Cancer Control Opportunities in Low- and Middle-Income Countries (2007) / Chapter Skim
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Appendix A Cancer Control in Malaysia and Tanzania
Appendix A Cancer Control in Malaysia and Tanzania
Pages 305-321
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From page 305... ...
By 2002, the youth literacy rate was 98 percent for males and females, and most youth were staying in school past the compulsory 6 years (Central Intelligence Agency, 2006)
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From page 306... ...
There is also an active private sector and a presence of traditional healers. The government health service provides practically free medical care for all, but facilities and personnel are overworked, and waiting lists can be very long.
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Few regional cancer registries exist; examples are the Penang Cancer Registry and the Sarawak Cancer Registry, which may not be very complete.
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From page 308... ...
National Cancer Control Plan In 2003, the Cancer and Tobacco Control Unit of the MOH held a workshop on the National Cancer Control Plan. Key aspects are efficient use of resources, appropriate use of technology, and active community participation, supporting an ambitious list of goals covering all aspects
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From page 309... ...
Screening is opportunistic, with Pap smears and clinical breast examinations offered to women at wellness clinics and maternal and child health clinics. The Ministry of Women, Family and Community Development offers screening and early detection of breast and cervical cancers.
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The necessary cancer specialists -- surgeons, radiologists, pathologists, radiation and medical oncologists, plastic surgeons oncology nurses, and counselors -- are not present in most hospitals. The country has only 21 cancer treatment centers, 6 of them in the public sector.
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From page 311... ...
None were specialized radiation oncologists. Only 12 of these 35 oncologists were in the public sector, and about half of the total practiced in and around Kuala Lumpur.
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From page 312... ...
The Penang Cancer Registry, established in 1993, has also published incidence data. Case registration there is based primarily on voluntary notifications received from medical professionals in Penang, an island in the northwest region of Malaysia with a population of about 1.2 million (Yusoff et al., 2003)
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From page 313... ...
Almost all offer supportive and counseling services, and almost all operate in urban areas, although some organize early detection campaigns in rural areas. One NGO, the Cancer Research Initiatives Foundation, is purely a cancer research organization.
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MAJOR HEALTH ISSUES Communities are well informed about maternal and child health, including safe motherhood and utilization of family planning services at public clinics. The role of traditional birth attendants, who were the main practitioners in remote areas, is diminishing in many places due to provision of government health facilities near the communities.
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From page 315... ...
Although much has been done to improve cancer services in the country, of the estimated 30,000 new patients each year, fewer than 10 percent are able to go for treatment at the Ocean Road Cancer Institute (ORCI) , the only cancer institute in the country.
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From page 316... ...
In children, Burkitt's lymphoma is the most commonly seen cancer, followed by retinoblastoma, nephroblastoma, and rhabdomyosarcoma. Ocean Road Cancer Institute and the National Cancer Control Plan Established by an Act of Parliament in 1996, ORCI, in the capital, Dar es Salaam, evolved from the radiotherapy department of the Muhimbili University teaching hospital.
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From page 317... ...
A cervical cancer screening project, using Pap smear and biopsy for those with a positive Pap smear, is also situated in Dar es Salaam. This project is donor funded with specific objectives and is time limited.
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From page 318... ...
The only Step 3 drug available in most district, regional, and referral hospitals is injectable pethidine, which is not recommended for the chronic pain of late-stage cancer and AIDS patients. A situation analysis and a needs assessment of palliative care, which was funded by WHO in 2002, revealed that the patients' biggest need was relief of pain with accessible and affordable drugs.
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From page 319... ...
The Tanzania Cancer Association has begun initiatives to improve cancer care in the country, with the following objectives: · Increase cancer awareness among Tanzanians · Promote cancer prevention, early diagnosis treatment, and palliative care · Improve treatment facilities for cancer patients · Encourage research on cancer in Tanzania · Utilize patients' voices to strengthen cancer care in Tanzania It is not yet clear how effective the Cancer Association will be.
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From page 320... ...
At this point even Kokoto gave up and advised her to try modern medicine at Ocean Road Cancer Institute, where she presented with incurable Stage IVA cervical cancer. REFERENCES Central Intelligence Agency.
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From page 321... ...
Penang, Malaysia: Penang Cancer Registry.
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