Hazel Marimbiza
The havoc caused by the Covid-19 pandemic continues to disrupt daily life, but its reach goes deeper and further with mounting consequences for women who need to undergo screening for cervical cancer.
Hospitals and clinics have shifted daily resources to cope with an influx of people testing for Covid-19 disease, forcing cancer patients to delay their treatments.
The coronavirus pandemic is a public health emergency that everyone should be worried about, including people who run hospitals. They need to preserve capacity and take a proper pandemic response.
But the things we do to diminish our risk are not without impact on other areas. Public health and cancer outcomes are inextricably linked.
We have to realise the trade-offs we make when we work on one versus the other and find that right balance.
Just like in any other country Zimbabwean women face the threat of cervical cancer. The disease also poses a threat to the futures of young women. Globally, cervical cancer is the fourth most frequent cancer in women.
However, cervical cancer screening is limited, and this has been worsened by the fact that most attention is now being directed to Covid-19.
That is why a local organisation called Generational Changes Girls (GCG) is focusing on prevention of cervical cancer by taking time to educate young girls through social media conversations on the dangers of having many sexual partners which can potentially lead to them contracting cervical cancer.
Speaking to B-Metro, Generational Changes Girls’ (GCC) founder Brenda Madondo said as a health practitioner who has dealt with so many cancer patients she saw it fit to open an organisation which would help deal with the spread of cervical cancer.
“Teaching girls about the dangers associated with having many sexual partners could see us as a nation having a cervical cancer-free generation,” said Madondo.
GCC is particularly worried about ignorance among girls on cervical cancer which results in it being detected at a later stage, requiring more aggressive and costly treatments, and worse outcomes.
“Several years of economic challenges have reduced the capacity of the health system to provide comprehensive care for cervical cancer. Challenges of affordability, availability of drugs and accessibility of treating facilities impede engagement of patients into treatment and care,” said Madondo.
Zimbabwe is facing challenges with treating cancer because most health facilities do not have capacity to conduct all the staging and monitoring investigations and provide the drugs that are needed by patients mostly chemotherapies and analgesics for pain management.
According to research most patients and health workers have reported that the radiotherapy machine has frequent breakdowns and there is no back-up for this machine as it is a very expensive piece of equipment.
Recently one 44-year- old woman, Tendayi Magwata, left many people on social media hurt after revealing that her cancer treatment abruptly ended when the only radiotherapy machine in the capital, Harare, stopped working.
“I discovered that there are 500 people sitting at home right now waiting for radiotherapy because of broken machines. It’s not just me. It’s not just a handful of people but it’s a lot of people. Having had personal experience of the pain and agony that you go through, going through chemo, surgery, raising money for treatment, the overall impact on your family, just to then fall at the last hurdle because these facilities don’t exist, that really struck a chord with me,” said Magwata.
Magwata represents many people suffering from cancer, whose situation is further worsened by Covid-19. The emergence of Covid-19 has seen delays in scheduling surgeries, diagnostic procedures, radiotherapy and systemic therapy.
Research indicates that these unintentional delays are likely to result in more people succumbing to cancer. Moreover, with a reduction in earning capacity and travel restrictions, a good portion of patients will default on their treatment as many rely on extended family income to support treatments.
“The difficulties in accessing oncology care, the economic burden posed by the pandemic and many other factors associated with the pandemic and its consequences will likely result in significant psychological distress in cancer patients in the medium to long run. Within the few days of the partial lockdown in Zimbabwe, patients receiving treatment at the specialised cancer hospitals are anxiously complaining to the media about reduced access to cancer facilities. Oncology centres worldwide have a difficult task of treating patients during these difficult times,” said Henry Goto, a private oncologist based in Harare.
According to the Zimbabwe National Cancer Registry, cervical cancer is now the leading cancer in the country.
At least 2 270 cases of cervical cancer cases are reported yearly and about 1 451 deaths attributable to cervical cancer are recorded annually.
Despite the fact that cervical cancer is preventable through early detection and treatment, most sub-Saharan African countries’ health systems are weak such that most cases present in late stages when incurable and only suitable for palliative care.
Diagnosis and treatment of cervical cancer requires a health system which is functional, interactive and responsive physically and in terms of human resources to be able to identify, diagnose and treat cases. The infrastructure and organisation of health systems in low-to-middle income countries are underdeveloped to provide comprehensive care to cancer patients.
Experts caution that cases of cervical cancer are subject to revision as the Covid -19 pandemic develops.
Madondo said early education and screening is crucial to preventing and treating cancer: “Before cervical cancer is called cancer the body develops pre-cancerous cells. At the pre-cancerous level a woman has between five to 20 years to get treatment and those cells can be completely cleared. However, most women come to us for treatment when the pre-cancerous cells have developed into cancer and it becomes hard for them to be treated. The Covid -19 pandemic is a wake-up call to thoroughly educate young girls on how they can prevent themselves from cervical cancer so as to avoid the risk of contracting the disease.
