Dr Jackson Orem, the Director of the Cancer Institute, gave a detailed patient history to highlight the cause of the departed former speaker Jacob Oulanyahs death at the State funeral in Kololo, Kampala. last Wednesday.

Eloquent he was in narrating that the patient had utilised the two lines of treatment available in Uganda and was only left with two experimental options including stem cell therapy.

Stem cell therapy involves extraction of bone marrow cells and implanting them in the body to rejuvenate its ability to produce white blood cells. In the case of the former Speaker, the Minister of Health Dr Ruth Aceng highlighted that the patient had lost his spleen decades ago compromising his immunity. She read from the post mortem report the patient suffered from a compound of various bacterial and viral infections and succumbed to multiple organ failure.

In all these, perhaps the only addition would have come from a pathologist to elaborate further and pinpoint the exact cause of death. Pathologists are the academic doctors who study forms of life in its innate forms, whether as tissue, examining dead bodies etc. In some analyses these are supported by microbiologists. All these people exist in close proximity on Mulago Hill and the new national testing center at Butabika. Listening to Dr Orem it is clear Ugandas problem is not the diagnostic part.

The diagnostic part has only failed in delivery to the general population due to its prohibitive cost. For most patients it is the treatment part that drives patients and their families to desperation.

The stories of the on-and off operations of the two cobalt machines in Mulago that administer radiotherapy is well documented. Radiotherapy burns the cancerous cells that are trying to outnumber the white cells that produce antibodies to defend the body from infections.

There are a few things Dr Orem may have inserted in the national conversation. First is the rising number of cancer cases. Last count says 30,000 cases but these are the diagnosed cases processed through the Cancer Institute. All non-communicable diseases are on the rise. Cancer is just behind cardio-vascular diseases. Others are chronic respiratory diseases, type 2 diabetes mellitus (DM), and chronic kidney disease.

A recent study in 2021 in BMC Journal shows that rural areas are seeing as much of an upswing as urban areas where conditions like cancer are associated with lifestyle. Non communicable diseases are a big profit center for big pharma as management costs are high. Its an area where name brands have overwhelmed generic drugs.

The other version of cancer triggers are stress and chemicals in the water supply. The introduction of contraceptives in the 1970s as women entered the workforce is blamed for a surge in a generation of mothers. GMO foods which have made cooking oil a staple in many homes are also a factor.

Processed foods are also a factor, including artificial colouring, hydrogenated fats and saturated oils. Very few Ugandans know that cooking oil can easily run a diesel engine.

During the Covid pandemic, NCD patients suffered more from the ravages of the disease, including debilitating strokes, heart attacks that played on the vulnerabilities NCD sufferers find themselves in.

Managing these diseases is only going to get more complicated as the big anchor in the healthcare supply system USAID is exiting.

The cancer center is already too small, patients waiting for hours in agony for relief. In the Covid interlude, Mulago (when patients dropped between January and April 2021), offered excellent care to in-patients.

This all round model can be replicated for cancer patients. If there is excess capacity at the new womens hospital it could be used. Cancer is a one way street, all the urgency that people are treated with dignity.

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Speaker's passing highlights the plight of cancer patients in Uganda - Monitor