Paul, thanks for coming in to talk about your important NGO activities and other things in Cameroon because you’re talking here at the conference in Lyon and you’ve got this NGO called SOCHIMIO, Solidarité Chimiothérapie in French. What are you doing in that? First of all can you tell me about cancer in Cameroon, what’s the pattern of the disease in your country?
Yes. Cancer is becoming a real problem in health in Cameroon and the Minister of Public Health even created a…
When you say it’s becoming a problem, it has presumably always been a problem but maybe not regarded?
No, it was not a problem at the beginning because the diagnosis of cancer was not met, there were no human resources to make that diagnosis; every fight was against infectious disease. But ten years ago we started now to diagnose cancer and to put the figures together and to make advocacy for cancer.
And what have you found?
What we have found is that cancer really is a major problem. There are different cancers in Cameroon, like elsewhere in Africa, and of the cancers the most cancers come in late stage in Cameroon.
In late, late stages?
In late stages, yes, and the patients don’t have the means to buy the drugs, there is not a lot of infrastructure to take care of them.
What sorts of cancers do you get, mainly, in your situation then?
The main cancer is breast cancer followed by cervical cancer. But we have also lymphoma and Karposi’s sarcoma which is related to the HIV infection. And we have also liver cancer.
Now, you’re a medical oncologist, how many of you are there in Cameroon and have you been equal to the task of dealing with these cancers?
No, really I’m the first one but I have my two students who have recently qualified as medical oncologists. So we have at least four medical oncologists in the country and three radiotherapists.
And you said that cancer was not being regarded as a problem, going back ten or more years, and now it is being paid attention. What is actually happening?
What is happening now is that there is a unit of cancer treatment in General Hospital with 25 beds and we receive almost 800 patients a year. There are also two units of radiotherapy, one in Douala and one in Yaoundé. And there’s a paediatric unit in Hôpital Central, meaning that there is some action taking care of cancer.
Now, can you paint me a picture of what happens? You said that cancer is being found at late stages at the moment. Typically, in the case of breast cancer, for instance, what do you find?
Really I don’t know if they see such cases as well because a woman came with a huge big breast, more than a balloon or a football, and with ulceration and water and blood coming out with a smell. That is a typical feature of advanced cases and with lymph nodes in the axillary.
What do you do for these patients now?
Yes, I do a palliative treatment but what I can tell you is that chemotherapy helps those patients to clean that necrosis and the wound becomes clean and no smell and sometimes I reduce the size of the tumour and the surgeon can operate.
What could you do if you found that patient at an earlier stage of the disease?
Yes, at early stage the treatment is well known, to do mastectomy. After mastectomy we can do chemotherapy according to the number of nodes involved and we can even do radiotherapy.
OK, you’re involved with SOCHIMIO, Solidarité Chimiothérapie, tell me what you’re doing and what is your big call for action at the moment?
The NGO called SOCHIMIO, Solidarité Chimiothérapie, is just there for helping patients and making what you call advocacy and prevention and physical support for the patient. For example, every December we organise a Christmas tree where we put together new cancer patients and the old cancer patients together. They eat, they discuss, and then that helps the new cancer patients to accept the treatment. That is support.
And I presume from the emphasis on chemotherapy that that is your big need that you’re emphasising?
Yes. We have got what you call social pharmacies where we can sell drugs in small, not expensive, just to help patients. It is what also we are doing to help. And also we can look for funds to try to help. We have what you call tutors, that means some patients can have somebody, a donor, who will help him. So it is what we are trying to do to help the patient. But we are also doing what I call prevention because we can work in the street, give information about cancer and with a flyer going all over and giving the message to people. Sometimes we go to the villages to try to explain, to give what you call information, education and communication about cancer, so we go deeply to the village.
So although you’re in a very difficult situation you’re doing everything – you’re improving treatment by boosting the availability of chemotherapy but you’re also preventing. What are you doing in prevention? What information you’re giving out, what sort of information and how well is it received?
Yes, I can tell you that cancer in Cameroon is taken like a disease sent by witchcraft, meaning that there is no medical treatment. So I have to inform people that cancer is a disease like any other disease that can be cured if there are some conditions so I have to teach them how the cancer can happen, how they can prevent the cancer. It is certain information I am giving and I have also cured patients who are making testimonies to push other people to believe that they can have treatment. Also I have to fight against some local beliefs that say, ‘Don’t go to the hospital, just go to pray and go and eat this tree because you have a cancer,’ so it is what we are doing in our group.
Right, so go and see your proper doctor, then, that’s one of the messages. Go and see a real doctor, a medical doctor, a Western doctor effectively.
Yes, I’m a medical oncologist qualified first in Cameroon and then trained in Paris and then I took all that knowledge and I’m working in Cameroon to try to help my people. Also I have the local belief which I have to fight against because I think they are a barrier to fight against cancer.
It seems to me that you have a lot to deal with but you are very optimistic. You’re sounding very positive and you seem to have a clear vision. What is the advice that you could pass on to other countries in that situation about tackling the difficulty of treating cancer and preventing it even though you may not have all the resources that you would like to have?
I think what I can say is that to fight cancer in a country you need to collaborate, foreigners and a local team, to try to see in the same direction. Nobody can come from elsewhere and think that he can treat a cancer in a country if there is no real collaboration. For me a cancer solution will not come from Europe or America but if we combine the knowledge in research or sharing information I’m sure that we’ll succeed to look what is the real problem of the cancer. But we cannot leave people dying from cancer because they cannot buy drugs which are not manufactured in a poor country like Cameroon. But I think that people can help such countries by helping them to do their research and giving them some simple drugs, well known twenty years ago, it is what I am using. I don’t use new drugs because my patients cannot buy them but I cannot understand that I don’t have cyclophosphamide, cisplatin, which are the common drugs and less expensive.
But from what you’re saying, the informal sector, private medicine, has to provide these even though the country is fairly poor.
It is what I’m really asking and if even those big pharmaceuticals can give some help for those countries. Cameroon is not alone but some poor countries who cannot buy drugs, there are some simple drugs that can help them if there is a medical team who can conduct the treatment, I think it would be useful. But prevention also and research are things which are very necessary to our countries.
And the message, the simple message you would say here from Lyon, this meeting of national cancer institute directors, how would you sum this up, your message?
My message is to fight cancer we need collaboration. And Africans, even though they are poor they can bring something in order to look what to do to fight this cancer in the world, not only in poor African countries but in the world. We have our message and our contribution to be given.
Paul, thank you very much for joining us here on ecancer.tv.
Thank you.
