World over, people commemorate childhood cancer day on February 15^th and these years celebrations in Uganda were marked with the United Commission launching Covid-19 isolation rooms in a cancer facility Bless a Child Foundation.

This is a home set up by none government organisation to help accommodate children suffering from various types of childhood cancer. The first facility was established at Makerere Kikoni in 2008 and now a second home was established this year same area with a total number of 35 children and some care takers.

Mr Brian Walusimbi the director of the faculty explains that everyday about 1000 children are diagnosed with cancer making it the leading cause of death in Children in the world.

According to him while advances have been made in childhood cancer with 80% survival in the developed countries, in Africa including Uganda the rate is 20%-30% due lack of access in care.

That is the reason governments and partners should think of setting up cancer day care facilities to help solve the challenge.

Brian and team in 2015 set up another facility in Gulu along Ogwok Ayaru Road with apparently 7 children. The Mbarara facility was set up in 2020 currently with 15 beneficiaries.

The home care are set up strategically where there are cancer referral hospitals. For the case of Kampala the children get treatment services at Mulago Hospital, those in Gulu are getting treatment at Lacor hospital and Gulu Referral Hospital and those in Mbarara are being treated at Mabarara Hospital.

According to Walusimbi there are clear differences in the incidence and survival outcomes of childhood cancers in Sub Saharan Africa compared with developed countries such as North America and Europe.

The overall childhood cancer incidence is lower in Sub Saharan Africa ranging between 139 per one million children born ranging from 0-19 years including Uganda.

“Since Covid-19 became a challenge, we were equally confused and did not know how to help the children. Since relatives come to visit them we were not certain if they have covid-19. This is the reason we sought for help from the British High Commission and they advanced to us Shs35million to set up 4 Covid-19 isolation rooms, 2 in the Kampala facility and 2 in Mbarara,” he notes.

Global Statistics

In a 2019 publication in Global Pediatric Health by a group of scientists from Uganda Cancer Institute led by Dr Innocent Mutyaba, it is stated that the figure in USA is 187 per every 1 million children, in Canada it is, 184 and 233.9 in Nepal.

The data shows 1 year survival rates ranging from 25% to 75% in Africa compared with 5 year survival rates that exceed 80% for most childhood cancers in North America and Europe.

The childhood age range is high in low income countries than in high income countries. In sub-Saharan Africa, for example, 4.6% of cancers occur at ages 0–14 years, compared with 0.5% in the high-income countries.

Success stories from recovering and recovered Children

The story of Ronnie Mbogo aged 13 years is so interesting because he was diagnosed with Lymphomas cancer just after 1 month after he was born.

His father Godfrey Ronald Mazinga a resident of Kayini Sub Parish, Namuganga Sub Parish in Mukono district narrates that Mbogo is his first born and they have come a long way.

“Mbogo was given birth in December 2008 to my then wife Shaidia Nasanga and in January 20009 we realized the baby was having difficulty in breathing and thereafter he developed tissue growth right from the mouth to the throat. We took him to Mild May Hospital along Entebbe Road and the Doctor told us these are signs of cancer. We were taken with Ambulance to Mulago Hospital as an emergence case,” he narrates.

The Doctors administered oxygen on the baby, testing was done and it was confirmed he had cancer. Later he developed skin cancer as well and operation to cut the growing tissue was done successfully and they were advised to get therapy treatment at the cancer Institute.

However he opted to take the baby to JRS private hospital in Mengo and they spent 6 months here but the hospital bill in this hospital was so high because he used to Pay Shs750, 000 per week.

In 2009 he opted to go back to Mulago hospital and the Doctors referred him to Bless a Child Foundation.

At the day care centre he was able to receive all the assistance ranging from being taken to Mulago Hospital every week for the child to receive treatment, food and accommodation among others.

It is in 2014 that Mbogo completely healed and they went back home. His father is a very happy man because Mbogo is now at School in Primary 2 at Mother Kevina Primary School in Seeta.

The boy is now living with his paternal Aunt Ms Beatrice Nakirwowa because his mother decided to abandon the marriage and gave up due to the condition of the son.

Mbogo told Healthy Living that his hobby is to play football with his colleagues and he loves Athletics. His best Subject is English and he is determined to study up to University. His dream is to become a professor and a lecturer at Makerere University

Story of Recovering Children

Mr Dramani Swadique is the father of Desire Nihaya aged 7 from Yumbe District in West Nile

He narrates the story of the child saying that the family realized the child was becoming anemic last year in September and they took her to Yumbe hospital but they were referred to Arua Hospital.

The doctors in Arua could not handle and they were referred to Mulago Hospital where they immediately brought the child to Mulago. She was diagnosed with Leukemia Cancer. Since then the doctors have been administering treatment on the child and she is recovering quiet well.

The challenge has been the frequent visits between Yumber and Mulago hospital given the higher costs of transport and cost of living.

However 8 days ago they were referred to the care facility at Makerere Kikoni and Mr Dramani says there is some relief

“Previously Nihaya lacked blood, her skin turned reddish and her hair was peeling off but she has now gained the colour of her skin and hair. Her mother is taking care of home, secondly I had to come here myself because I am educated and I can speak fluent English with the Doctors and all those trying to help. However as head of the home I feel challenged because I have 2 children who are candidates in senior four and Senior six, payment of school fees is becoming a challenge,” he notes

He has appealed to policy makers to ensure government Hospitals in the district must be equipped with facilities where services of childhood cancer can be advanced to affect children in the communities. This is because the problem is huge and many children end up dying because the services are far.

Another child Jackline Kimpaya aged 7 is also recovering at the care center. Her grandmother Ms Sprencia Bakule is taking care of the child

She is a resident of Kasese and she first took the child to Fort portal hospital in March 2020 having realized that the stomach was swelling and she was finding difficulties lying down to sleep.

They were referred to Mulago Hospital where the child was diagnosed with Stomach Tumor which affected her Kidney and three tumors in her lungs which were treated. She came to the care centre in April 2020.

The doctors have been administering medication and one of her Kidneys removed

The child is very active and plays a lot with her friends. The grandmother is happy to the medical doctors and the management of Bless a Child Foundation for saving her grandchild’s life.

Types of Cancer that Develop in Children

Assistant Vice President Uganda Pediatrician and World Health Represented Dr Ann Akullo  notes that Scientists do not know the exact cause of childhood cancer, some are genetic while others as a result of diseases such Human Papilloma Virus, Hepatitis B, infections arising from Malaria. It is important to detect early because they are curable.

She explains that the types of cancers that occur most often in children are different from those seen in adults with the common ones as highlighted as Leukemia, Brain and spinal cord tumors, Neuroblastoma, Wilms tumor, Lymphoma including both Hodgkin and non-Hodgkin, Rhabdomyosarcoma, Retinoblastoma, Bone cancer including osteosarcoma and Ewing sarcoma

Leukemia

Leukemias, which are cancers of the bone marrow and blood, are the most common childhood cancers. They account for about 28% of all cancers in children. The most common types in children are acute lymphocytic leukemia and acute myeloid leukemia. They can cause bone and joint pain, fatigue, weakness, pale skin, bleeding or bruising, fever, weight loss. Acute leukemia can grow quickly, so they need to be treated typically with chemotherapy as soon as they are diagnosed.

Brain and spinal cord tumors

Brain and spinal cord tumors are the second most common cancers in children, making up about 26% of childhood cancers. There are many types of brain and spinal cord tumors and the treatment and outlook for each is different.

Most brain tumors in children start in the lower parts of the brain such as the cerebellum or brain stem. They can cause headaches, nausea, vomiting, blurred or double vision, dizziness, seizures, trouble walking or handling object. Spinal cord tumors are less common than brain tumors in both children and adults.

Neuroblastoma

Neuroblastoma starts in early forms of nerve cells found in a developing embryo or fetus. About 6% of childhood cancers are neuroblastomas. This type of cancer develops in infants and young children. It is rare in children older than 10. The tumor can start anywhere but it usually starts in the abdomen where it is noticed as swelling. It can also cause other symptoms, like bone pain and fever.

Wilms tumor

Wilms tumor also called nephroblastoma starts in one, or rarely, both kidneys. It is most often found in children about 3 to 4 years old and is uncommon in older children and adults. It can show up as a swelling or lump in the abdomen. Sometimes the child might have other symptoms like fever, nausea or poor appetite. Wilms tumor accounts for about 5% of childhood cancers.

Lymphomas

It start in immune system cells called lymphocytes. They often affect lymph nodes or in other lymph tissues like the tonsils. They can also affect the bone marrow and other organs. Symptoms depend on where the cancer starts and can include weight loss, fever, sweats, tiredness fatigue and swollen lymph nodes under the skin in the neck, armpit, or groin.

The 2 main types of lymphoma are Hodgkin lymphoma (sometimes called Hodgkin disease) and non-Hodgkin lymphoma. Both types occur in children and adults.

Non-Hodgkin lymphoma makes up about 5% of childhood cancers. It is more likely to occur in younger children but it is still rare in children younger than 3. The most common types of non-Hodgkin lymphoma in children are different from those in It can grow in any of the body but quickly responds to treatment

Retinoblastoma

Retinoblastoma is a cancer of the eye. It accounts for about 2% of childhood cancers. It usually occurs in children around the age of 2 and is seldom found in children older than 6.

Retinoblastomas are usually found because a parent or doctor notices a child’s eye looks unusual. Normally when you shine a light in a child’s eye the pupil the dark spot in the center of the eye looks red because of the blood in vessels in the back of the eye.

Bone cancers

Cancers that start in the bones primary bone cancers occur most often in older children and teens, but they can develop at any age. It develops in areas where the born is growing