EDWARD BITOK

By EDWARD BITOK
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The recent loss of three prominent leaders to cancer has opened up further dialogue on healthcare access and affordability in Kenya.

One can’t help but notice how the conversation has dominated the media. But my guess is as good as yours.

Soon the discussion will quiet down until another prominent Kenyan succumbs to this ugly malady.

The unfortunate reality is that more than 90 cancer-related deaths occur amongst ordinary Kenyans daily, as 130 more new cases are diagnosed.

There has been a loud cry for the government to declare cancer a national disaster, and it seems that this might just be the right time to do so.

Many Kenyans I have spoken to think of cancer as a new disease, akin to HIV-Aids in the late ’80s and early ’90s, and more recently, the dreaded Ebola.

The truth is that human beings and other animals have had cancer throughout recorded history. Some of the earliest evidence of cancer is found among fossilised bone tumours, human mummies in ancient Egypt, and ancient manuscripts.

In fact, the origin of the word cancer is credited to the Greek physician Hippocrates (460-370 BC), who is widely considered the ‘Father of Medicine’.

Hippocrates used the terms carcinos and carcinoma to describe non-ulcer forming and ulcer-forming tumours.

But even with this historical understanding, we still consider cancer a twentieth-century disease.

It was in the 12th century that it became such a dominant force, recognised as a leading cause of death and the focus of high-profile advocacy movements as well as extensive investigations around the world.

Recent reports from the World Health Organisation indicate that one in six deaths globally is due to cancer. The rates of most cancers are higher in developed countries, mostly due to a rapidly ageing population.

However, approximately 70 per cent of cancer deaths occur in low-and-middle-income countries.

Developed countries have registered successes in lowering cancer-related mortality primarily through reductions in smoking and advances in early detection and treatment.

Many cancers have a high chance of cure if diagnosed early and treated. The fight against cancer in Kenya can only be enhanced if screening facilities and cancer registries are available across the country.

In fact, each county should have at least one comprehensive cancer centre that can handle various activities such as screening, treatment, registry, and surveillance.

There are only two registries, one in Eldoret and the other in Nairobi, serving only about 10 per cent of the population. This not only makes cancer treatment costly, but also explains the high mortality rate.

Public health campaigns aimed at maximising population’s uptake of screening should also be initiated.

One method that works well as far as screening is concerned is to use tools of persuasion, including fear, guilt, and a sense of personal responsibility.

I recall how effective the HIV-Aids awareness campaigns were in the ’90s. A similar approach could be used to educate the masses about cancer prevention.

It has been shown that a large proportion of cancers (40 per cent) can be prevented by maintaining a healthy weight, adopting a physically active lifestyle, limiting alcohol use and consuming a healthy diet with an emphasis on plant foods.

In the past decade, the country has rapidly undergone change towards westernisation.

With a speedily expanding middle-class, there has been a rise in rural-urban migration, increased motorisation and reduced physical activity.

Furthermore, many Western fast food chains are filing into the country to satisfy the rapidly growing middle class appetite for exotic cuisines and sugar-and-fat-laden fast foods.

I was in Eldoret a few months ago and witnessed a large number of parents and children lining up at an international fast food restaurant.

Most of the children were overweight, some obese. For some parents and children, eating local staples in a restaurant is frowned upon and even considered uncivilised, yet local food is more nutritious.

Also, we have to remember that what we eat, and don’t eat, can have a powerful effect on our health.

Fighting cancer requires a shift towards a diet filled with fruits and vegetables (of different colours), which are rich in micronutrients and phytochemicals.

It also requires avoidance of processed foods, which are often high in fat, sugar, sodium, and low in fibre.

Dr Bitok is an assistant Professor of Nutrition at Loma Linda University, California, USA; [email protected]