Allen Namale potential trainee for breast cancer diagnosis
By PATRICIA TAREMWA and YVONNE NJUNA
Allen Namale was heading home one evening from work when she was attacked by an unknown person who poured her acid on her face and parts of her arm. She had to start a new life, learning how to live as a blind person from scratch. Unlike many disabled people, Allen impressively gets around her house hold chores and even runs a hair salon business. The ease with which she gets around makes it hard for one to believe that she is blind. Allen is a social and outspoken young lady.
In Uganda, blindness is a scourge in its own respect, a blind person is automatically perceived as a dependent. The stigma against blind people in Uganda is also quite strong. Allen also shares that even as a trained blind hair dresser, some customers refuse her to work on them. Human rights watch report, “As if we aren’t human” conducted in Northern Uganda concerning disabled women (including blind women), is a representative case of stigma to show what happens in the rest of the country in varying extents.
Audio interview by Dr. Kenneth Kagame.
After legislative changes concerning breast cancer diagnosis in 2005 in Germany, Dr. Frank Hoffman, a respected gynecologist and founder of various a health ventures including Quality Circle of Gynecologists in Duisburg, Germany, embarked on research with a team of doctors to incorporate blind ladies in the primary health care system as Tactile Breast Examiners, under an organization called Discovering Hands.
This new adjustment in the law stated that the mammogram test was only available to women above 50 years, and those below 50 would be subject to a 3-minute brief examination by a medical doctor which gave inaccurate results. The statistics at the time show that breast cancer caused the death of women between the ages of 40 to 44 years, while women between 25 to 74 prone to contract the deadly disease whose mortality rate mostly depends on early detection.
This light bulb idea by Dr. Frank Hoffman created a unique link between breast cancer and blindness. Discovering Hands trains blind and visually impaired women to do extensive breast examinations. They undergo an intense 9 months training in which they learn how to use government approved, personal, low cost method to diagnose breast cancer. They are trained to use a brail-enhanced tactile tape measure enables the Tactile Breast Examiner to navigate a breast in search for any cancerous lumps.
While a doctor with sight might detect a lump that is about one centimeter in diameter, the Tactile Breast Examiners are able to detect lumps between six to eight millimeters in diameter, this according to a study conducted on 451 patients by Discovering Hands. The blind and visually impaired women are now able to earn a decent living with this new carrier path.
Breast cancer examination at Discovering Hands in Germany
The training includes, classes in psychology, communication and administration. The latter subjects equip them to learn how to appropriately counsel the patients, enlighten them about what breast cancer, and to give an accurate report to the medical doctor. This explains why the breast examination takes 30 minutes as opposed to the ordinary 3 minutes. It is important to note that the Tactile Breast Examiners are not a replacement for any medical position but they only assist doctors. Once an unusual lump is detected, the Tactile Breast Examiner immediately refers the patient to a medical doctor for a mammogram test to see the extent of the cancerous lump.
Gifted Hands Network in Uganda will be following in the footsteps of Discovering Hands to introduce a similar method in Uganda. Much as it is still at the establishment stage, the organization hopes gradually to solve most challenges, like stigma against the blind ladies by changing their status in society to be viewed as differently abled, enable them to earn a living as Tactile Breast Examiners while at they also help to detect while reducing the risk of women in Uganda dying due to advanced cases of breast cancer.
Allen Namale is one of the two candidates who will be travelling to Germany under the Gifted Hands Network to become a professional Tactile Breast Examiner in Uganda. Marie stopes Uganda, a Uganda Reproductive Health Voucher Project has ranked breast cancer the third among the most common cancers in Uganda.
Dr. Moses Galukande is a senior faculty member at Makerere College of Health sciences who has done research on breast cancer in Uganda for about 10 years now. He reveals that realistically dealing with breast cancer in the Ugandan setting on a public health scale for instance is complex system with various bottle necks.
The cost of breast cancer treatment for an economy like Uganda. Even after diagnosis, only half of the problem is solved. Chemotherapy is expensive given the financial state of the average Ugandan. The Uganda National House Hold Survey 2016/17 released by the Uganda National Bureau of statistics report published in 2017, indicates an increase of the number of people living below the poverty line rose from 19.7% in 2012/13 to about 27% in 2016/17.
Considering these statistics, the Uganda Cancer Institute reveals that the cheapest Breast Cancer Chemotherapy would cost about 600,000/- per month which is quite expensive for a population where about 10.1 million people are identified as an absolute number of people living in poverty. Besides that, the cost of $10 for a breast cancer examination would be quite expensive for the ordinary Ugandan with the latter economic status.
The existing platforms via which sensitization about breast cancer reaches the public are weak. In a research conducted by Dr. Moses in a selected part of Kampala on about 700 women. It was found that majority knew very little or nothing about breast cancer. So, establishing effective sensitization platforms and ably sustaining them would be quite a challenge.
Nevertheless, even with the restrictions above there is hope that the death caused by breast cancer can be reduced and blind women can in the same spirit have an outstanding career that defy stigma and over negative ways that people treat blind women in Uganda.