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In 1988, when Anna Nyakabau started work as a radiotherapy registrar in her native Zimbabwe, there were no cancer specialists. The country of 12 million people relied on expatriate doctors working on secondment.
Recognising her country's needs, Dr. Nyakabau made up her mind to become a radiation oncologist. She was unable to travel abroad, so had to wait until 1990 when a training course became available in the capital, Harare.
Zimbabwe has many of the components for an effective national cancer control programme. It has a cancer registry and a functioning cancer centre involved in holistic and complementary cancer care. It also has two radiotherapy centres. On the other hand, there are only three qualified oncologists currently working in Zimbabwe. Although both government and private chemotherapy facilities are available, the cost of drugs in a high inflation environment is a challenge for health professionals. “We have the infrastructure and commitment to manage cancer patients,” says Dr. Nyakabau. “Economic challenges sometimes set us back, but the commitment remains.”
Within an environment of limited resources, most cancers present at an advanced stage and can only be treated palliatively. Although palliative care facilities are available, Dr. Nyakabau says they need to be expanded to meet current needs. More doctors and nurses need to be trained and morphine availability needs to be scaled up.
The biggest challenge in the battle against cancer, says Dr. Nyakabau, is the limitation of both human and financial resources due to poverty. Stakeholders need to make concerted efforts at various levels to take up the challenge. “Overcoming our economic challenges will go a long way to alleviating many of our problems,” she says.
Still Anna Nyakabau remains optimistic. In spite of the challenges, helping patients makes the work worthwhile, she says. Maintaining a positive attitude and shifting goals when managing patients, keeps the commitment going.
With the continued spread of the AIDS epidemic, cancer rates in Zimbabwe have risen dramatically, largely involving increases in the incidence of AIDS-associated Kaposi sarcoma and squamous cell carcinoma of the conjunctiva. For black cancer patients in Zimbabwe, survival rates are very low, not exceeding 55 percent after 5 years for any of the most common cancers.
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