offered me a scholarship to attend the African Cancer meeting in Cape Town, South Africa in November, 2007. It was my second return to Cape Town. This time again I met Anso, a committed South African Health Journalist and Robert my good friend from Zimbabwe. He is a story of his own. Malawi has lost since September 2006 three remarkable women to Cancer. On December 24, 2007 I joined hundreds of who is who of Malawian society to bury Kate Kainja-Kaluluma at Lobi in Dedza. It was raining, but from President Bingu wa Mutharika, Aleke Banda, Luis Chimango, Friday Jumbe, Nga Mtafu, Besiton Majoni, Loveness Gondwe, Lillian Patel and even my dad were all there to bury the woman who they described as a woman of “substance, wise, great and development conscious” Kate Kainja was the Minister for Women and Child Development and a founder of hosts of gender, child development and education foundations. She was one of the very qualified Malawians in her field of education, nutrition and home economics. She was a strong politician too, defying her party president and ally, John Tembo who has always found a way of absconding funerals of greats such as Kanyama Chiume and now his former ally Kate Kainja. But what struck me more was the coincidence of the date Kate Kainja was buried. 24th December. This is the official birthday of the Late First Lady Ethel Mutharika who died on 28th May 2007. The First Lady was buried while I was out of Malawi. Two great women one was buried on the day the other was born. Now, Kate Kainja Kaluluma, she is the second woman Cabinet Minister to die. Elizabeth Aipira died in September 2006, she was the Minister for Statutory Corporations. The three were great women, I knew them all in different set up. I interacted with them all as a Journalist. And I have been shocked that most Malawians have come to readily accept their deaths without looking into the cause and how as a nation we can learn from their experiences. The three women died of cancer. All of them at any given time received treatment from outside the country. Kainja had to die in the United Kingdom where she was diagnosed and received chemotherapy. Late Aipira personally told me of her trips to South Africa. Dr. Ntaba explained how the First Lady had sought treatment outside the country. The most striking thing is how ill equipped Malawi is to diagnose cancer early. We do not have the machines for radiotherapy and we have very few cancer specialists. I have had the privilege of interacting with Dr. Dzamalala, Dr. Taulo and Elizabeth who work at College of Medicine and Queen Elizabeth II Hospital in Blantyre. They told me that Malawi has a very good cancer registry and that’s where the story ends. Part of my Nieman Global Health Fellowship took me into Zambia and Zimbabwe. Zambia by July 2007 had acquired its own cancer radio therapy machine while Zimbabwe is medically advanced. The only challenge with Zimbabwe is the current political state that has seen qualified medics and specialists moving out of the country. Cancer specialists told me in Cape Town that up to 60 percent of most cancer types is treatable if diagnosed early. The other 20 is preventable with right diet and physical exercise while only 20 percent is terminal. Even in the era of HIV and Aids, mostly men with Cancer mainly Kaposis Sarcoma and HIV have shown to have strong survival rates if treated early and for those with low CD4 if receiving ARV, it has been shown that one can survive the cancer.
My point is no preventable death is acceptable even for a poor country like Malawi. We have cholera killing 4 people already by December 18, 2007, we have hundreds of children and pregnant women dying from malaria and delivery complications and we have many more deaths from road accidents due to drunken motorists or those that have bought licenses from the market. Cancer should not add the early mortality rates of the country. No, let Government and the private sector raise the much needed money to buy the machines and let us set up a cancer unit in all of our major hospitals.
The whole country had to wake up and raise money to treat celebrated ethno-musician Stonald Lungu’s cancer treatment in Tanzania. Parliament can afford to spend 300-million on a budget deliberation that was unnecessarily extended. The State would have spent millions of kwacha for cases such as Cassim Chilumpha’s treason trial which doesn’t seem to end or compensate people like Harry Thomson. MBC can afford 200 percent hike for its managers.
Why can’t we afford a machine to treat cancer internally?
The death of the First Lady and two Cabinet Ministers from such a cause should awaken us to reality and try to save hundreds of ordinary women threatened by cervical and breast cancer.
Let us declare our commitment to serve as in the memory of our great mothers who have departed, because we did not act early enough to improve our national diagnostic capacity and treatment.
I will be happy the day I will write of the radiotherapy machine at Kamuzu Central Hospital or Queen Elizabeth Central Hospital. As I finished going through this page, Jake Muwamba, popularly called Senior Citizen was being buried at Chifira in Nkhatabay after succumbing to Colon cancer on Sunday 6th January, 2008.

End Note: I believe the Health Minister Marjorie Ngaunje has the welfare of Malawians at heart but when we see qualified and experienced officials leaving the Ministry headquarters faster than they came, alarm needs to be raised. I know Dr. Richard Pendame was not the most perfect health Principal Secretary but we all agreed, with SWAP and coming of the Essential Health Package, he was a team leader and good player. No wonder when we decided to demote him to something else, the British Department for International Development offered him a lucrative deal. Is this the tale of a rejected stone? I know Dr. Habib Somanje and his vast knowledge of Preventive Health, together with Dr. Sangala, Dr. Storns Kabuluzi and Dr. Salaniponi and Dr. Pendame they formed a ring of dedicated Malawian health administrators. They have been offered lucrative deals before but they chose to receive low public salaries. Dr. Pendame left, Dr. Somanje has joined WHO Africa Office in Congo and Dr. Kabuluzi someone with vast Malaria management experience has gone to preventive health services. I am not sure if the misallocation or is it suddenly those that are leaving have chosen greener pastures. But one thing, loosing experienced people will not help matters, worst still at the moment when things were moving in the right direction. I hope Dr. Somanje is the last man to leave the Ministry of Health.


Acacia said…
it is estimated that more than 25,000 people in malawi live with cancer... plans for a national cancer centre have made progress in raising awareness about the importance of cancer treatment. alongside treatment there must be care; the new 'palliative care association of malawi' has over 200 members and supports health care workers across malawi to improve the quality of life of cancer patients... contact
musawononge said…
Good post. See views about this on
RME said…
It's definitely an issue that requires more attention, education and resources at all levels, especially as the life expectancy in Malawi will soon rise again (I hope), and cancer is associated, but not exclusively, with the older generations.

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