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The Tanzanian women's action group MEWATA (Medical Women's Association of Tanzania) was formed in 1987 by a group of female doctors dedicated to tackling women's health issues in their home country. It was fully registered as a Non-governmental Organisation in 1989. With cancer given low priority in Tanzania due to the health system's heavy burden of infectious diseases such as HIV/AIDS, TB and Malaria, MEWATA decided to focus its efforts on raising cancer awareness. It is badly needed. Tanzania, population 38 million, currently has some 35,000 new cancer cases each year.
Dr. Petronilla Ngiloi is an ex-officio Executive Committee member and former Vice-President of MEWATA. She explains that although cervical cancer is the most common women's cancer in most developing countries, including Tanzania, a public screening campaign was beyond the resources of MEWATA. Instead, members decided to concentrate on breast cancer workshops, training and informing women of the importance of self-examination and early detection. “In Tanzania, many women turn up at hospital with cancer at a very advanced stage,” says Dr. Ngiloi. “Very often, we can offer only palliative care.” She says women would frequently tell her that they had noticed a breast lump months or even years earlier but, because it was painless, they didn't bother to seek medical attention. “Many diseases are associated with pain, but in the early stages breast cancer is very often painless,” Dr. Ngiloi says. “For this reason, many women don't take a lump in the breast seriously.”
MEWATA's first initiative — a mass screening of women and, at the same time, teaching them how to do regular breast examinations — took place in 1993 in Dar es Salaam. Of the 600 women who turned up, roughly 90 had lumps or lesions requiring further investigation. 30 cases of breast cancer were confirmed. At this point, members realized they needed to raise funds to cover the further investigation and/or treatment of those women requiring it. “There's no point in creating awareness in a woman if, at the end of the day, you can't help her,” says Dr. Ngiloi. “Once cancer has been identified, it's vital that patients get treatment; from diagnosis to surgery to chemotherapy. But most of our women are very poor.”
The group started to approach private individuals, companies and organisations for donations. A private broadcasting company, ITV/Radio One, started to support MEWATA's fundraising efforts and launched a mass media campaign sponsoring the NGO. MEWATA's voice was also heard by Tanzania's First Lady, Mama Salma Kikwete, who became a dedicated patron, helping to spread the word and attract more donors. More recently, MEWATA has lobbied regional governments and communities to help stage local breast cancer awareness workshops, with very encouraging results.
By 2005, MEWATA had grown from its original 32 to a membership of more than 200 female doctors. To capitalize on their large numbers they decided to hold a major screening event, with radio and television spots urging women to attend. The weekend exercise, held in Dar-es-Salaam and timed to coincide with International Women's Day in March 2005, attracted more than 7000 women. A second weekend initiative, in the northern city of Mwanza in September of that year, involved 80 MEWATA doctors and brought in 11,000 women.
“Requests started coming in from all over the country,” remembers Dr. Ngiloi. “The success of the campaign is an indication of MEWATA's impact.” The most recent breast cancer initiative, held in the south of Tanzania in November 2006, underlines that point. It attracted a massive 23,150 women, all of whom were checked by doctors and shown how to carry out self-examination of the breasts.
Breast cancer is the third most common cancer among women in Tanzania, after cervical cancer and HIV-related Kaposi's sarcoma. Dr. Ngiloi says MEWATA would like to carry out cervical cancer screening exercises but the cost remains prohibitive. “With the kind of numbers we are dealing with here, that would be too expensive for us,” she says. “Instead, when the women come for breast screening, we educate them about the risk of cervical cancer, especially associated with sexually transmitted diseases.”
Today, MEWATA is going from strength to strength. A Breast Cancer Awareness Walk last year, in collaboration with the Lions Club of Dar es Salaam Central, helped raise funds towards the purchase of a mammography machine. In addition, an administrative centre for MEWATA is being planned—until now the organisation has been without an office. “We started MEWATA as a pressure group, to create awareness among women and draw the government's attention to the cancer problem,” says Dr. Ngiloi. “We are very happy about the success we have had, but there is still much to be done.”
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