Wednesday, March 25, 2009

Woes of cancer patients - Reach for Recovery offers supoort

Article: Salome Donkor
Women who are diagnosed with breast cancer and who require surgery to remove the affected breast (mastectomy) experience fear, anger, depression, anxiety and a sense of helplessness.
Most of the patients who find it difficult to bear the cost of surgery and treatment become stressed up and, therefore, need a lot of counselling and other support.
To raise awareness of the suffering caused by breast cancer and help survivors to access the best possible treatment and care, Reach for Recovery Ghana, a breast cancer support group working closely with nurses and doctors at the Korle-Bu Teaching Hospital, the Trust Hospital and the 37 Military Hospital, visits women who have been diagnosed with the disease and those who had gone through mastectomy.
The organisation also solicits funds to help pay part of the treatment cost of some of the patients, which include physiotherapy and radiation to prevent the cancer from spreading to other organs of the body.
The support group ensures that the patients have seasoned speakers to talk to during their monthly meetings, during which they are provided with the opportunity to ask questions bothering them.
The survivors are encouraged to participate in stress-relieving trips and also take active roles in visiting one another.
The word ‘cancer’ conjures up deep fears of a silent killer that creeps up on a patient without warning. It evokes such desperation that it has become a metaphor for grief and pain, a scourge that strains intellectual, social and emotional resources.
Statistics from the World Health Organisation (WHO) indicate that there are over 20 million people living with cancer in the world today, with majority in the developing world.
According to medical experts, cancer, which is the term used for diseases in which abnormal cells divide without control and invade other tissues, is one of the killer diseases among both men and women.
According to Dr Clegg Lamptey of the Surgical Department of the Korle-Bu Teaching Hospital in Accra, roughly 70 per cent of women diagnosed with breast cancer had no identifiable risk factors for the disease.
But the family history risks are that if a first-degree relative (a parent, sibling or child) has had or has breast cancer, one’s risk of developing the disease approximately doubles. Having two first-degree relatives with the disease increases one’s risk even more.
Each cancer is thought to first start from one abnormal cell. What seems to happen is that certain vital genes which control how cells divide and multiply are damaged or altered. This makes the cell abnormal. If the abnormal cell survives, it may multiply “out of control” into a malignant tumour, which consists of cancer cells that have the ability to spread beyond the original area.
Dr Lamptey says cancer affects various parts of the body, which results in various types of cancers, each with its own name and its treatment.
Some types of cancers that affect parts of the body, in addition to the breast, are lung, stomach, skin, cervical and prostrate cancers.
Doctors say cancers in children can affect any part of their bodies. Leukaemia is a type of cancer that starts in blood-forming tissues such as the bone marrow and causes the production of large numbers of abnormal blood cells which enter the blood.
Doctors contend that irrespective of the type of cancer a patient develops, she or he may need one of the following processes — surgery, chemotherapy, radiotherapy and hormonal therapy — pointing out that usually patients who have prostrate and breast cancers go through hormonal therapy.
Dr Lamptey points out that cancer can be cured when it is detected early, stressing that cancers need multi-disciplinary treatment with various specialists. However, if left untreated, it may spread and destroy surrounding tissues. Sometimes, cells break away from the original cancer. They may spread to other organs in the body through the bloodstream or lymphatic system.
Mrs Gladys Boateng, Director, Reach for Recovery, who was diagnosed with the disease in Accra in 1999 and got treated in South Africa, said she was scared when she got to know of her condition, but Dr Clegg-Lamptey explained the disease and mode of treatment to her and that raised her confidence level.
She said she also went to a pastor for prayers and went ahead for the surgery, which was successful.
She said Reach for Recovery currently had an active membership of over 100. The volunteers have visited over 1,000 women since 2003 and participated in free-screening programmes, educational and television programmes, adding that the support group had lifted the shroud of secrecy surrounding breast cancer diagnosis and having mastectomy.
Speaking at a breast cancer symposium in Accra, Mrs Boateng said while on admission in South Africa, she had a visit from a volunteer from Reach for Recovery, South Africa who had then survived for nine years after she had been diagnosed with the disease and she really gave her hope, which made her work towards the formation of the support group in Ghana, after her return from South Africa.
According to Mrs Boateng, it was initially difficult to get integrated with the medical team and also convince other women to be volunteers because some women didn't want others to know of their status because they might be stigmatised and others would gossip about them but later some volunteers offered to help and that strengthened the support group.
“We counselled them and gave them 'goody bags’,” she said.
She said the group was also working closely with the Department of Women, the Breast Clinic and other support groups to launch the National Breast Cancer Fund to aid women go through the expensive cost of treating the disease.
She said Ghanaian women diagnosed with breast cancer had a number of challenges, including stigmatisation and gossip about affected women and lack of silicone prosthesis, while the few available were unaffordable, adding that the cost of treatment was highly unaffordable to most patients and the support group was not able to raise enough funds to help affected women
Mrs Boateng also said some herbalists and religious leaders still confused some women that cancer could be cured spiritually and attributed the illness to the devil,
She said the reconstruction of the affected breast needed to be properly addressed, while husbands of affected women needed to offer support to their wives, stressing that survivors needed love, care and encouragement from family members and friends.
She also said there was the need to establish a hospice for terminally ill cancer patients for proper care and support and pointed out that the support group needed to be offered the maximum support to continue the good work.

Tuesday, March 10, 2009

Women’s empowerment needs commitment

Article: Salome Donkor
THE first world conference on the status of women was held in Mexico City to coincide with the 1975 International Women's Year, to remind the international community that discrimination against women continued to be a persistent problem in most parts of the world.
The conference led to the declaration of the United Nations Decade for Women (1976-1985), proclaimed by the General Assembly which launched a new era in global efforts to promote the advancement of women by opening a world-wide dialogue on gender equality.
A process was set in motion to involve deliberation, negotiation, setting objectives, identifying obstacles and reviewing the progress made.
Despite these efforts, many women around the world continue to suffer discrimination and challenges posed by social attitudes and policies that continue to condone and perpetuate violence against women and girls.
The 1992 Constitution of Ghana provides a framework for equality of all persons and outlaws discrimination on the basis of gender/sex. It promises to protect and promote all human rights and also prohibits all harmful customary practices.
However the Network of Women’s Rights in Ghana (NETRIGHT), a coalition of organisations and individuals advocating for gender equity, which made an assessment on issues of concern to women in Africa in 2008, has established that discriminatory practices against women in the name of culture still prevailed in Africa while increasing efforts are being made to address them.
Making a statement in Parliament to mark this year’s International Women’s Day on March 8, on the theme “Women and Men united to end violence against women and girls” the Member of Parliament (MP) for Twifo Ati Mokwa, Mrs Elizabeth Amoah-Tetteh, observed that women empowerment continued to be a central feature of the United Nation’s efforts to address socio-economic and political challenges confronting women across the world.
To add her voice to calls on the need to get more women involved in politics and decision-making, an American philanthropist, writer and gender activist, DR Swanee Hunt has urged Ghanaian women to be firm and resolute in the use of their imaginative, and visionary qualities to promote the interest of women and other vulnerable groups in the society.
She described Ghanaian women as energetic people with strong, imaginative and visionary qualities which could take them far if they received the neccessary support to develop their capabilities.
Speaking to the Daily Graphic after a meeting with 30 Ghanaian women, made up of parliamentarians, lawyers and representatives from non-governmental organisations, during a three-day visit to the country recently, she said Ghanaian women have made giant strides in national development, despite the challenges.
Dr Hunt, who is a Lecturer of Public Policy, is committed to the attainment of gender parity, especially as a means to end war and rebuild societies, as well as to alleviate poverty and other forms of human suffering.
She served as President Clinton's ambassador to Austria, from 1993 to 1997, where she hosted negotiations and international symposia, which focused on stabilising the neighbouring Balkan states. She had also worked extensively in Rwanda, Sudan, Uganda and a little in South Africa and Liberia, and notably with the most strong women all over the world.
Ambassador Hunt was the Founding Director of the Women and Public Policy Programme at Harvard's Kennedy School of Government, where she also teaches “Inclusive Security”, exploring why women are systematically excluded from peace processes and the policy steps needed to rectify the problem. She has conducted research, training, and consultations with women leaders in some 60 countries.
She pointed out that as a gender advocate and women rights advocate, she decided to visit the country to learn more about the role of women in the country.
She described Rwandan women as strong women who played a crucial role during the ethnic genocide and pointed out that with the Hutsi, Tutsi conflict some key women in Rwanda, namely Inyumba Aloisia and Rose Kabuya, played crucial roles.
Dr Hunt said 14 years after the genocide, Rwanda's constitution adopted after a referendum held in 2003 guaranteed 30 per cent quota of the 80 seats in the Chamber of Deputies, for women.
They also created women councils in villages where they run offices and they got themselves in the constitutional committee with 30 per cent set aside for women who only contested those seats.
That strategy, she said, worked fantastically and after the country’s 2008 elections, the country became the first nation in the world whose legislative assembly had the majority of women when the party of the ruling government headed by President Kagame endorsed 35 female candidates in an inter-party coalition, adding that “if you want to look for a mother for Africa, look from Rwanda”.
She said Ghana lagged behind in the representation of women in governance, explaining that in the US as of the 2008 elections, there are 74 women serving in the current House of Representatives while the Senate had 17 women in 2008.
On the perception that ‘politics is a dirty game’, she said it would continue to be so until women got actively involved and indicated that like other countries, women in the US would be prodded many times before they will decide about politics.
She said such women should believe in women’s rights and concerns.
She advised women not to think that they do not have the capabilities and were not qualified to contest elections and advised women to look at the EMILY's List that helped to elect progressive female candidates who were pro-choice to office.
EMILY's List, which is an acronym for "Early Money Is Like Yeast," is a political action committee (PAC) in the United States, founded by Ellen Malcolm in 1984. From the common political saying that, "Early money is like yeast, because it helps to raise the dough", the concept encourages women who want to enter into politics to start mobilising funds early.
Dr Hunt advised Ghanaian women, who want to contest in elections at both the district assembly and national level to take the decision now by starting to organise immediately, so that they can contest the elections and win.
In another interview, Mrs Gifty Klenam, the Member of Parliament for Lower West Akyem, who was at the meeting with Dr Hunt, described it as fruitful and said it provided a congenial atmosphere for deliberations on women in politics, trafficking and the United Nations Security Council Resolution 1325 (UNSC Resolution 1325), relating to women, peace and security.
The Resolution, which tasks UN Systems and Member States to ensure that gender considerations are thoroughly integrated into all aspects of its security platform from conflict prevention to post-conflict reconstruction, was unanimously adopted by the Security Council in October 2000.
She said they deliberated on the negative effects of child trafficking in the country and the need to assess causes of child trafficking in order to come out with workable solutions to the problem.
She also said the meeting deliberated on the need for gender advocates to also contest in elections after doing their advocacy work to serve as an inspiration to women.

Wednesday, March 4, 2009

Childhood cancer - A growing problem

Article: Salome Donkor
Some parents of child cancer patients who recounted their traumatic experiences in a documentary compiled by the Children’s Department of the Korle-Bu Teaching Hospital have pathetic stories to share.
I had the opportunity to watch the film after interviewing Dr Lorna Awo Renner, a paediatrician at Korle-Bu. One woman whose baby was diagnosed with cancer of the eye recounted how they supported the child to go through an expensive and painful treatment, which resulted in a surgery to remove the damaged eye in South Africa. The treatment, which involved the replacement of the damaged eye with an artificial one, also included chemotherapy at an expensive cost.
One man lost two children because he could not afford the cost of treatment for a bone marrow transplant that needed to be done in South Africa to save the lives of the children who were diagnosed with a kind of cancer that caused life-threatening blood disorders.
To raise awareness of the suffering caused by cancers in children and help them to get the best possible treatment and care, the Ghana Parents Association for Childhood Cancer (GHAPACC) was inaugurated in Accra to commemorate the International Childhood Cancer Day, which fell on February 15.
The mission of the association is to contribute to the health needs of children with cancer and other life-threatening blood disorders and their families.
It is also to provide support for children with cancer and make available to parents and families of newly diagnosed children information and logistics to organise support groups to assist children and their families to cope with the stress that accompanies diagnosis of childhood cancer and advocate for improved care for children with cancer and other life- threatening blood disorders.
The word ‘cancer’ conjures up deep fears of a silent killer that creeps up on a patient without warning. It evokes such desperation that it has become a metaphor for grief and pain, a scourge that strains intellectual, social and emotional resources.
However, when cancer affects a child, family members, friends and the patient are touched with such emotions and frustrations that cannot be described.
Cancers in childhood are supposedly rare events and, therefore, do not receive as much attention as other common diseases like malaria, diarrhoea, pneumonia, among others. However, the extent of sickness and pain caused by these cancers places a high burden on individuals, families and their communities.
Statistics from the World Health Organisation (WHO) indicate that there are over 20 million people living with cancer in the world today, with majority in the developing world.
The WHO estimates that each year, more than 160,000 children are diagnosed with cancer and 90,000 will eventually die of it.
Health experts maintain that childhood cancers can be cured, provided prompt and essential treatment is accessible. However, the most pathetic aspect of the problem is that 80 per cent of children with cancer live in developing countries where effective treatment is not available and, as a result, one in two children diagnosed with cancer will die.
According Dr Renner, who is working in collaboration with the GHAPACC, access to treatment for children with cancer in Ghana started in 1965 when the Burkitt’s Tumor project, which offered free diagnostic services and drugs treatment for children with the commonest type of cancer in Ghana (Burkitt’s lymphoma), got underway.
She said that offered real hope of cure for hundreds of children, mainly from deprived rural areas, many of whom are now adults and contributing their quota to society.
The paediatricians who were pioneers of the project were Procis Nkrumah and the late Dr (Mrs) Susanna de Graft Johnson, with Prof Janet Neequaye, Dr R. Biggar and Prof Jennifer Welbeck playing important roles.
Unfortunately, this project, which was implemented with an American grant, ended in 1994. Thereafter, the Canadian High Commission, using proceeds from the Terry Fox Run, continued sponsorship from 1995 to 2001 and since then it has been up to families themselves to fund their children’s treatment.
Dr Renner said in Ghana there was no comprehensive epidemiological data on the magnitude of childhood cancers but she said with the country’s population of about 20 million, they expected about 1,200 children below 15 to be affected yearly.
She said there were only two centres at the Komfo Anokye Teaching Hospital (KATH) in Accra and Korle-Bu in Accra that had paediatric cancer units and children were referred from all over the country, even as far as Bawku, to these centres and that such children invariably arrived at an advanced stage of the disease.
Although in highly developed countries over 70 per cent of children with cancer are cured and over 90 per cent cured for some specific cancers, Dr Renner said the outlook in Ghana was dismal.
She mentioned late presentation, as a result of ignorance of families and health workers, lack of trained health workers to manage cases, limited access to the two paediatric cancer units, limitations with diagnostic capacity, inductee supportive care and cost of chemotherapy as some of the reasons.
She said the approximate cost to treat fully and cure one of the commonest childhood cancers (Burkitt’s lymphoma) is GH¢500 per patient within a period of three months, while others such as leukaemia, which is more expensive to treat, costs about GH¢10,000.
She said the cost of treatment was not covered by the National Health Insurance Scheme and parents of the patients lost hope as a result of lack of funds, leading to treatment abandonment.
She, therefore, asked philanthropic organisations, individuals and corporate bodies to join hands with the GHAPACC in order to provide financial, logistics, psycho-social support, among others, for children with cancer and life-threatening blood disorders.
“Using the slogan of the Paediatric Society of Ghana ‘Our children’s health is our nation’s wealth’, we have to show that we ‘genuinely care and support’ and contribute in whatever way possible to ensure that the children of Ghana have access to improved health care,” she said.
Chaired by Mr F.K. Aveh, the association advised parents to look out for the St Siluan (a Russian monk who died in 1938) warning signs for childhood cancer and seek medical help for persistent symptoms.
These are a white spot in the eye, new squint, blindness, a bulging eyeball, a lump in the abdomen and pelvic, head and neck, limbs, testes, glands, unexplained fever, loss of weight and appetite, fatigue, easy bruising or bleeding, aching bones, joints, back and easy fractures, as well as neurological change in behaviour, balance, gait, headache and enlarged head.