Mulago

Today I joined a group of women from Seattle looking to develop connection with cultural workers here. Today they were touring the cancer ward at Mulago and one of the women was hoping to connect the community outreach people with theater makers in the hopes that theater could be used as a tool to sensitive people to cancer and spread information about diagnosis and treatment.

Mulago is the largest hospital in Uganda doing amazing things with limited resources. Challenges include: people are not familiar cancer, so they often come late to hospital. When they do come, they often need good time to raise the funds for medication. There is a program to give people free cancer drugs, but often there is enough for only 5% of the patients. The hospital will have some drugs and not others and it will be on the families to buy that drug independently. Or people have enough money to pay for 3 rounds of treatment, but they need 6. By the time people are ready and willing for treatment, they are often in stage 4 cancer.

I thought cancer treatment was brutal, but cancer untreated appears to be a rough way to go. One woman with breast cancer offered to show us her breast. These kinds of offering of witness amaze me. Hair like fire. Two grown daughters in light green dresses tend her on the bed. She smiles with her whole face, taking careful time to greet visitors. Her breast eaten pink. Eyes smiling open.

Most of the care in this room is palliative. People usually stay one or two weeks.

Outside, it rains. Air through the open glass slats smells cold and clever.

The hospital has better success rate with lymphona, Burkitts. A cancer that strikes children here peak age 7. A mother pours milk through a tube in her son's nose. Asleep on a tiny bed with a yellow t-shirt written on "children are the future". This one, if detected early, has about an 80% success rate.

But it's difficult to track the success here because there is no real way to follow up with patients after they leave. If they are cured, we never hear from them again. If they pass on, we never hear from them again. There is some initial planning for a program that can track patients through text messages since most people here have a cell phone, or know someone who does.

The two buildings are relatively clean and well kept. Apparently, a legislator in the federal government had advanced lung cancer and had to get chemo at Mulago. He complained to Parliament that the ward had cockroaches and even rats and so the government invested money to start a cancer center. Growing numbers of oncologists. Growing numbers of partnerships with US institutions (mammogram buses parked outside from Yale New Haven and Dana Farber). It's a big project - making cancer publicly visible and building the infrastructure to treat it. A lot to accomplish with fitful funding, but moving forward.

I learned a small program offers patients or family members of patients the ability to sew dresses and other clothes for sale, since they are often leaving jobs in their villages to come here to Mulago.

Every Friday, they offer a free clinic for women to come and screen for breast and cervical cancer. I am coming back this Friday to learn more about developing a small outreach theater project with survivors.