The crucial role of radiotherapy

Harmony Agere and Epsiya Chigumbura —
Radiotherapy helps about half of all patients cured of cancer.

After surgery, according to the epxerts, radiotherepay is the second-most successful method of curing cancer, and it can be used alone or in combination with chemotherapy to cure and sometimes treat benign tumours.

But, according to Health and Child Care Minister Dr David Parirenyatwa, freezing of posts in the health sector has stopped recruitment of radiographers.

Radiographers oversee radiotherapy treatment, working with equipment such as computerised tomography (CT) scanners, magnetic resonance imaging (MRI) scanners, digital X-ray machines and ultrasound scan units.

He says there are less than 300 radiographers remaining in Zimbabwe, with only 40 therapy radiographers practicing at present.

“As you can see, this is very unsatisfactory situation, given the healthcare demands,” said Dr Parirenyatwa in a speech read on his behalf by the director of nursing services in the Health Ministry, Dr Cynthia Chasokela, at a recent event to mark World Radiography Day in Harare.

“With the unprecedented increase in cancer cases being seen in Zimbabwe, there is an urgent need to have the required number of professionals to combat the scourge.”

This has been compounded by brain drain and low recruitment by training institutions.

“The situation has further been exacerbated by the posts freeze by Treasury that has led to trained professionals remaining unemployed at home or leaving the country for better employment opportunities,” added Dr Parirenyatwa.

Radiographers Association of Zimbabwe president Mr Abel Karare said the number of Zimbabwean radiographers practising outside the country was triple that of those practicing locally.

He said every provincial hospital should have radiographers and the necessary equipment rather than the current situation where almost all cases were being referred to either the Parirenyatwa Group of Hospitals in Harare, or Mpilo Hospital in Bulawayo.

“Provincial and district hospitals should have radiographers and the necessary equipment but currently these departments are short staffed and something needs to be done immediately,” he said. “In the country we have almost 300 radiographers and triple the number is outside the country such that the country now lacks adequately trained personnel.”

Zimbabwe trains therapeutic and diagnostic radiographers.

“The therapeutic radiographers specialise in the treatment and management of cancer, and diagnostic radiographers specialise in a variety of imaging techniques such as X-ray radiography, ultrasound, CT scans and magnetic resonance imaging that are used to diagnose and/or treat diseases,” explained Mr Karare.

“With more training and appropriate licences, intensity-modulated radiotherapy can be offered. The country is in short supply of qualified personnel and we are overworking the few therapy radiographers we have.”

Government has embarked on a countrywide re-capacitating programme of public hospitals with state-of-the-art radiography equipment.

However, with the shortage of the practitioners, the equipment could be under-utilised; and many cancer patients resort to expensive private service providers. Rukudzo Mawoyo (27) of Bindura is one of those patients.

After being diagnosed with cervical cancer, her doctor referred her to a hospital in Harare where the costs were beyond her means.

“The doctor told me that cervical cancer was curable but he was frank with me and said it would be costly. He also told me that radiation therapy at the referral Government hospital in Harare was very limited, expensive, and patients may wait many months for treatment.

“I left the hospital shaking. I thought this was my end since I had did not have enough money. I cried myself to sleep, my main worry being my daughter. Who was going to take care of her? Fortunately my late husband’s relatives assisted me with the money that was needed and currently I am recovering after undergoing radiotherapy sessions.”

Cervical cancer is the most common type of cancer in Zimbabwe. The most recent cancer registry, published in August 2015, shows that 6 548 new cancer cases were diagnosed in 2013.

The most commonly diagnosed cancers among all Zimbabweans were cervical (18 percent), Kaposi sarcoma (10 percent), breast (seven percent), prostate (seven percent), non-Hodgkin’s lymphoma (six percent), non-melanoma skin (six percent), oesophageal (four percent), colo-rectal (four percent), and squamous cell carcinoma of the conjunctiva (three percent).

According to research by Dr Webster Kadzatsa, a radiation oncologist and lecturer at the College of Health Sciences at the University of Zimbabwe; and Mr Eric Chokunonga, the registrar of the Zimbabwe National Cancer Registry, Zimbabwe has made strides in improving its radiological equipment.

“Despite the economic crisis that Zimbabwe has continued to face, the Government allocated approximately US$10 million in 2012 for the revamping of the country’s only two State-owned radiotherapy facilities, located in the capital city, Harare, and in the second-largest city, Bulawayo.

The money was used to replace all the aging equipment at these two centres and to buy five linear accelerators, two CT simulators, two conventional simulators, three high dose rate brachytherapy units, and two treatment-planning systems.

This has allowed us to move from 2D treatment to 3D conformal radiotherapy. With more training and appropriate licences, intensity-modulated radiotherapy can be offered at both centres in the near future.”

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