In June 2017 the country woke up to an alarming headline “Abandoned to die” in one of the dailies. The patient in question was reffered from Soroti to Kiruddu Hospital who diagnised leukaemia but upon receipt of the referral note the patient’s attendant without consulting management, went straight to the ambulance driver and demanded that they should be taken to UCI. On reaching UCI they didnt consult any Clinical team but sat in a tent meant for cancer awareness where the patient died. All blame was raised towards UCI for negligence.
Many were quick to blame without necessarily looking at the two sides of the coin. Can this incident really occur in Uganda Cancer Institute? Yes, No, may be one probable answers. The Ministry of Health instituted a committee to investigate the matter and the overall conclusion was that the patient died from failure in the referral system not UCI negligence as earlier reported.
According to Daily Monitor in an interview with the State Minister in charge of General Duties Sarah Opendi said that “Ministry of Health regrets the incident”. She further added that the report recommendations will fully be implemented beginning with fixing the referral system. The professional body that licenses, regulates and disciplines health workers, called for the review of the entire referral care system and not just Mulago Hospital and Uganda Cancer Institute.
However let’s look at a Uganda with Four regional Cancer Centres. After gaining it’s autonomy status the Uganda Cancer Intsitute has revitalised its quest for establishing regional cancer centres so that patients do not have to travel from so far to seek services at the institute’s headquarters here in Kampala. Plans to establish these centres are underway with Mbarara, Arua, Gulu and Mbale regional cancer centres. These centres will have fully established cancer care services right from cancer awareness, cancer detection, cancer treatment to palliation just as it is at Uganda Cancer Institute Mulago.
Health sector decentralization has become appealing to many because it has several advantages which include the potential for a more rational and unified health service that caters to local preferences, improved implementation of health programs, decrease in duplication of services as the target populations are more specifically defined,reduction of inequalities between rural and urban areas, cost containment from moving to streamlined targeted programs, greater community financing and involvement of local communities, greater integration of activities of different public and private agencies and improved intersectoral coordination, particularly in local government and rural development activities.
While speaking at the Cancer Walk organised by Bishop Stuart University Mbarara last year , the Chief Walker and Executive Director of Uganda Cancer Institute, Dr. Jackson Orem said: Cancer is a major health care challenge, he stated, which affects all groups of people directly and indirectly. He educated the gathering about the risk factors for cancer which included life styles such as tobacco smoking and excessive consumption of alcohol which damages the liver. In addition tobacco smoking and alcohol consumption, he added that eating foods rich in fats was responsible for cancer of the colon which is rated as the third commonest cancer in the Western Region of the Country.
He added that setting up these regional centers will also enable the institute to capture data right from the grassroots and also enable better research into the probable causes of dominance of cancer in particular areas. To this he noted that once the centre is set up in Mbarara, research into intestinal cancers will be paramount thus improvement in treatment as well as cancer care in this region.
With the decentralization of these services it will improve on cancer care outcomes since people will seek services that are closer to them. If we all support the government’s efforts to establish these regional cancer centers then the likelihood of patients dying without treatment and late diagnosis will be dealt away with.