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Partner Profile Ocean Road Cancer Institute
Tanzania is in East Africa and is the land of Kilimanjaro and the Zanzibar spice islands. Although it has abundant natural resources, it is one of the ten poorest countries in the world. Since its independence from British rule in 1961, Tanzania has been spending its meager health care budget on the prevention of communicable diseases. Until very recently even medical students were taught that cancer is not a problem in Tanzania, and national policymakers have taken no keen interest in cancer prevention and treatment. In 1999 a workshop setting Tanzania’s health-care and medical research priorities excluded cancer from the top ten diseases. No wonder that raising funds for cancer services in Tanzania is a struggle. Tanzania has only one specialized center for the treatment of cancer—the Ocean Road Cancer Institute. Established by the government in 1996, OCRI evolved from the radiotherapy department of the university teaching hospital called Muhimbili. The services offered here include palliative care, radiotherapy, chemotherapy and cancer screening services. Surgical services are offered at Muhimbili Hospital. At the ORCI, both the adults and children on chemotherapy are under the care of a medical oncologist. Until recently, we had a medical oncologist from Germany who has since completed his seven-year contract; local doctors who worked with him are continuing to take care of the chemotherapy patients. Two radiation oncologists who had their training in the United Kingdom are part of the medical oncology team. All cancer patients in Tanzania are exempted from cost-sharing for medical services, with the government paying the costs of services provided at ORCI. The government of Tanzania in 1997 endorsed the National Cancer Control program. The broader objective is to establish sustainable cancer services which will effectively contribute to the health of Tanzanians. The main activities include cancer research, training of cancer experts, mounting cancer prevention strategies, promotion of cancer detection services, improvement of cancer treatment facilities and palliative care services, and networking with other organizations. Recent initiatives at the OCRI include cervical screening and palliative care. Since we began a cervical screening program using visual inspection last December, more than 1,500 women have been screened. This project is being undertaken in collaboration with IARC and INCTR. Last year, we also completed a situational analysis and needs assessment study on palliative care. This project was funded by the World Health Organization. The Ministry of Health has endorsed our proposal for palliative care nationwide, and we hope to get some funding from the Diana Memorial Palliative Care Fund to implement some of the elements in the project proposal. About 2,000 new cancer patients, both children and adults, are seen each year. Doctors treat cancers of the cervix, breast and esophagus, Kaposis sarcoma, Burkitt’s lymphoma, head and neck cancers, and ovarian cancer, as well as leukemia. In addition to providing cancer treatment services, the Ocean Road Cancer Institute has a cancer prevention division that coordinates education programs and screening services to the outskirts of Dar es Salaam region. The Ocean Road Cancer Institute manages its patient load with modest diagnostic and therapy equipment. What we urgently need is a new -70º refrigerator and a high-dose intracavity machine to cope with the increasing number of patients with cervical cancer.
INCTR has proven to be a vital partner for improving cancer services in Tanzania. In addition to opening an INCTR Tanzania office, INCTR has supported IARC’s initiatives to undertake a more comprehensive cervical cancer screening program based on visual inspection with acetic acid and visual inspection with lugols iodine. IARC has provided three colposcopes, cryotherapy and LEEP (loop electro-surgical excision procedure) equipment for the treatment of premalignant lesions, and has trained doctors and nurses in screening methods and colpscopy practices. As we continue, we hope to develop collaborative research proposals with INCTR and other institutions such as SAREC. Already a draft research proposal addressing the most common childhood cancer in Africa—Burkitt’s lymphoma—has been completed. An agreement has been reached on the first-line therapy for newly diagnosed patients with Burkitt’s lymphoma in the planned collaborative study. We consider INCTR a valuable collaborator in this undertaking as we strive to increase our treatment results and bridge the gap between developing and developed countries in the fight against cancer. INCTR’s keen interest in improving cancer services in developing countries and its goal to send help where it is needed most has proved beneficial for us. Its additional objective to facilitate research activities will certainly help the ORCI to achieve its mission and vision. Our mission is to work in partnership with the community so as to create and maintain an integrated, accessible and affordable health system with quality service as the focus and improved health and well-being as the constant standard. The Institute aims to prevent cancers, and for cancers which have already occurred to heal sometimes, to relieve often and comfort always. Our vision for the Ocean Road Cancer Institute is to be an institute of excellence for the treatment of cancers in Africa. The staff at ORCI realize that the making of an institute of excellence is a process, not a destination, and that it will take place over many years of good political will, hard work, financial support and collaboration with other institutions/centers of excellence.
Twalib Athuna Ngoma
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