Uganda’s Ministry of Health has announced an increase in breast cancer in women under 40 in Uganda, with the age trend of breast cancer shifting from 40-50 to 30-40, though the median age for women living with breast cancer is 45 years old, New Vision reported on April 26th.
The Ministry believes that this increase in younger patients being diagnosed with breast cancer could come from a variety of factors. They include greater awareness and screening for breast cancer in younger women, an overall increase in cancer globally, delaying pregnancy, a reduction in time spent breast-feeding, and an increase in women who are overweight or obese in Uganda. As more women join the formal workforce, for instance, they are more likely to delay their first child and to spend less time breastfeeding when do they have children.
Eating a diet rich in meat and fatty foods, and not much physical activity, also increases women’s chances of suffering from breast cancer. Nutritionists and doctors have been warning in recent years that the number of overweight and obese people in Uganda has spiked significantly, even among people living with HIV.
Women who do not have children or have children after 40 have a slightly higher chance of developing breast cancer, according to the Ministry of Health.
Similar to women suffering from cervical cancer in Uganda, women tend to be diagnosed with breast cancer in its late stages, making survival very difficult. Doctors recommend self-examination due to a shortage of mammography units in Uganda, and because of its low-cost. 95 percent of women diagnosed with breast cancer have already advanced to the cancer’s late stages, according to reporting by Fred Ouma for New Vision in 2008.
U.N. officials are asking some clinics for people living with HIV overseas to stop enrolling new patients, in the hopes of scaling back the cost of PEPFAR. The Boston Globe reported the story on April 11th. PEPFAR is a program started by President Bush in 2003 that primarily provides antiretroviral drugs to 2.4 million people, but also funds prevention efforts and strengthens countries’ health care systems abroad. PEPFAR provides treatment for 175,400 people living with HIV in Uganda.
Almost 300,000 people each in Kenya and Tanzania receive medicine through PEPFAR, as do more than 45,000 in Rwanda.
Former American president George W. Bush launched PEPFAR in 2003.
About 40 percent of people living with HIV who need ARVs currently receive them. Officials in the Obama administration say they are not trying to curb the amount of patients entering the PEPFAR program, but trying to control costs. When the program started in 2003, it cost $2.3 billion in 2004, and now costs almost $6 billion a year.
However, the U.S. global AIDS coordinator, Eric Goosby, says they “are not at a cap point yet.” But prominent Ugandan advocate Peter Mugyeni says his clinic has received sharp e-mails from USAID telling them to stop enrolling new patients, as have other clinics. Goosby responded by saying that thousands of new patients have been rolled in Uganda, and that USAID was concerned that clinics were going above their agreed-upon budget. Cost-cutting measure include consolidating clinics, treating the sickest patients first, and planning to transfer patients’ treatment to their governments in the long-term.
Mental health patients receive treatment at Butabika Hospital in Kampala, Uganda.
After a mentally-disturbed resident of Wakiso district turned himself into the Ugandan police, claiming responsibility for the destruction of Kasubi Tombs, the Ugandan press has run stories on the disturbing state of mental health in Uganda. Last summer, I attended a mental health conference in Lira with journalists Chris Conte (who organized it through the Health Communication Alliance), Lydia Namubiru, and Igor Kossov, among others, where reporters were trained in covering mental health issues.
Uganda may very well be ground zero for mental illness internationally– despite that it is a country of 33 million people, many of who have lived through several wars, there are only 28 psychiatrists (much less than Kenya’s still-anemic 80). Most Ugandans, perhaps as many as 80 percent, visit traditional healers for madness, dementia, and other problems. Egan Taboro reported on self-injury for the Daily Monitor last March, and Chris Kiwawulo took on the mental health beat in New Vision recently– check out his reporting here.
Kiwawulo says that David Basangwa, a leader on mental health in Uganda, and the senior consultant psychiatrist at Butabika Hospital, estimates that as many as 35 percent of Uganda suffer from mental illness. A study that came out in 2006 in a publication called BMC Psychiatry estimated that half of adults assessed in two districts in northern Uganda, Gulu and Amuru, suffered from post-traumatic stress disorder (PTSD).
The Ministry of Health and World Health Organization announced a high cholera alert for Manafwa, a district in eastern Uganda southeast of Mbale.
86 people in the district have been diagnosed with cholera, due to heavy rains, flooding, and a lack of pit latrines. 3 deaths have occurred so far, and over 200,000 thousand people in the district are at risk.
Cholera is spread by consumption of food or water that is contaminated with feces. Only 45 percent of residents in the district have access to toilets, according to reporting by New Vision. 95 percent of people in the district depend on the River Manafwa for drinking and wash water, but the river has been contaminated. Submerged pit latrines and people without toilets attempting to relieve themselves near the shores are a major problem.
In Bududa, the district where devastating landslides recently occurred, health officials are reporting cases of diarrhea from a camp for displaced people that lacks clean drinking water and firewood for cooking food. Health officials are concerned that a cholera outbreak will spread to Bududa.
As the bodies of the 300 people and many livestock killed by the landslides decompose, bacteria might leak into nearby rivers and contaminate people’s drinking and bathing water. Anyone relying on the Manafwa River is at a serious health risk, according to ministry of health spokesman Paul Kagwa.
A UNICEF representative told the Daily Monitor that “the control of cholera will be our priority.”
According to the World Health Organization, cholera has been endemic in Uganda since a major outbreak in 1997. The first cholera epidemic in Uganda was in 1979.
