In a country like Ghana, the inadequate number of oncology and breast care facilities continues to jeopardize the fight against breast cancer, especially in rural areas.
According to Ms. Nina Ahemaa Duodu, Advocacy Officer at the Meena Breast Cancer Foundation, many women have to travel from distant locations to Korle-Bu in Accra to access treatment.
"This is very sad and pathetic for a country like Ghana," Ms. Duodu lamented.
The Meena Breast Cancer Foundation has initiated programs to address the issue, but Ms. Duodu stresses the need for support from policymakers and stakeholders to expand access to breast cancer treatment across the country.
"We do not have a lot of funds, but we acknowledge the few supporters we have," she said, highlighting the financial burdens on patients.
Ms. Duodu further revealed the dire economic situation many breast cancer patients face, stating that surgeries can cost between GHS 12,000 to GHS 60,000, a sum unaffordable for most vulnerable women.
"Imagine a poor woman with breast cancer. What is she going to do? How is she going to get that money?"
She also pointed out the lack of infrastructure, particularly in rural areas, noting that there are hardly any oncology units outside of major cities.
"We are begging and pleading with the government. Can these centers be set up at least in regional hospitals?" she urged, citing the difficulty for patients traveling long distances from places like Tarkwa to Accra for treatment.
Shockingly, Ms. Duodu noted that the entire Northern Region lacks a mammogram machine, let alone a radiotherapy machine, making early detection and treatment even more challenging.
"This is really sad for a country like Ghana," she remarked.
During their outreach programs in senior high schools, the foundation uncovered alarming results.
At St. Mary's Senior High School, 6 out of 450 girls screened were found with suspected breast cancer. At Adonten Senior High School, 22 out of 426 girls had suspected cases.
Similarly, at Ebenezer Senior High School, 4 out of 315 students, including one male, were found with potential breast cancer.
Ms. Duodu emphasized that men are also at risk, calling for greater awareness among both genders.
Ms. Duodu appealed to healthcare providers and urged all Ghanaians to take the issue seriously.
"Breast cancer is deadly," she warned, emphasizing the need for collective action to prevent unnecessary deaths due to late detection and lack of access to treatment.
Ibrahim Kwarteng, CEO of Meena Breast Cancer Foundation, has made an impassioned plea to the media and government to prioritize breast cancer awareness and treatment, particularly as Pink October—Breast Cancer Awareness Month—continues.
Mr. Kwarteng expressed gratitude for breast cancer survivors, emphasizing that their recovery stories serve as proof that the disease can be fought and overcome.
He highlighted the ongoing battles faced by many women across Ghana, particularly those in rural areas, who are currently undergoing treatment for breast cancer.
Mr. Kwarteng shared the story of a woman under the care of the Meena Breast Cancer Foundation who is in critical condition, reliant on oxygen, and struggling with the toll of the disease.
"She pleaded with me for support in her recovery, and her story reflects the difficulties many women face in their fight against breast cancer," he said.
He underscored the challenges posed by the high costs of treatment, such as chemotherapy, which many women cannot afford.
While chemotherapy remains the standard treatment, Mr. Kwarteng acknowledged the concerns surrounding its side effects and the ongoing debate about its efficacy.
"Chemotherapy is not without risks, but it remains the standard treatment available, and we must work with it until better alternatives are found," he added.
Reflecting on his personal experience, Mr. Kwarteng reminded attendees of the tragic loss of his wife to breast cancer on June 18, 2022, which he described as a "terrible" experience.
He noted that many women are diagnosed late, often after being reassured in earlier screenings that a lump in their breast was not of concern.
"The journey with breast cancer can be confusing. You may feel a lump and be told not to worry, only to return later and find out it's cancer. It's concerning what doctors may see and what they don't," he remarked.
Mr. Kwarteng also pointed out that black women are often more susceptible to aggressive forms of breast cancer and that many are diagnosed later than their white counterparts, making treatment more difficult.
"Research tells us that black women, on average, get breast cancer in their younger years, and it's often more aggressive."
In a call to action, Mr. Kwarteng urged the media to place greater focus on health issues, particularly breast cancer, rather than predominantly on political stories.
"We are all aware of the media's addiction to politics and other matters, but health issues should take center stage in our headlines. It’s time the government and all stakeholders take proactive steps to address this growing problem," he appealed.
Despite efforts to improve healthcare access through the National Health Insurance Scheme (NHIS), patients continue to face significant challenges, according to Dr. Abigail Nyarko Codjoe Derkyi-Kwarteng, Acting Director of Claims at the National Health Insurance Authority (NHIA).
She expressed concern over the long waiting times at hospitals, the shortage of healthcare facilities, and the financial burdens still experienced by patients, even those with active NHIS memberships.
“Women facing health crises, such as breast cancer, find it difficult to uphold their family responsibilities, and no one prays to be in such a situation,” Dr. Derkyi-Kwarteng said, highlighting the emotional and physical toll on patients.
She also pointed out that despite NHIS coverage, many patients are still left with hefty bills at hospitals.
"At the end of the day, you're trapped with a bill, even when you have an active NHIS card. These are serious issues that we cannot ignore."
Dr. Derkyi-Kwarteng acknowledged the frustrations of many who assume the NHIA is solely responsible for these challenges.
However, she explained that the NHIS operates within a broader health financing framework, which includes healthcare providers and the Ministry of Health as key regulators.
“We’re not the only player in this system. The service providers and the Ministry of Health are also responsible,” she noted.
While NHIS is responsible for processing and paying claims submitted by healthcare providers, Dr. Derkyi-Kwarteng explained that once a service is covered under the NHIS benefits package, providers are expected to treat patients without charging extra.
“I cannot speak for why some providers still charge patients, but we are engaging them to resolve these issues," she added.
The NHIS currently covers around 95% of healthcare services in Ghana, including treatment for breast cancer, cervical cancer, and several childhood cancers like Wilms' tumor, retinoblastoma, Burkitt's lymphoma, and leukemia.
"We’ve also begun discussions on adding prostate cancer to the package," she revealed, indicating ongoing efforts to expand the scheme's scope.
However, Dr. Derkyi-Kwarteng admitted that inflation and rising costs have made it challenging to keep up with timely payments to healthcare facilities.
“We are working hard to ensure timely reimbursements, but we also need collaboration from the providers to make sure that patients are not charged unnecessarily.”
She urged patients to be proactive by asking questions when charged for services supposed to be covered under the NHIS.
“Sometimes, questioning these charges can prompt providers to reconsider. Health is a fundamental right, and no one should be denied access to it based on their financial situation.”
Dr. Derkyi-Kwarteng reaffirmed the NHIA’s commitment to ensuring equity and social justice in healthcare.
"Health should come at no cost to the patient, and that’s what we strive to achieve at the NHIS," she concluded.
Evelyn Amoako, Deputy Director of Nursing Services at the Ministry of Health, has reiterated the government's dedication to improving breast cancer screening, treatment, and overall support for women battling the disease.
She expressed concern over the devastating impact breast cancer continues to have on women, particularly in Ghana.
"Earlier this year, I lost two of my classmates to breast cancer, both in their 30s," Madam Amoako revealed, emphasizing the urgency of addressing breast cancer care.
"We understand the challenges, and we are committed to ensuring that women living with breast cancer receive the necessary support."
Evelyn Amoako highlighted that breast cancer screening and treatment are covered under the National Health Insurance Scheme (NHIS), as mentioned by representatives from the National Health Insurance Authority (NHIA).
However, she acknowledged ongoing challenges faced by patients at health facilities, such as delays in accessing care and concerns about treatment quality.
"These issues have been noted, and I will ensure they are communicated to the Minister of Health so that interventions can be implemented," she said.
The Deputy Director also spoke about the Ministry of Health's broader efforts to combat noncommunicable diseases (NCDs), including breast cancer, through its NCD policy, which prioritizes prevention, early detection, and treatment.
"Our policies provide a framework to raise awareness and improve early detection for breast cancer and other cancers," she explained, adding that the government is working to expand the NHIS benefits package to include conditions like prostate cancer.
Addressing the risk factors for cancer, Madam Amoako pointed to government initiatives aimed at mitigating predisposing factors such as tobacco use and unhealthy diets.
"We are preparing to launch a trans fatty acid policy soon and will also introduce new guidelines on physical activity," she announced.
Evelyn Amoako stressed the importance of building capacity within the healthcare workforce.
“The Ghana College of Physicians and Surgeons, as well as the Ghana College of Nurses and Midwives, are working tirelessly to train specialists, doctors, and nurses in cancer care,” she noted.
She also emphasized the critical role of the private sector and non-profit organizations in complementing government efforts to provide quality healthcare across the country.
To further strengthen the healthcare system, Amoako discussed the Ghana Health Service's "networks of practice" initiative, which connects healthcare facilities to share expertise and resources.
She highlighted the importance of the Community-based Health Planning and Services (CHPS) system in linking community-level care to district hospitals.
"Government cannot do this alone," she emphasized, acknowledging the valuable contributions of non-profit organizations, such as the MEENA Breast Cancer Foundation, and the private sector.
"Collaboration is key to ensuring that all Ghanaians, regardless of their financial situation, have access to quality healthcare as part of our universal health coverage policy."
Madam Amoako also underscored the role of research in understanding disease dynamics specific to Ghana and Africa.
"Research is crucial in helping us develop suitable interventions for conditions like breast cancer," she said, calling for more focus on local health research to inform policy and treatment strategies.
She urged patients to speak up if they encounter challenges at healthcare facilities.
"Every facility has customer service representatives, and there are mechanisms in place to report poor service.
The NHIA also has a customer care portal for reporting issues. Let's make use of these channels to improve our healthcare system together," Madam Amoako concluded.
Rita Gbeku, a midwife at the Ridge Reproductive Health Unit, Ridge Hospital, has called for increased breast cancer awareness and education, especially in rural areas.
Speaking on the need for in-service training for community health workers, she noted that many are only focused on immunization and youth education, neglecting breast cancer screening and education.
“Our in-service training should ensure that nurses in rural areas are equipped to screen and educate women on breast cancer,” Madam Gbeku said.
She also emphasized the importance of breast cancer survivors forming support groups to encourage others going through treatment, highlighting that psychological support plays a crucial role in recovery.
Madam Gbeku further stressed the need for community health workers and midwives to incorporate breast cancer education into their services, ensuring women in all parts of Ghana have access to vital health information.
Some breast cancer patients and survivors have made an urgent appeal to the government to include comprehensive breast cancer treatment under the National Health Insurance Scheme (NHIS).
They highlighted the financial burden associated with treatment, making it difficult for many women to access timely care.
"Many of us struggle with the cost of treatment, and rolling it onto the NHIS would ease the financial strain on patients," said one survivor during a recent health forum.
While the NHIS covers breast cancer screening and some aspects of treatment, patients are calling for the inclusion of more advanced treatment options such as chemotherapy, radiotherapy, and surgery, which are critical for survival.
The appeal comes amid efforts by the Ministry of Health and the NHIA to review healthcare packages under the scheme, with a growing focus on noncommunicable diseases like cancer.
Patients hope that this move will improve access to life-saving treatments and reduce the number of women succumbing to breast cancer due to financial constraints.
Story by: Joshua Kwabena Smith
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