Opinions

Radiotherapy Machines Breakdown Eliminating Hope in Cancer Patients

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By Michele C Madzudzo  and  Mackintosh Chigumira

 

RADIOTHERAPY is given by high energy machines known as linear accelerators and such machines are found at government institutions such as Parirenyatwa and Mpilo hospitals, and at Oncocare — a private centre in Newlands, Harare.

 

However, most cancer patients throughout the country are struggling to get radiation treatment given the frequent breakdowns of the radiotherapy machines.

 

The country has acquired five state-of-the-art radiotherapy machines. However, it is very rare for these machines to function simultaneously.

 

In most cases, one or two machines will be operational mainly in Harare leaving many cancer patients stranded waiting for their turn on a usually long waiting list.

 

Multiple faults reported on these machines have halted their operation, which resulted in a prolonged downtime of some machines, especially at Mpilo radiotherapy centre.

 

This has caused many cancer patients from Bulawayo and lower parts of the country to migrate to Harare seeking an opportunity on those already overloaded machines, if by any chance functioning.

 

As radiation therapists, we find it worrisome that while patients are waiting for their turn to get treatment, the disease continues to grow and metastasise.

 

Eventually, cancer patients are cornered to seek alternatives like getting treatment in other countries such as neighbouring South Africa, which is very costly.

 

Sometimes they would get treatment from the private centre in  Newlands, Harare, if the machine is working, but the prices are much higher as compared to government centres.

 

Cancer is mainly managed through surgery, chemotherapy and radiotherapy. Though an individual treatment modality can help to suppress the disease, there is empirical evidence that using more than one modality can improve patients’ prognosis.

 

More importantly it is the consistent and timely treatment which yields a more favourable outcome.

 

Failure to stick to those time conscious treatment protocols consequentially puts cancer patients at risk of metastasis and or recurrences.

 

Ideally, a radiotherapy treatment course should not be skipped if its intended effectiveness is to be achieved. However, that is not often the case as a result of those operational hiccups.

 

The International Atomic Energy Agency recommends that for every 500 000 to one million of the population, there should be at least one to two cancer treatment machines.

 

Accordingly, for a country like Zimbabwe, it requires from 14 up to 28 machines for an adequate cover of the entire population.

This means each and every city should have at least one machine, taking advantage of established referral and central hospitals.

 

Scattering these machines around the country would help to decongest the Mpilo and Harare radiotherapy centres while promoting the decentralisation of cancer management, which can be done at provincial level.

 

Careful planning towards such a move can conveniently help cancer patients, especially those from rural areas who usually struggle to find a place to stay in town since hospital accommodation can only cater for a handful of these patients.

 

Without being rescued by their relatives staying in town, they would accrue huge bills since they have to secure their own accommodation.

 

Daily transportation also adds to their expenses since radiation treatment is usually given on a daily basis.

 

According to latest statistics, in 2018, there were 17 465 new cancer cases and most of these cancer cases were diagnosed at an advanced stage. This puts intense pressure on the already overburdened and underfunded health delivery system.

 

Efforts by several cancer groups and associations such as Talk Cancer Zim to maximise cancer awareness programmes have been on the increase to try and counteract the escalating prevalence. In contrast, those efforts have not been taken advantage of due to minimum resource mobilisation and lack of funding.

 

Early detection and early treatment of cancer is known to improve survival rates of patients diagnosed with this dreadful disease.

 

Though cancer can be diagnosed early, it is disheartening that patients do not always receive early treatment given the costs related to its management and the above-mentioned machine-related issues.

 

Cancer radiotherapy treatment should be administered without any interruptions or extension in overall treatment time.

 

Over the prescribed period, some of the patients end up undergoing half of their treatment courses or the course is extended beyond the prescribed period.

 

This may have adverse effects on the treatment outcome. Delay in instituting appropriate cancer management has made cancer awareness programmes futile since they are failing to address accumulating new cancer cases.

 

Amid the COVID-19 pandemic which has taken centre stage, it is important not to starve cancer of the attention it deserves.

 

Despite some short-term measures implemented by government through funding to fix radiotherapy machines, there is a need to prioritise cancer treatment, otherwise total control of the disease remains far-fetched.

 

Having a service contract with the manufacturers of these radiotherapy machines may help with a prompt attendance to technical faults.

 

Though this would require significant funding by government and all stakeholders, it is just that one more necessary push is needed for these machines to keep running.

 

Definitely, it will bring great relief for cancer patients who seem to have been deprived of this paramount and life-saving treatment.

Once all machines in the country are operational, it makes standardisation of cancer management across health institutions possible even within the primary healthcare system.

 

Direct solutions towards breakdowns must be sought through implementation of strategies which help to eliminate or prevent such circumstances.

 

New and advanced treatment techniques can as well be adopted to improve the survival rate of cancer patients.

 

We are radiation therapists making strides against cancer, we are here to save the nation, we are there to treat cancer patients wholeheartedly, their lives depend on the radiotherapy machines, hence their functionality gives a ray of hope to them.

 

Zimbabwe, let us all join hands in the fight against cancer.

  • Michele C Madzudzo is a radiation therapist and Talk Cancer Zim founder and president.
  • Mackintosh Chigumira is a radiation therapist by profession.
  • They write here in their personal capacities.
Robert Tapfumaneyi

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