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Breast Cancer Treatment in Ethiopia – Patient Stories

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					Breast Cancer Treatment in Ethiopia – Patient Stories
Four patients share their stories and experiences with Breast Cancer in Ethiopia.
Senait is 37 years old. After completing high
school, she obtained a diploma in nursing. She is currently separated from her husband and they have a 15year-old daughter. About four years ago, she felt a lump in her breast and went to the nearby clinic. There, a biopsy was carried out. The result was negative, so she returned home. Two months later she felt another lump, but this time it was very painful. She returned to the clinic and they did another biopsy. It was confirmed positive for breast cancer. She was referred to Tikur Anbessa Hospital for surgery, radiotherapy and six courses of chemotherapy. “My father cried and cried when I told him I had breast cancer. He was convinced that I was going to die”, says Senait.

Senait holding a photo of her 15yr daughter, Hilina

When asked how she felt when she learned she had breast cancer and needed surgery, she replied: “I was always hopeful that I would be cured, even though the treatment was very hard and painful”. Throughout her treatment she continued studying to complete her BSc Nursing, as she was due to graduate five months later. “My family supported me, and my father is now very happy that I am healthy again”, she says. Senait is proud to tell us that she never sought help from traditional healers or took Holy Water, but only “asked God to give her strength to get over her illness”. She adds: “I was

always hopeful. If I am destined to have this disease, I will face the challenge”.
She has now been on Tamoxifen for 18 months. To begin with, she felt “very hot and sweaty” but now feels better. When asked about the impact of the treatment on her life, Senait states enthusiastically: “My life is so much better. I feel healthy and my hair has grown back”. Today Senait is working at a Family Guidance Clinic where she promotes breast self-examinations, pap smears, use of contraceptives and, as appropriate, refers women to hospital for more specialized medical assistance.

“I am very happy to teach other women how to self-examine their breasts in front of a mirror, so that they don’t get breast cancer like me”, she says. Forty-year old Almaz was born near Addis Abba. She completed high school and obtained a diploma in accountancy. She is married with two boys and a little girl.
Two years ago she felt a lump in her right breast. “I started having difficulty in picking up heavy things”, she said. She went to the nearby health centre. They could not help her, so she was referred to another clinic where they conducted an FNA (fine needle aspiration). She was informed she had third-stage breast cancer. “When the doctor told me I had breast cancer, I was so shocked”, she recalls. After several discussions, however, she became “comfortable” with the idea that surgery was the best choice for her. She says:

“I knew that this treatment would improve my life”.
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Almaz tells how she had difficulty picking up heavy objects, which turned out be Stage 3 breast cancer.
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When asked how he felt about his wife’s cancer, Almaz’s husband replies: “My wife called me when she felt the lump in her breast. We then spoke to some elders in the community who suggested we see a traditional healer - but we went instead to the hospital”. He continues: “I was very disturbed to hear that my wife had breast cancer, because I thought she was going to die, and leave me and the children”.

Almaz had to pay US$ 600 for the chemotherapy treatment, to which her relatives also contributed. So she was very happy to then hear from Dr Bogale at Tikur Anbessa Hospital that there was a breast cancer donation program through which she could obtain free medication. She says: “We had no more money; everything had been spent on the chemotherapy”. Today Almaz speaks freely about her breast cancer:

“I take the initiative to talk about my disease. I tell women to examine their breasts”. Almaz says she is not afraid of stigma or
discrimination, even though some of her women friends warned her to “hide her disease”. She simply replies: “This is a gift of God”. When asked what the worst problem was that she had to deal with, she recalls that because of the nature of the disease and its treatment, she missed many days of work. The authorities penalized her as a result by making her pay a fee of US$ 100. She says: “Governments should support cancer patients and allow them to stay home as long as they need in order to recover”. Almaz says she has witnessed a great deal of progress in breast cancer treatment at Tikur Anbessa Hospital. A few years ago, only surgery was available; today, patients have access to chemotherapy. Almaz says that she speaks to many patients during her monthly visits to the hospital, and they share their stories and experiences.

“I see improvements in my life every day”

Menbere is 38 years old. She lives in Addis Ababa
and works as a secretary at a church. Her husband works at the local post office and they have three children aged 12, 6 and 3 years. They live next door to her parents, brother and younger sister. About two years ago, while taking a shower, Menbere felt a lump in her breast. She immediately told her husband who took her to their nearest clinic. From there they were referred to Tikur Anbessa Hospital for tests and breast cancer was confirmed. Menbere, however, did not want to believe the news and returned home. “How can this happen to

me?” she said. She continues: “I was angry and very unhappy that I needed surgery”.
Menbere was diagnosed with breast cancer at TA hospital.
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Both her mother and sister tried to convince her to go to another hospital for a second opinion. Following their advice, she went to a private clinic where they performed a biopsy and re-confirmed breast cancer. Some distant relatives from England urged her to go for treatment as soon as possible, or as they pointed out: “the disease could be fatal”. Menbere underwent a mastectomy at a private Korean hospital, an operation that was paid for by her family and distant relatives. Later she was referred to Tikur Anbessa Hospital for chemotherapy. After her chemotherapy, Dr Bogale introduced her to the Breast Cancer Program and informed her that she could receive Tamoxifen free of charge.

Menbere tells us that she knows many women in her community who have died of breast cancer because of stigma and discrimination. “In my culture, people don’t want to talk about this disease,” she says, “and then they die”. Traditional healers, in her opinion, “simply don’t work”. Menbere tells us of a woman in her neighbourhood who had breast cancer but chose to go to a traditional healer and take Holy Water and later died. Menbere strongly advises women to seek medical help as soon as possible.
Menbere feels very strongly about talking to others about cancer. She says: “Everyone in my office knows I had breast cancer”. She emphatically makes a point of telling everyone who will listen that cancer can be treated. When asked about her first thoughts of cancer and its impact, she says: “I thought cancer

was a Western disease that could not affect me”. But now she realizes
that there are many people affected by cancer in her country. Menbere says that cancer awareness in her country is still weak and that more time is spent on HIV education. She feels she has learned more about cancer and her illness through the education programs at Tiku Anbessa Hopsital provided by the Ethiopian Cancer Association (ECA).

Menbere with her sister and brother. She was supported by her whole family and her parents offered her the house next door so that she could be closer during her treatment.

“I received pamphlets on cancer which I shared with my family, and now I have also became a member of the ECA”, she tells us proudly.
Menbere strongly recommends the program at Tikur Anbessa Hospital and thinks it offers a great opportunity for women like herself to receive “life-saving drugs”. “I have even become close friends with other cancer patients whom I have met during my regular visits to the hospital”, she says with a smile.

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Forty-three year old Desta comes from Gondar, a region situated some 850 kilometres from Addis Ababa. She is
married with two children and is self-employed. About two years ago she felt a swelling under her arm and visited her nearest health clinic. From there, she was referred to Gondar Teaching Hospital. At the hospital, she underwent several tests and it was confirmed that she had breast cancer. The doctor strongly advised her to have a mastectomy. After waiting five months for the operation, Desta became frustrated and travelled to Addis Ababa. The hospital fees for the surgery were very expensive and Desta had to ask many of her relatives to contribute. After her chemotherapy course, she was referred to Tikur Anbessa Hospital for radiotherapy. Her doctor there, Dr Bogale, introduced her to the breast cancer program and told her that she could be given Tamoxifen - “a live-saving drug” - free of charge. “I was very surprised to hear

“My family paid more than US$1000 for my surgery and chemotherapy”.

about this program and to learn that I was included,” she says. “But I
am very comfortable about taking Tamoxifen and keep it safely with me at all times”.

When asked what her family felt after she told them she had been diagnosed with breast cancer, she says: “They were shocked and cried because they thought I was going to die”. “They wanted me to see a traditional healer because they thought only he could help me, but I refused“, she says. Desta resisted all attempts to make her seek out traditional healers and drink Holy Water. Instead, she travelled to Addis and convinced some of her relatives living abroad to help pay for her treatment. When asked about the impact of the treatment on her life Desta proudly states: “I now understand that cancer is treatable. My community back home also sees that cancer is curable because they see that I am healthy again. People think I am rich because I was able to get treatment, but I say to them, I am just lucky because my family supported me all along”. Daniel, a relative of Desta’s, feels very frustrated that not more is done about cancer in his country. He tells us: “I wish I knew

more about this disease and why it affects so many of our women”. Hamma,
another relative of Desta, states: “Cancer is incurable and a deadly disease”, reflecting what he hears from those around him. When asking Desta about cancer awareness in her country she says: “The Government must make cancer education a priority like HIV. There is a very poor understanding of cancer, which also continues to have a lot of stigma attached to it. They must also provide more hospitals for surgery. We have to wait too long and many patients then decide to return home and die”.

Desta with her relatives at her brother’s house where she regularly stay’s during her visits to TA hospital

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Description: Breast Cancer Treatment in Ethiopia – Patient Stories