Cervical Cancer In Nigeria
Cervical cancer in Nigeria is a major public health issue, as the country has 56.2 million women who are at risk of having the disease. Cervical cancer ranks second on the list of most common cancers in women ranging between the ages of 15 and 44, in Nigeria.

Human Papillomavirus (HPV)

Human papillomavirus (HPV), which is a virus that commonly transmits through sex, causes cervical cancer. It can transmit from mother to child. Cervical cancer is treatable when one detects it early and manages it clinically. According to WHO, HPV 16 and 18 are responsible for 70% of cases of cervical cancer.

In a 2021 report, the HPV Information Center stated that there were 12,000 new cases in 2020, while almost 8,000 women die annually from cervical cancer in Nigeria. This type of cancer affects the cervix. The cervix connects the uterus to the vagina in a woman and is located between the uterus and the vagina. The cervix functions in various processes such as menstruation, fertility, pregnancy, childbirth and also the protection of reproductive organs.

Treating Cervical Cancer in Nigeria

The poor health service system makes accessibility to the treatment of cervical cancer in Nigeria difficult. Being a low and middle-income country, Nigeria’s health system lacks cervical cancer services. Cervical cancer is preventable and treatable, but without the necessary vaccines and other health services, prevention and treatment are difficult.

Although HPV vaccines are effective, they cost a lot and are quite unaffordable. A dose of  HPV vaccine costs no less than 13,000 Naira ($29.18), three doses are necessary and the doses are only available in private health facilities. The scarcity of vaccines also stresses the ones who can afford them.

In November 2022, the World Health Organization (WHO) launched a cervical cancer screening and treatment project in Anambra state, Awka. The project aims at the treatment and prevention of cervical cancer in women of productive age across the state.

Some of the medical equipment and supplies that WHO donated include “four examination couches, 20 anglepoise lamps, 50 Cusco’s speculum, 15 instrument trolleys with wheels, 50 disposable aprons, 50 kidney dishes, 20 mackintoshes standard size, 100 packets of swab sticks, 10 punch biopsy forceps, 150 liters of 90% ethanol solution, etc.”

WHO has decided to train 100 health workers on the processes involving cervical cancer screening services and also provide ongoing technical support to ensure the project achieves its goal.

Planned Parenthood Federation of Nigeria (PPFN)

Planned Parenthood Federation of Nigeria (PPFN), collaborates with local government authorities and primary health care systems, in a bid to eliminate cost barriers, it also “conducts mobile outreach clinics offering a wide range of sexual reproductive health services, including cancer services, to vulnerable communities in hard-to-reach, poor and marginalized areas” free of cost.

The intervention of WHO and PPFN in various states of the country brings more awareness about cervical cancer. Making screening more available will make early detection and prevention possible.

– Oluwagbohunmi Bajela
Photo: Flickr

Cervical Cancer in Botswana
In November 2022, Penn Medicine, the clinical and research entity of the University of Pennsylvania, received a $3.5 million grant from the National Cancer Institute (NCI) to better address cervical cancer in Botswana.

Poverty Among Women in Botswana

In Botswana, the percentage of employed women living under the international poverty line is 10.1% in comparison to 8.7% among employed men. The World Bank has explained that “vulnerable employees” are employees who are “the least likely to have formal work arrangements, social protection and safety nets to guard against economic shock.” In 2019, Botswanan women had a 23% vulnerable employment rate. In comparison, men had a 19% rate, meaning women were more susceptible to losing their sources of income and falling into poverty.

Women-headed households are more likely to suffer from poverty than male-headed households in Botswana. This is especially the case for women-headed households in rural areas as economic opportunities are scarce. Impoverished female households cannot afford health care for themselves or their families. The Botswana government has attempted to decrease poverty and increase access to medical treatments in Botswana.

The government released its Vision 2036 plan in 2016, which outlines transformation goals for Botswana to reach by 2036 in the realms of “Sustainable Economic Development; Human and Social Development; Sustainable Environment and Governance, Peace and Security.” In this plan, Botswana recognizes “good health and wellness” as a human right and a key to development. Botswana aims to significantly reduce HIV prevalence through greater emphasis on “prevention, treatment, care and support.”

Women’s Health in Botswana

Botswana’s HIV prevalence rate stood at about 20% in 2020, according to UNAIDS, with women accounting for most of these cases. UNAIDS explains that a woman living with HIV is as many as five times more likely to develop cervical cancer than a woman without HIV. The immunosuppression that HIV causes can exacerbate pre-cancerous lesions in the cervix.

As of 2021, 220,000 women in Botswana aged 15 or older are living with HIV. Cervical cancer stands as the main form of cancer mortality among Botswana’s female population. The death rate is “10 times higher” among Botswanan women than among the U.S. female population as women’s cancer treatment is lacking in Botswana.

Over the years, Botswana has made improvements with regard to cancer screening and treatment. However, several factors lead to delays in screening and diagnosis, which contributes to the high prevalence of cervical cancer cases in Botswana. Since 2001, the University of Pennsylvania has helped to improve health in Botswana through the Botswana-UPenn Partnership (BUP). BUP works with Botswana’s Ministry of Health, the University of Botswana and partners to “care for patients and develop initiatives advancing cancer education, research and capacity.”

Penn Medicine has noted that a lack of coordination and communication between labs, patients and healthcare centers leads to diagnosis and treatment delays.

Reduced Waiting Periods

The $3.5 million grant to Penn Medicine will go toward testing strategies that shorten women’s wait between screening, results and treatments. After the initial biopsy, months or even years can pass before a healthcare facility becomes aware that the diagnosis is cancer. A shorter waiting period and better communication between labs, clinics and patients can significantly improve a woman’s chance of surviving cervical cancer.

Penn Medicine’s research will play a significant role in reducing cases of cervical cancer in Botswana.

– Clara Mulvihill
Photo: Flickr

Cancer Care in India
Cancer is an issue common across the world, without a cure no matter the financial circumstances of a country. The care that is available for treating cancer is expensive, limiting cancer care to individuals who are financially well-off. India is looking to establish universal health care insurance so that more people can access health care and organizations aim to extend the reach of cancer care in India.

India’s Poverty Epidemic

Poverty is one of India’s largest problems, with 256 million inhabitants living below the poverty line of $1.90 a day as of 2020. Poverty is a complicated issue, with many different causes and effects that intertwine. The economic causes of poverty in India include rising rates of unemployment, inadequate infrastructure, slow economic growth and development and resource deprivation. The social causes of poverty include caste system-based discrimination, societal inequality and corruption. Since Russia’s invasion of Ukraine in February 2022, inflation has increased worldwide, with especially high inflation rates in developing countries.

In countries already struggling with economic instability, like India, inflation hits hard. The cost of living goes up, but it does not always mean that salaries go up to support that. Several organizations aim to unravel the web of poverty by seeking to help the impoverished improve their quality of life.

Cancer and Poverty

Medical care is significantly expensive, even in developed countries. It is no different in India. Along with general inflation, India is also facing increasing medical inflation. In 2021, India noted “the highest medical inflation rate among the Asian countries,” at 14%. In April 2022, the price of medical treatment, including medicines and procedures, rose by 7.21%. These circumstances make it difficult for the impoverished to access health care services in India, let alone specialized cancer care. According to statistics from the National Cancer Registry Programme, about 1.4 million people in India had cancer in 2020.

Because of circumstances of poverty and the expensive nature of health care, among other reasons, the majority of Indian cancer patients often do not receive an official medical diagnosis until the cancer is in its later stages.

Fortunately, the Indian government has recognized this and is moving toward creating universal health care insurance, which would extend health care to more people from lower socioeconomic classes. In particular, this would cover chemotherapy and other cancer medications to improve cancer care in India.

In an article, Dr. Navneet Singh, an expert in “non-small cell lung cancer,” stressed the importance of patient advocacy in countries like India. This involves educating the public on cancer and treatment options. Singh said further that developed countries like the United States can aid India and other developing countries with similar issues “in the area of patient support groups and advocacy platforms.”

CAM Ensures Accessible Health Care

Organizations such as Charutar Arogya Mandal (CAM) aim to make health care accessible and affordable for the impoverished in India. In terms of cancer care, the organization runs a cancer center to provide treatment to impoverished cancer patients. The organization began in 1972 because of the dream of Dr. H.M Patel, a former minister of India. Patel looked to create an institution to “offer comprehensive and compassionate health care to everyone and anyone.” CAM takes special measures for those in less stable economic situations by providing free consultations and free treatment to women and children below the poverty line.

With commitments from the government and organizations, cancer care in India can include the impoverished.

– Kelsey Jensen
Photo: Flickr

Childhood Cancer
Cancer is a disease that has gripped the nation for decades. Given its aggressive nature and ability to target anyone, the illness has earned significant public attention and resources. In the United States alone, approximately 10,500 children aged 15 or younger were diagnosed with cancer in 2021. Thankfully, the survival rate for children diagnosed with cancer in the U.S. is about 80%. Yet in low- and medium-income countries (LMIC), where this disease is even more prominent, the survival rate is less than 30%. That is why the World Health Organization (WHO) and St. Jude Research Hospital are teaming up to target LMIC with high childhood cancer rates and poor access to cancer medication.

Moreover, pediatric cancer has substantially increased since the 1970s. Since 1975, the cancer rate in children under 19 has increased by 27%. Less mentioned is that 85%-90% of childhood cancer cases occur in LMIC countries that possess less than 5% of the world’s resources.

St. Jude Research Hospital and WHO Partnership

On December 13, 2021, WHO and St. Jude announced the Global Platform for Access to Childhood Cancer Medicines, their partnership to fight cancer in LMICs. St. Jude is a research center and hospital that seeks cures and prevention for diseases that target children. The team pledged $200 million for use between 2022 and 2027. The two-year pilot phase will target 12 countries and after that, the program will expand to 50 LMICs. In addition to aiding countries in need obtain cancer medication, this process includes consolidating and shaping global markets, setting new treatment standards and improving the information systems used to track innovations. While St. Jude and WHO have not yet selected the countries, all will be countries with high rates of childhood cancers and limited access to available treatments.

Program Launch to Raise Awareness

WHO has used this program to shed light on the difficulties that developing countries face when addressing the health of young children. A WHO Noncommunicable Disease Country Capacity survey published in 2020 reported that of all low-income countries, only 29% reported availability of cancer medications within their populations. Contrastingly, 96% of developed countries attested to having consistent and reliable access to cancer treatments.

A Symbol of Hope

The next few years will serve as a pilot period for testing the new program and its distribution methods on a global scale. Childhood cancer rates require a diligent focus given the widespread nature of the disease. Nevertheless, St. Jude Research Hospital and WHO are making history through their dedicated partnership addressing global health needs. The wide scale of the program, although it still has a long way to go, presents significant hope in the long battle against childhood cancer in developing countries.

– Chloé D’Hers
Photo: Wikipedia Commons

healthcare access in LMICs
Around 2 billion people around the world lack proper access to surgical care or advanced medical care. On average, low-and-middle-income countries (LMICs) have fewer than two operating rooms and one trained surgeon per 100,000 people. Due to this, treatable maladies often result in death. In 2011, around 5 million people died of injuries in LMICs. The barrier between proper medical care and patients is the cost of care. More often, the costs of admission, medications and food are based on the strained economic conditions of impoverished countries. The shortage of medical professionals in LMICs has been identified as one of the most significant obstacles to achieving health-related U.N. Millennium Development Goals (MDGs). One can see the severity of this lack of healthcare access in LMICs in countries such as Mozambique, with only 548 doctors for more than 22 million people.

Lack of Medical Professionals

The absence of medical professionals in LMICs is often due to the poor economic situation of these countries. This results in limited financial resources to support a good healthcare system and provide proper training for doctors. Even when training is available, many skilled doctors work overseas due to others offering them a better medical career abroad, leading to a lack of healthcare access in LMICs. The British Medical Journal claims that “African countries have lost about $2.6 billion…training doctors who are now living in western countries.”

On average, there is less than one doctor for every 20,000 people in Chad. In addition, an equipment shortage in Chad means there are fewer than four hospital beds for every 10,000 people. Furthermore, inequitable distribution of service is a major problem in these countries. Due to a limited number of doctors being available to treat millions of people, often patients with a higher income receive what little medical support is available. Those of a lower income in these countries find it more difficult to afford treatment and especially cannot afford emergency medical procedures.

Consequences for Patients

Lack of trained medical professionals often means that diseases, surgeries, injuries and complications often result in death. Disease is excessive and often untreatable in these countries. Medical procedures often require advanced training and experience to be conducted successfully. The demand for these procedures greatly exceeds the supply of surgeons and institutions, leading to low healthcare access in LMICs.

For example, 90% of those who are visually impaired live in LMICs. According to the World Health Organization (WHO), 80% of cases involving visual disability are preventable. Eye surgery, an effective method of treating blindness, is rarely available. Furthermore, according to the National Library of Medicine, 6 billion people in LMICs lack access to safe and affordable cardiac surgery.

According to WHO, 94% of all maternal deaths occur in low- and lower-middle-income countries. Many women facing birth complications rarely have access to trained professionals who can handle these complications. Sometimes, doctors with insufficient training may perform emergency procedures improperly, resulting in debilitating injuries or even death. Furthermore, 99% of hemorrhage-related peripartum deaths occur in LMICs. These problems all stem from the fact that a qualified medical professional attends less than 50% of all births in LMICs.

Rising Cancer Rates

Another consequence of a poor global healthcare system is the rising cancer mortality rates in LMICs. More than half of the 10 million cancer deaths in 2020 occurred in LMICs. When comparing the healthcare systems of different regions, high-income countries usually spend around five to 10 times more per person. As a result, less than 50% of those diagnosed with cancer in high-income countries die from the disease. On the other hand, 66% of those diagnosed with cancer in LMICs die from the disease. This is mostly due to the fact that LMICs do not have the resources for treatment facilities or radiation therapy centers.

Organizations Making an Impact

Organizations like the Medical Education Partnership Initiative (MEPI) support the training of doctors to improve healthcare access in LMICs. MEPI works to increase the number of new healthcare workers, strengthen medical education systems and build clinical and research capacity in LMICs. Charities such as Mercy Ships send volunteer surgeons to provide lifesaving surgical procedures and invite local doctors to expand upon their surgical skills alongside the volunteer surgeons. Mercy Ships also provides mentoring programs for surgeons, anesthesia providers, ward nurses, operating nurses and biomedical technicians. By providing new medical tools and resources, constructing new medical facilities, providing training for local professionals and working with local governments, Mercy Ships leaves a long-lasting impact.

Poverty and disease are closely related. In order to have significant improvement in global health, economic development of LMICs and improved medical education is essential. The growing disparity in surgical access and other health services requires urgent attention. We can put this into action through the comprehensive development of healthcare access in LMICs.

– Arya Baladevigan
Photo: Unsplash

Cancer and Poverty in AustraliaThe nation of Australia suffers from the highest rates of cancer in the world, but, the disease takes a significant toll on the disadvantaged and rural residents in particular. Impoverished and disadvantaged Australians are 60% more likely to die from cancer due to a lack of finances for a timely diagnosis and proper treatment. The connection between cancer and poverty in Australia can be clearly seen.

The Link Between Cancer and Poverty

The cost of treatment is only one part of the problem. The importance of prevention cannot be overstated and because of a disadvantaged situation, many poor Australians are more likely to smoke cigarettes, be overweight and not get screened for cancers. This leads to more impoverished residents developing a range of cancers that reach later stages before they are diagnosed.

While the country has a decent healthcare system, the connection between cancer and poverty in Australia is significant. Poor citizens are more likely to develop cancer and are the least financially prepared for it. One out of every three Australian cancer patients has to pay out-of-pocket for treatment ranging from a few hundred dollars up to $50,000 AUD. Patients that have private health insurance rather than public medicare often pay far more out-of-pocket, sometimes double, in addition to their regular insurance payments.

Rural Residents in Remote Areas

Residents of Australia’s rural areas often face the worst financial obstacles as they must incur travel expenses and be far from home for extended periods. In 2008, only 6% of oncologists practiced in rural areas, leaving a third of Australians that live in remote regions without immediate access to decent treatment. There were 9,000 more cancer deaths in rural areas than in urban areas over a decade, a 7% higher death rate compared to city residents.

Due to the extensive travel time, many cancer patients from remote regions are forced to quit their jobs increasing the financial burden of treatment. Those that can keep their jobs, often force themselves to continue to work despite their illness and during treatments in order to pay the bills. In many instances, cancer patients must take loans from friends or family. creating further financial obligations.

Indigenous Australians

In addition to rural residents, indigenous citizens also disproportionately die from cancer compared to other residents. Indigenous Australians have a 45% higher death rate from cancer compared to non-indigenous patients. Cancer is extremely underreported by indigenous people in remote or rural areas resulting in a lack of proper data for the government to act on.

Addressing the Link Between Cancer and Poverty

To reduce the mortality rates of cancer patients, the government must address the correlation between cancer and poverty in Australia. As of 2017, only 1.3% of Australia’s health budget is allocated for cancer prevention, screening and treatment. The country must invest in prevention as well as rapid-access cancer aid for both patients and caretakers.

The Clinical Oncology Society of Australia and Cancer Council Australia are working to improve cancer treatment in rural areas of Australia. Solutions to diminish the connection between cancer and poverty in Australia include new methods of diagnosis and treatment. Telehealth and shared care, in which the patient’s primary physician works with an oncologist to limit travel for treatment, help cut down on costs for struggling patients.

Cancer organizations in Australia have worked with the government to set up the regional cancer center (RCC) initiative across the country to make cancer care more accessible for residents living in rural areas. Since 2010, 26 regional cancer centers have opened to help patients living in remote locations.

Prioritizing the Health of Rural Residents

For the mortality rates of impoverished or rural cancer patients to lessen, the government must invest in prevention as well as access for rural residents. Above all, for Australia to successfully provide aid for cancer patients there must be accurate data collection on cancer and poverty in Australia to properly allocate funds for all demographics.

— Veronica Booth
Photo: Flickr

The Max FoundationIt is a struggle to deal with a family member having cancer emotionally, physically and financially. The burden of paying for a family member’s hospital bills makes it difficult to pay for other things like food, shelter and clothing. The Max Foundation in Argentina has stepped up to this challenge by helping cancer patients get the treatment that they need.

Poverty Rates

Argentina’s poverty rate was 35.5% at the end of 2019, which shows a steady increase over the past few years. The poverty rate of children younger than 14 is 53%. The statistics have gotten better in the six years prior to 2018, an 18.7% drop in poverty rates. However, COVID-19 has not been kind to Argentina as the country continues to battle its two-year recession.

Disease

In addition to the poverty rate and pandemic, Argentina is not immune to cancer either. Every year more than 110,000 people are diagnosed with some form of cancer in Argentina. Some of the causes of cancer in this country are tobacco and HPV.

Around 22% of the population smokes and children who are between the ages of 13 and 15 are six points higher than that. Out of all the deaths caused by cancer, 26% are caused by tobacco. Argentina does have the resources to enact preventative measures. The country has even enacted breast cancer screening, although most women do not attend regularly. However, more could still be done.

That’s why organizations like the Max Foundation are so important. Poverty is hard enough to try to overcome when one is healthy let alone when having to fight cancer. Cancer patients need organizations like the Max Foundation, so they have one less thing to worry about during the tough fight for their life.

The Max Foundation

The Max Foundation has been around since 1997. The Rivarola family left Argentina to travel to the U.S. to get cancer treatment for their son Max. The organization was founded when he passed away. Other families in Latin America have children with leukemia just like Max, and the Rivarola family wanted to do something for them.

Now, The Max Foundation provides cancer treatments to countries all around the world. The world has seen that viruses like COVID-19 have no borders and neither does cancer. The Max Foundation almost has no borders as well. It has served 73 countries and given over 11 million cancer treatments to people as of the start of 2017.

The Max Foundation works by offering help to patients whose doctors have recommended them. The organization then gets the medicine to them through the partner companies. The medicine is donated by pharmaceutical companies like The Tanner Pharma Group.

Argentina’s poverty rate has not been helped by the recent pandemic. COVID-19 is not diminishing cancer diagnosis either. But there is still hope. The Max Foundation has been helping cancer patients for years and they are a light in the dark for the cancer patients of Argentina as well as many other countries around the world.

Moriah Thomas
Photo: Flickr

Indigenous Peoples
Indigenous peoples in Canada have roots in poverty tracing back to the 19th and 20th centuries. They had to relocate to small plots of land called reserves where destruction of their traditional way of life “combined with the poorly organized set-up of reserves resulted in impoverishment for those on the reserves.”

In Canada, 25% of Indigenous peoples live in poverty with 40% of those living under the poverty line being Indigenous children. Many Indigenous peoples died due to lack of shelter, adequate food, access to health care and lack of federal relief services. Today, Indigenous communities continue to suffer at the hands of institutionalized colonial violence.

Housing Inequalities

Several cross-country reserves have declared a State of Emergency due to poor living conditions. Statistics deemed only 56.9% of homes on reserves adequate in 2000 and 43% unsafe and in need of repairs in 2016. In 2016, both reserve shelters and Inuit homes qualified as overcrowded — 28% and 30% respectively.

Some Indigenous people moved off of reserves and into urban centers. Even there, they continued to face economic struggles. Indigenous peoples are twice as likely to live in poverty in comparison to non-Indigenous folk. In 1995, 55.6% of Aboriginal people in urban centers lived in poverty. Meanwhile, in 2003, 52.1% of Indigenous children lived in poverty.

Income Disparities

Impoverishment within the Indigenous community has resulted in fewer on-reserve schools, rising illiteracy and rising unemployment. Indigenous households making an income below $20,000 represented almost 20% of the entire Canadian population; whereas, non-Indigenous homes only represented 9.9%.

Non-Indigenous folk in lower-income homes have a 12.9% outcome of people with major depressive episodes. Meanwhile, Indigenous folk in lower-income homes had a 21.4% outcome — almost double. The values for higher incomes families are much closer; 6.3% for non-Indigenous and 7.7% for Indigenous.

Health Inequities

The Well-Being Index determined that First Nation and Inuit communities ranked on average 20 points lower than non-Indigenous communities. Despite being only 4% of the Canadian population, Indigenous people make up 14% of the population relying on food banks. Smoking and lung cancer statistics also show an overrepresentation of Indigenous peoples. Lower-income Indigenous households reported daily smoking levels at 48.8%.

The lowest-income Indigenous populations also experience disproportionate difficulties in accessing health care. Popular barriers are that Indigenous peoples are “unable to arrange transportation (19.6%); not covered by Non-Insured health benefits (NIHB) (18.4%); could not afford transportation costs (14.6%); prior approval by NIHB denied (14.2%); could not afford the cost of care, service (11.4%).”

Aid

Many community activists and grassroots organizations work tirelessly to help support the Indigenous communities in Canada. Dismantling generational poverty is another focus of activists and organizations. True North Aid is just one of those in the fight for Indigenous peoples in Canada.

True North Aid has decades’ worth of experience. It has an advisory council of four Indigenous Elders, partners and a Board of Directors with over 35 years of experience. Under such leadership, the organization successfully raises awareness for Indigenous struggles. Additionally, it provides home reconstruction aid, water purification technologies and health care aid to Indigenous communities in Canada.

Activists and organizations supporting Indigenous peoples are imperative in the fight to end poverty for Indigenous people. Indigenous communities suffer disproportionately and need advocacy and action.

– Jasmeen Bassi 
Photo: Flickr

Children with Cancer in Mexico
For the last two years, parents of children with cancer in Mexico have been fighting the government due to drug shortages. Children are going months without chemo and those lucky enough to have the treatment are not receiving the drugs that keep the rest of their body safe from the radiation. Children have died waiting for their treatments. Parents are protesting in the streets and taking the word of the President on reform of the corrupt healthcare system with a grain of salt.

Corruption and Reduced Budgets Collide

To the people of Mexico, it does not come as a surprise that the President announced the existence of corruption in the medical industry and the healthcare system. During a speech, the President rebuked the notion that his recent budget cuts aided in the shortage, focusing instead on the healthcare system’s alleged internal corruption. AMLO claimed that pharmaceutical monopolies have gone as far as to withhold drugs from the ill.

However, in May 2019, the first large budget from the current administration hit healthcare. The cuts resulted in the cancellation of surgeries for children and layoffs of nearly 200 people per hospital. Operating on an extremely reduced budget means that hospitals can no longer afford large quantities of necessary medicines. One hospital has had to cancel multiple surgeries due to its inability to afford the normal amount of anesthesia.

Cuts to staff have put more patients at risk as there are not enough nurses to provide the necessary care. Another hospital currently does not have enough nurses for its pediatric floor. Additionally, it is running low on basic supplies and surgical equipment. Meanwhile, Mexican civilians believe both are the root cause of the extreme shortages and they want answers, not deflection.

The Biggest Risk for Children

Cancer is the most predominant reason of death for children in Mexico with an age range of 5 to 14 years old. This type of situation tends to hit families from rural areas the hardest due to the lack of healthcare facilities nearby. Low education rates among Mexico’s poorest make it nearly impossible for parents to know the signs of cancer, too. Malnutrition and consistent illness are not uncommon among extremely impoverished families and it is often too late once they are able to get to a doctor.

Preceding 2005, over half of the children with cancer in Mexico did not receive comprehensive medical care. Now, a child dies from cancer every four hours and the lack of drugs only amplifies the chance of mortality. The mortality rate is 50% but 70% of deaths are preventable if the child receives proper drugs and treatments early on.

Parents Fight Back

On September 4, 2020, parents and family members of children with cancer in Mexico took to the streets of Mexico City to protest drug shortages that have severely hindered their child’s quality of life. Their children have gone months without vital drugs like cardioxane that keep toxicity from chemo away from the heart. Meanwhile, canceled chemotherapy sessions are becoming routine. Cancer, no matter the type, does not yield in times of crisis. Children have died waiting for the reinstatement of treatments or for the refilling of necessary prescriptions.

The march was not the first and will not be the last. Throughout 2020, protests in Mexico have become an everyday occurrence in the fight for necessary cancer drugs for the children of the country. Most of the families that the shortage has afflicted are low-income or in extreme poverty and their only option is to fight to end the suffering of their sick children.

A Single Institute Makes A Difference

Casa De La Amistad (CDLA) is a Mexican organization in Chiapas (one of the poorest states in Mexico) dedicated to helping pediatric patients afflicted with cancer in rural areas. It provides a multitude of services for children diagnosed with cancer and their families. The CDLA works with hospitals spanning over the county and receives a notification when a child is in need of its services. It gives children transportation to and from hospitals for treatments and appointments, housing for them and their families, food, counseling for families and individuals and the continuation of school.

A recent partnership between CDLA and the AbbVie Foundation, Direct Relief has improved the survival rate of the children it provides for. Families are no longer abandoning treatment due to a lack of funds or transportation. In the first three years, the abandonment percentage dropped from 6% to 2%. Children receiving aid from the CDLA had a 50% lower mortality rate in comparison to the national average. Since 2018, CDLA and AbbVie have helped over 300 children, many of whom were on a waitlist.

Children with cancer in Mexico are suffering from a dilapidated healthcare system. Passing the blame does not solve the problem. Children’s lives are at stake but citizens from around the world are trying to make a difference where the government is failing.

– Amanda Rogers
Photo: Flickr

Healthcare in Chile
Healthcare in Chile primarily comes from the state-funded insurance National Health Fund (Fondo National de Salud – FONASA) or from private companies collectively known as Las Instituciones de Salud Previsional (ISAPRE). According to a 2019 report from the Organization for Economic Cooperation and Development (OECD), 78% of the population participate in FONASA and around 17-18% enroll in ISAPREs, while 3-4% receive coverage from the armed forces insurance program. A number of newly implemented government reforms in Chile have challenged healthcare inequity to ensure universal healthcare for all.

Morbidity and Mortality

In the 1980s, a series of successful reforms decreased infant mortality rates (from 33 per 1,000 live births in 1980 to only eight per 1,000 in 2013) and improved communicable disease rates, nutrition and maternal and child health. While the health status of Chileans consistently fell below average among OECD nations in recent decades, the life expectancy in Chile in 2015 rose to 79.1 years in the last 40 years, nearly on par with its OECD peers. Determinants of health status include life expectancy, avoidable mortality rates, morbidity rates from chronic diseases and percentage of the population in poor health.

Non-communicable diseases (NCDs), such as high blood pressure, diabetes and heart diseases are identified as the burden of disease in Chile, accounting for 85% of all deaths. Key risk factors include high obesity rates, heavy tobacco use and increasing rates of alcohol consumption. The infant mortality rate is improving but remains high, as are mortality rates from cancer compared to cancer incidence.

Some Effective Government Measures

The Chilean government has undertaken effective measures to address the nation’s most urgent issues through a multi-intervention strategy that targets different population groups and settings:

  • Obesity: According to a 2016 WHO report, 39.8% of the Chilean population was overweight, and another 34.4% was obese. Childhood overweight and obesity rate is particularly problematic at 45%, with no reduction in prevalence over the past 15 years. Chile has implemented nationwide policies to tackle behaviors that cause obesity, especially inadequate physical inactivity and unhealthy diets. At the national level, mass media, such as websites, Twitter, TV and radio adverts, educates the public on healthy food choices and emphasizes the consumption of vegetables and fruits. The government has also mandated labels on packed foods that indicate high caloric content in salt, sugar and fat.
  • Tobacco Use: Tobacco consumption rates in Chile in 2016 stood at 37% (41% among men and 32% among women) of the adult population. Adult smoking rates have declined from 45.3% in 2003 and 39.8% in 2009, a percentage below average in comparison to other nations. Since joining the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2005, Chile has implemented various tobacco control policies, such as prohibiting smoking in public spaces, requiring health warnings on tobacco products and raising taxes on these products.
  • Cancer Care: The OECD projected that cancer could soon become the leading cause of mortality in Chile. Among men, prostate, stomach, lung, colorectal and liver cancer have the highest mortality rates. In women, breast, colorectal, lung, stomach and pancreas cancer account for high mortality rates. To lessen the burden of cancer, Chile has reinforced its cancer care system and launched nationwide programs focused on cervical and breast cancer and cancer drugs for adults and children. From 2011 to 2015, Chile reduced cancer by 4.1%.

Challenging Inequity

The establishment of the National Health System (NHS) in 1952, subsequent expansions and reforms together enabled Chile’s move towards universal coverage with more than 98% of the population having some kind of health insurance. However, inequality remains one of the main challenges in Chile’s two-tier healthcare system, mainly due to the unequal distribution of resources between the underfunded public facilities and the elitist private clinics. Equity monitoring shows less insurance coverage for less educated people, low-income quintiles, residents from rural areas and those with state insurance.

Significant inequalities due to socioeconomic position and residence area persist. According to a study that PLOS Medicine published, the infant mortality rate among the highest educated women was 2.3 times lower than the least educated, while the ratio was 1.4 between urban and rural residence. Risk factors like obesity, alcohol use disorders and cardiovascular risks also disproportionately affected the least educated segment of the population.

Moving Forward

Despite tremendous challenges, healthcare in Chile has improved thanks to the government’s effort to prioritize health reforms. In 2005, Chile launched Universal Access with Explicit Guarantees (AUGE) program that sought to improve access, timeliness and quality of care in the public sector. The OECD assessed that the system of healthcare in Chile is overall “well-functioning, well-organized and effectively governed,” with a particularly robust public healthcare program that operates efficiently on both the central and regional levels. Although challenges such as rising rates of certain NCDs and inequities between sectors and populations persist, the country’s ambitious reforms demonstrate its preparedness to tackle these issues.

– Alice Nguyen
Photo: Flickr