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Pink October: what are the challenges of treating cancer in Mali?

During the Pink October campaign, MSF and its many partners screened more than 5,000 women in Bamako for breast and cervical cancer.

Alice Authier, MSF’s oncology project coordinator in Mali, spells out the challenges of screening and treating cancer in the country. In 2018, MSF’s teams joined forces with Mali’s Ministry of Health to assist patients suffering from breast and cervical cancer.

During the Pink October campaign, MSF and its many partners screened more than 5,000 women in Bamako for breast and cervical cancer. What kind of support are our teams able to provide?

Our aim has been to develop a project with the Malian authorities to ensure all women with suspected breast or cervical cancer have access to screening, diagnosis and treatment. Early diagnosis, particularly in the case of breast cancer, is essential to improving chances of survival and ensuring speedy access to treatment. This is the message repeated over and over by all the associations, health workers and volunteers who participated in Pink October in Bamako.

We organise information campaigns, donate equipment like biopsy forceps and provide technical assistance to midwives and nurses in Bamako’s health centres. We also cover the cost of mammograms, additional examinations, medical imaging and follow-up of patients while they’re on treatment.

All samples and specimens are sent to Point G Hospital’s anatomopathology laboratory [examination of abnormal changes in cells and tissues], the country’s only publicly funded laboratory with the facilities required to diagnose cancer. We helped to refurbish and equip the laboratory and continue our work there to ensure diagnoses are accurate and rapid. Depending on the results, we offer patients specific therapies.

Bintou Soumbounou, performed the song "N'ayons plus peur", written for the Pink October campagin, at the opening ceremony of the Pink October campaign in Yirimadio health centre, Bamako. [Ⓒ MSF/Mohamed Dayfour ]

What are these therapies and what packages of care are available to patients?

There are three therapies which, depending on the stage of the cancer, can be either used together or separately. These are surgery, chemotherapy and radiotherapy. A joint MSF and Ministry of Health medical team provide chemotherapy sessions in Point G Hospital’s oncology and haematology department. In 2020, there were a total of 3,000 sessions. We have also refurbished a room for preparing chemotherapy to improve safety standards. And, when the government runs short of drugs, we supply them so that patients have access to free treatment. We also pay for our patients to have surgery in Point G and Gabriel Touré hospitals as it’s essential they’re able to initiate treatment as quickly as possible. Beating the disease is a race against time.

Radiotherapy, which is often used to treat breast and cervical cancer, is available in Mali Hospital. The hospital has Mali’s only radiotherapy machine, and as the country has a population of over 20 million, it isn’t enough to treat all patients. Waiting times can be long and breakdowns are common. It should also be pointed out that radiotherapy can’t be interrupted because the effects can be more harmful than if the patient had never started it.

Diawara Fatouma Dicko, from the Yirimadio health centre, in a consultation with a patient.  [Ⓒ MSF/Mohamed Dayfour ]

What are the next steps for the oncology project in Mali?

Palliative care, pain management, psychological and social support, care of malignant wounds – including in the home – continue to be an important part of our work with our patients.

We plan to do even more to inform women and their families of the importance of getting screened and the different treatment options available to them. We also need to increase systematic breast and cervical cancer screening in routine medical consultations. We now want to go farther afield than Bamako and set up similar activities in other of the country’s regions.

Building multidisciplinary cancer care with Mali’s health authorities, associations and civil society and facilitating patients' access to treatment pathways, radiotherapy in particular, are set to be the priority for the next few years.

As part of the project, 166 women were diagnosed with breast cancer and 126 with cervical cancer between January and June 2021. Since the beginning of the year, MSF’s teams have provided over 1,110 patients with support and palliative care. Services include home visits, psychological and social support for patients and their families and mental health consultations.

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