Kenyan doctors rarely recommends mammograms to women over 40 for breast cancer screening. Instead, 80% of all mammography tests are done to confirm breast cancer diagnosis. Cancer Free Women aims at increasing preventive mammograms in Kenya

Breast Cancer Took My Mom in Kenya: How She Died

If there is true suffering, pain and depression I know in this world, its breast cancer. I hope my story will inspire every reader to STOP hoping and start doing something about breast cancer. This is a tough one to live with and life will never be the same without my beloved mom, the only parent I ever knew. The only child she ever had.

Back in 2008, my mother visited us in USA and we had a great time. We visited any attraction you could think of. From the great Canyon, Himalayas to Miami Beach, you name it. From NASA center in Houston Texas to Niagara falls to Canadian attic. Life was good and we enjoyed each other company, little did I know this was the only time I’ll ever spend with my Mom.

Early the following year, my Mom started complaining of feeling itchy all the time on her breast. As a nurse in USA, I advised her to use anti-histamine. Women in Africa are known to persevere a lot and so my mom stopped telling me much about it. But the itching progressed slowly over the year of 2009 and 2010.

A year or more later, my mom wasn’t feeling well and I sent money for her to go to Nairobi Hospital for check-up. Being the only parent I ever knew, I had to give the best I could to my beloved mom. In Nairobi hospital, my mom was found to have elevated white blood cell count but all cultures tested turned no positive results for any infection. Needless to say, she was not even admitted, it was an out-patient visit.

Out of the blue moon, I remembered to ask her if she still feel the itchy feeling she had on her left breast. She told me it’s been there and “due to scratching it too much, it hardened and darkened”. “Sometimes it makes me wake up at night and I feel sweaty and hot”. Breast cancer was not one of the things I could have thought about at the moment.

I advised her to give me a few weeks to plan my trip to Kenya to see her. In 1 month time, I landed in Kenya and the first thing I noticed was my mom had lost a lot of weight. I also noticed that she was getting tired really easily, even going up simple stair cases. I knew something was wrong, really wrong. As soon as we got home from airport, I asked her if I could see her “hardened and darkened left breast”.

Even before I could see it, the picture of breast cancer had already been painted in my mind but didn’t want to say anything. Her breast was obviously harder and darker. I also noted obvious lymph nodes swelling on left armpit and neck region.

The following morning, we returned to Nairobi hospital and a mammogram was performed. The radiologist called us and recommended a CT Scan of the whole body. The mammogram was positive for probable breast cancer until a biopsy results could return. CT scan showed lung nodules and similar nodules on her left kidneys.

My Mom had stage 4 breast cancer with metastasis to the lungs and kidneys. She had lost nearly half her weight since the last time I saw her in America. Even worse, her lung capacity was less than 50% of expected. Series of surgeries, radiation and chemotherapy was prescribed.

Breast cancer is a stealthy killer. She went through left lunch removal (pneumonectomy) and was started on chemotherapy. She also got a mastectomy of her left breast. Treatment was outdated and my mom succumbed to her illness a month after the surgery. REST IN PEACE MY MOM!

I feel I should have been more proactive from when she first mentioned about itchy breast feeling. I feel like if she had a mammogram a year before she started feeling the itch, she would have made it. I feel like I had the best chances in this world to save the life of the only parent I ever knew. I am guilty conscience every time I look at her pictures. It saddens me to look at the pictures we took when she visited me.

I’m a nurse and my guilt is even worse because I should have known better. It’s even worse because same year she visited me, a friend of mine asked me if I ever talk to my mom about breast cancer but I brushed the topic off. Jane Njoki always told me of how she makes sure both her parents get annual physical and screening. Since it’s not the norm is Kenya to go for screening annually, I never paid much attention to her. If I did the first time she asked me about breast cancer, my mom would be alive today.

Breast cancer took away my mother, my best friend and the only parent I ever knew. I was left ever depressed fighting guilt and self blame of her death. I have been on antidepressants since she’s been gone. My life changed has no joy and hopefully some day, I’ll come to peace within myself.

Today, I sponsor mammograms every month to a random person. I already do to my Mom sisters (my aunties) and I feel obligated to do this. I stopped partying and drinking since my mom passed. I dedicated the amount I was sending on party and alcohol to sponsoring women to get breast cancer screening. 2 years today, 5 women have been diagnosed and have started treatment.

My advice to anyone who is reading this is simple. Mammograms saves lives. Educate everyone you know and encourage them to get a mammogram. I feel my mom would still be alive if her beast cancer was caught early enough. The other thing I wish you could learn from my story is that any changes in breast should be investigated to rule out breast cancer. For her, she thought itchy breast discolored it and made the skin hard. Get your loved one tested way ahead of these symptoms.

My name is Joyce Kiama

Kenyan Government Need to Work With Diaspora to Control Breast Cancer

Kenyans in Diaspora may hold the most important role in fighting breast cancer in Kenya today. More than 50% of Kenya educated doctors are practicing medicine abroad. Another more than 5,000 doctors left Kenya and later became doctors and dentist abroad and have never returned.

Breast cancer kills more women than HIV/AIDS and Malaria combined globally but the focus on breast cancer has been very minimal in Kenya and Africa in general. Over 70% cases of breast cancer diagnosed in Kenya today are stage 3&4, meaning the cancer has already spread regionally or to distance organs. Other reports have shown that 15% of newly diagnosed breast cancer cases are fungating, meaning they have exploded the skin.

But is the government of Kenya doing anything to help fight breast cancer in Kenya? I feel like breast cancer does not get the attention it deserves in Kenya and Africa in general. The government and regulating bodies should make re-entry of Kenyans in Diaspora easier and lucrative. An average doctor in Kenya earns about $2500 a month, making doctors flee abroad as “economic refugees”.

Kenyans in Diaspora could also contribute in creating breast cancer awareness. It is estimated that one in every 3 families in central province has or knows someone in Diaspora. This translates to powerful information, motivational and financial resource that can help reduce mortality of breast cancer in Kenya from 80% to 50% in 3 years. If every Kenyan in Diaspora sponsored their family to get breast cancer screening, this number could drop drastically.

If the government made technical and legal arrangement to re-import expertise back home, breast cancer and all other diseases killing Kenyans could decrease. Kenyans in Diaspora have been exposed to current treatment modalities, current research and treatment options. Many more have been involved in breast cancer awareness campaigns abroad, something that Kenyan women are missing.

Sponsor your Mom, your Aunt, your neighbor or a friend to get breast cancer screening, education and mammogram today. It could be the most important thing you have ever done for them. It cost less than a weekend night out abroad.

The conclusion is Kenyans in Diaspora hold a great knowledge and financial resource in fight against breast cancer. Unfortunately, no one family is immune to breast cancer and often, breast cancer is fatal in Kenya and rest of Africa. The government bodies needs to rethink how they can tap onto diverse knowledge, talents and financial resources from Diaspora to control diseases and improve quality of life

Cost of Mammogram in Kenya. Does it Matter?

So, if breast cancer is such a killer in Africa, how comes women are not lining up to get mammograms in cities like Nairobi? Is it the cost of mammography in Kenya that is too high or is it that there are no equipment to service all the women at risk? Is it that women are not even aware of the risk or it is that no one really cares about breast cancer?

The truth is, all of the above factors contribute to this. In a simple random survey done in Kiambu Kenya, 71% of women of all women interviewed have never heard of the word “Mammogram”. 88% of women over 40 years old of those interviewed have never heard of mammography in Kenya. Only 11% have heard about mammography and only 7% have ever had a mammogram. None of those interviewed had a preventive screening mammogram

Cost of Mammogram in Kenya
Mammograms in Kenya have no standardized price. The cost primarily depends on where it is taken. Some hospitals like Nairobi Hospital charge around KSH8,000 or about $100. Compared to world average, this is relatively cheaper than most countries. But the cost of $100 for preventive mammogram is not affordable to over 80% of susceptible women in Kenya. Even 25% of that price is not affordable to 80% of Kenyan women. The only way to increase the number of preventive mammogram screening is through government funded project or donor funded mammography.

Mammogram Machines in Kenya
Kenya has a population of about 45 million people and about 18-20 million women are over 40 years old, requiring annual mammograms per Center of Disease and Control (CDC) recommendations. While mammogram machines are not the most expensive gadgets Kenyans can afford, it is discouraging to investors to buy equipment but consumers cannot afford to pay for tests. It’s heartbreaking to note that over 90% of all mammograms done in Kenya today are done for diagnostic reasons, not preventive reasons. Kenya has just over 10 mammogram machines and 95% of all these machines are located in Nairobi

Lack of Knowledge
While they say “Ignorance is a bliss”, the kind of ignorance we face in Kenya is not a bliss. This is the ignorance that kills because not knowing about breast cancer does not stop breast cancer from killing young moms and sisters. The level of awareness about breast cancer in Kenya and the rest of Africa is extremely low. We have to create necessary awareness starting with the closest woman we can reach.

Kenyans living abroad should really consider informing their loved ones about preventive mammograms. Sponsoring mammograms for loved ones in Kenya could help save a life of some one you really love.

Expertise
Believe it or not, there is not one single mammography trained specialist among the few radiologists in Kenya. The few radiologists in Kenya have cross-trained across many disciplines to accommodate many under-served areas of diagnostics. Mammography technicians are as well cross-trained across many disciplines and have no mammography specific training backed by continuous education and skills update as technology and evidence based practice evolve.

CONCLUSION
The cost of mammography in Kenya is not standardized but even the most expensive hospitals charge below developed countries average price. Mammography machines are expensive and sometimes not the most worthwhile investors can channel their money to. Majority of Kenyans live below poverty line and cannot afford even highly subsidized mammograms annually. Majority of women in Kenya and all over Africa have never heard of mammograms. Lack of awareness is the biggest contributor to poor breast cancer screening in Kenya.