After years of violence and the devastation of Ebola, Sierra Leone’s health professionals can finally look beyond urgent crises. The government is now turning its attention to the increasing number of citizens suffering from cancer and has decided to set up a radiotherapy and nuclear medicine service in a new hospital close to Freetown, with support from the IAEA.
At the government’s request, an IAEA expert mission reviewed the country’s cancer control capacity last month and will subsequently provide detailed recommendations to the national health authorities, which will form the basis for a national cancer control strategy.
“Cancer is one of the leading causes of death in the country and must be treated as a public health emergency, like any other disease concerning the public’s health,” said Brima Kargbo, Sierra Leone’s Chief Medical Officer. “We must immediately establish the necessary structures to address this as a priority.” He also underlined the need for a national cancer control steering committee to develop a national cancer control plan.
The team of international experts who reviewed Sierra Leone’s cancer control capacity was nominated by the IAEA, the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC). Such assessments, known as imPACT reviews, are often the first step an IAEA Member State takes to understand the scope of its cancer burden and develop a national cancer control strategy.
As part of the review, the cancer experts visited public and private healthcare facilities, medical schools and liaised with health organizations to appraise the key areas of cancer control: prevention, early diagnosis, treatment and palliative care along with cancer planning, data collection and the safe application of radiation medicine with regard to health workers and patients.
What the experts found
It is estimated that almost 3,000 people develop cancer each year in the country, and over 2,000 die from the disease. They are largely preventable or curable if discovered early.
Nonetheless, the majority of cancer patients in Sierra Leone seek medical attention when their illness is far advanced or at an incurable stage because of limited access to early diagnostic services.
There are no radiotherapy services in the country and the provision of other modalities of cancer treatment, such as surgical oncology or chemotherapy, is hampered by a severe lack of human resources and medical equipment. This limited access to cancer care services, including qualified staff, means that patients have poor chances of survival if they develop the disease.
The imPACT experts recommend developing a comprehensive cancer control plan, including necessary palliative services with relevant training for health care professionals to make sure patients receive effective pain relief.
They visited the Melvine Edith Patricia Stuart Trust (MEPS) Well Women Clinic, one of the few clinics that offers clinical breast screening and prevention programmes and that refers patients for cancer treatment.
The non-profit organization witnessed rising demand for support from 1,500 women in 2009 to over 6,000 in 2013, said Director Jennifer Renner-Thomas, but at the same time saw its funding diverted towards dealing with the Ebola emergency. “Awareness and education activities were suspended, as were our screening and treatment services for cervical cancer, and the patients we see require palliative care.”
The team commended Sierra Leone’s commitment to provide access to radiotherapy treatment as a key priority, while re-building and training the country’s health workforce to support the new facilities.
Kargbo said that the recommendations from the imPACT review will help to prioritize cancer control interventions in Sierra Leone and facilitate collaboration among the relevant organizations.
