Carol Atuhirwe (30) was diagnosed with cancer of the throat in 2011, and since then she has been unable to speak. Nevertheless, when This is Africa went to interview her where she was lying in bed in a rented house in Makindye, a suburb of Kampala, Carol smiled throughout our interaction. To communicate, she now uses signs or writes down what she wants to say.

Because of the wounds and burns in her throat and a hole in her oesophagus, Carol has to eat and drink through tubes. She says that she has undergone various operations at Mulago Hospital, the national referral hospital and the home of the Uganda Cancer Institute (UCI). Her doctor, Dr Jeff Otiti, an ENT specialist at Case Medical Centre in Kampala, dresses her wounds twice a week. He was unable to comment on Carol’s present condition.

Carol with some of her guests in her bedroom
Carol with some of her guests in her bedroom. Photo: Arthur Matsiko

Carol requires another operation in the USA for her health to be restored. But this comes with a price tag of USD 80 000, which is too steep for the daughter of peasants. In response, the Save Carol fundraising drive was launched, giving well-wishers the chance to contribute so that she could fly to the USA and access the required treatment. Irene Aturinda, her care taker and also her younger sister, , says that Atuhirwe was referred to the USA so that the radiation burns, a result of radiotherapy, and the wound that resulted from frequent operations, could be treated.

Carol Atuhirwe one of many

Carol is one of many people who have used the radiotherapy machine that was donated to Uganda 20 years ago. And now ithas broken down. Thismeans that until the government acquires a new machine, cancer patients who require radiotherapy either go home to die or they go abroad.

Cobalt 60 radiation machine at Mulago hospital in Uganda. Photo: Arthur Matsiko

However, Ugandans – and this includes the president, Yoweri Kaguta Museveni – have a culture of fundraising for cancer patients who require treatment abroad. The president contributed Shs 5million of the Shs 100 million (about USD 30 211) required to cover former local television news anchor Rosemary Nankabirwa’s medical bills at Aga Khan Hospital in Nairobi. Unfortunately, Nankabirwa died after about Shs 110 million had been raised. The money was donated to UCI for the construction of a waiting room for cancer patients.

Although Museveni’s contribution was heartwarming, you cannot help but notice the admission of failure in the gesture. Museveni is not a private citizen with no power to improve the country’s limping health sector. He has, after all, been in power for more than 30 years. He is promoting and presiding over a begging culture in a country where taxpayers, in addition to paying their taxes, are also being asked to dig into their savings and help fix medical emergencies out of their own good will.

The government says that it sets aside about Shs 227,2 billion (about USD 68 000,000) every year for ordinary Ugandans with ailments that cannot be treated at Uganda’s medical institutions. Even though this fund exists, most Ugandans have had to devise their own means of soliciting funds. (About Shs 6,6 billion (USD 1 981 980) is also set aside annually for government officials to secure treatment abroad.).

Acquire a new machine or repair the old?

 A Cobalt-60 radiation machine has a lifespan of about 10 years, yet UCI director Dr Jackson Orem believes that Uganda’s 20-year-old machine could be repaired. “We are doing all it takes to make sure that we can repair it, so that it can still provide some service, while we expedite the process of getting the new one into the country,” Dr Orem was quoted by a local tri-weekly. He also explained that costs were further increased by the need to construct bunkers. These are shielded rooms that safely house radiotherapy equipment and they are very expensive to build. Uganda was considering the future construction of seven bunkers in a single complex, at a cost of Shs 31 billion (about USD 9 295 350).

Speaking to This Is Africa, UCI publicist Christine Namulindwa said that the construction of one bunker would commence in May and it would be ready in six months. “[The process] has taken a long time because we are bringing atomic energy into the country. We have to follow and meet all the regulations,” Namulindwa said. “Getting a company to design that room wasn’t easy.”

The Uganda Cancer Institute. Photo by Arthur Matsiko
The Uganda Cancer Institute. Photo by Arthur Matsiko

Who needs radiotherapy?

Radiotherapy uses radiation to target and kill cancerous cells in a specific part of the body. According to Namulindwa, about 80% of the cancer patients at UCI die “because they present late. They come when the disease has already advanced to stage four.” She adds that the radiotherapy given at UCI is mostly palliative, just “to stop the symptoms,” and not to kill off the cancerous cells.

So, where does that leave Carol? For now, the struggle to raise the USD 80 000 continues and Carol lives in the hope that she will eventually be able to travel to the USA and get access to life-saving surgery.