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Why war on cancer needs local solutions

Health secretary Cleopa Mailu has declared cancer a national crisis. It is the number three cause of death in Kenya after infectious and cardiovascular diseases and number one cause of death at our public referral hospital, Kenyatta National Hospital.

To fight this tormentor, we could do better. First, we need to create a multidisciplinary research team to start local cancer research centres. The answers as to why cancer is killing us lie in the health records scattered throughout the country.

These records must be digitised, analysed and visualised in a simplified manner for the public to begin the journey of understanding cancer. This is what we call big data analytics.

The good thing with big data is that we may begin to map cancer types in specific parts of the country. This uniqueness can never come from outside of our country. It is what separates local research from that which comes from elsewhere.

And if we are able to map, we can suspect certain environmental changes that might be causing cancer and provide preventive measures.

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This is possible because access to high-speed computers is now possible and it will perhaps be our contribution to the world.

Although research from other parts of the world is often helpful, it may never be conclusive, or locally contextualised, for us to develop preventive or early detection abilities. We can therefore never be dependent on research from other parts of the world.

If, for example, fertiliser got into the ground water that we use in households in a particular area and associate it to cancer, it will reduce the cost of diagnostics if patterns of disease are found to be similar.

With such knowledge, it would be easier to develop new therapies to manage the disease. Local research will complement global research, which is now focused on genetics to decipher the factors that lead to cancer.

The African context is critical to the survival of her people. This does not mean Africa should forget research on early detection abilities, improved diagnostics, new therapies and preventive measures.

The second point that I want to bring here centres around communication.

Even as we know that early detection of cancer leads to better curative outcomes, our research knowledge communication strategies are very weak.

Research is less impactful if the results are not communicated to those who need it most – the people. We must begin to use every opportunity to create awareness.

Part of the Constituency Development Fund should go towards awareness creation and mass health checkups especially in cervical, breast and prostate (three of the most common cancers) cancer detection.

Thirdly, we should create a forum to learn from experiences and measures being taken by other countries to lessen the impact of cancer. Having lost my mother to cancer, I know the harrowing experience that affected families go through.

We could, for example, put up nursing homes for the terminally ill to avoid frequent hospitalisation that often is very expensive. These homes will act as aggregation centres where we can have frequent visits by oncologists.

Many times when we took our mother to the oncologist clinic, we painfully waited for as long as six hours to see the doctor and we had no alternative since we have very few oncologists in the country.

Fourth, we must leverage on technology to manage critical care of patients wherever they may be in order to share the scarce resources.

A Reuters article titled , ‘‘Battling doctor shortage, Indian hospitals offer intensive care from afar,’’ highlighted what India is doing to deal with doctor shortage, a situation that is similar to ours.

In the article, doctors in Delhi, using what they call eICU, managed to save a patient several miles away after the oxygen flow to a 67-year-old patient had stopped when no critical care doctors were present in a hospital in the northern city of Amritsar.

The article says hospitals charge between $10 and $30 a day to virtually monitor a patient from their eICUs, with revenues shared between hospitals and companies such as General Electric and Philips that have developed the tracking software.

Compare this with the usual spend on critical care that range from $200 to $500 in Kenya. In technology we have a real chance to provide affordable healthcare.

With this knowledge, we don’t need any tendering process. Dr. Mailu could just call Phillips and GE to start implementing eICUs next week under public private partnership framework.

The writer is an associate professor at University of Nairobi’s School of Business.

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