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Njoki Njiraini


My Interaction with Cancer

During a medical doctor’s training especially in East Africa you have the privilege of working and interacting with patients from all walks of life, class, ethnic background and education. The patient’s let the doctor share their worries, joys, concerns, wisdom and also their ignorance. Being in a country where women are a majority it follows that most patients are women and they usually are very open about their symptoms and experiences.

One morning in the oncology clinic a 35 year old lady from Murang’a had discussed with me at length her diagnosis with cancer of the cervix made 3 months prior and her constant worry about the vaginal bleeding that she had been experiencing that had since increased and the constant pain in her abdomen that she was experiencing. We discussed her treatment modalities and she raised an issue why the illness had not been diagnosed early. I asked her if she had ever done a pap smear, her response, “what is sperm smear?”. I later explained what the procedure was and the benefits of getting the test done. She has since completed her treatment and is disease free.

Another lady came to the office she was 27 years of age, had never had a child, and had just completed her degree in business at one of the Universities in Nairobi. She had been having lower abdominal pain and heavier than normal menses with a persistent discharge for a period of two months. She also was attending the Comprehensive Care Clinic (CCC) because she was on anti retroviral drugs since she was 19 years of age. She had heard of a pap smear but had never had the test done. After running tests on her we confirmed she had cancer of the cervix and due to the presence of H.I.V the cancer was in Stage 3 and rapidly progressing. She went through her treatment despite having recurrent infections but she developed a fistula as a side effect of the Radiotherapy treatment. She is currently on follow up in the clinic but the fistula has not yet been repaired.

These are just two of the many women I interact with every day, they willingly share their most intimate details on how many sexual partners they have had, how many times they have had bleeding after coitus, the shame of having to sit in public transport smelling of urine, the sorrow of being shunned by their husbands or family because of this illness. These women also act as a beacon of hope that if we can spread the word, get the society talking about the illness, mobilise our women to test and our men to remind, console and not stigmatise our women, our policy makers to put structures in place for screening not just for cervical cancer but for all cancers and I to do my part in disseminating information, testing and treating the men and women, we will all have contributed a part in stopping this disease.

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