Friday, October 24, 2008

Breast Cancer Clinics

We are almost finished with the month of October. It seems like it flew by, while we were busy with breast cancer awareness campaigns, as well as breast cancer treatment campaigns. I am enjoying my work at the Swaziland Breast Cancer Network. I am coordinating our breast cancer clinics that are held two times weekly in two different locations on Tuesday and Thursday mornings. We have two doctors from Cuba who are working with us in these clinics. The challenge is that the Oncologist does not speak much English as all, and my Spanish is extremely poor. We spend a good deal of our time at the clinics trying to understand each other. The other day, he was trying to get me to tell the patient to eat more beef. He didn’t know the English word for cow and I didn’t know what vaca was until he put horns on his head and I said MOO! It was quite amusing!
We are seeing quite a few patients that have breast cancer, and amazingly, some of them are very young, late 20’s, early 30’s. One young 29 year old woman came in with a large lump on one of her breasts. She said that she came last October and was told that it was cancer, but she didn’t have money to go to South Africa for treatment and so she did nothing. She returned this year, 7 months pregnant, unable to walk, lots of swollen lymph nodes, and much pain. I just wanted to cry, she would not let us admit her to the hospital for the first couple of weeks. Now she is very sick and in the hospital with a pulmonary effusion and heart problems. They are trying to let her carry the baby to term and then see if there is anything we can do to help her.
Oncology care in a third world country is very complicated. We don’t have access to a mammogram machine, so we send them for ultrasound of the breast when we find lumps on breast exams. Today, we found out that the only guy that does the ultrasounds was in a horrible car accident over the week end and is now in the hospital. Now we have no way to do ultrasounds. So, we either wait to see if the government will try to find someone else to do them, or try to negotiate with a private radiology clinic to see if they can help us. The best thing to do is to pray for the speedy recovery of the ultrasound tech that is in the hospital!
We have been very successful with our breast cancer awareness campaign this month! We are even going to companies and doing health teaching and breast exams. Our clinics are over flowing with people! We are seeing 60-70 people in a day! We have been flooding the paper with articles on breast cancer, TV, radio, posters, etc. When we finally get all of the ultrasounds done, we then send for FNA (fine needle aspiration) those that the doctor thinks are suspicious on ultrasound. A pathologist comes in from South Africa when we have 20 or more FNA’s to be done. When we get results, if they think they are fibroadenoma’s, a lumpectomy is scheduled and done by the Cuban Oncologist here in Swaziland. If it is diagnosed to be cancer, either, a mastectomy is done here, or the patient is sent for chemo first in South Africa, then a mastectomy is done here.
Our goal is to administer chemotherapy here in Swaziland. We are fund raising to buy a biological safety cabinet to mix the chemo in. Breast Cancer Network will then buy the chemotherapy drugs from a local wholesale pharmaceutical company. We have already started training nurses on chemotherapy administration. This will save the government and the patients a lot of time, headache, and money if we are successful. We want to have a cancer treatment program with high standards and excellent outcomes. We hope to expand our diagnosis and treatment program to cervical cancer this next year. Cervical cancer is the number one cause of cancer deaths in women in Swaziland, with breast cancer at number two. We definitely have our work cut out for us! Please keep us in your prayers as we attempt to help the women in Swaziland!
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