In a world that is not short of inventing fear – terrorism, nuclear threats and environmental catastrophes – cancer occupies a space of its own judging by the extent of dread it instils.
For Kenya, the disease has become a deep-reaching metaphor -for failure. Statements like the cancer of corruption or the cancer of ethnicity are common.
The government has done very little to curb the killer’s tentacles.
A country that is 50 years old managed to institute its first five-year National Cancer Control Strategy – in 2011. The strategy recognises that the country is ill-prepared to fight cancer. It expressly agrees that “research wasn’t commensurate with the magnitude of cancer” prevalent in the country.
According to the Kenya Cancer Network the country only has four radiation centres (all of them in Nairobi) and four treatment facilities.
The human resource capacity is equally limited, with four radiation oncologists, six medical oncologists, four paediatric oncologists, five radiation therapy technologists, three oncology nurses and two medical physicists.
In the general public psyche, cancer is a lifestyle disease that can be prevented with healthy living. According to the Kenya Cancer Control Strategy (2011-2016) the “Primary prevention of cancer involves eliminating/ minimising exposure to the risk factor incriminated in its causality”.
For the people of Kargi and Kalacha in Marsabit County the solution lies in “protection against exposure to environmental carcinogens”. It has been shown in reports that the water in the area has chemical concentrations that are higher than safe levels.
In the same region water sustains lives and the economy. Asking the residents to stop drinking well water- is like asking them to choose another kind of death.
Marsabit, where hamlets like Kargi and Kalacha are located, is bigger than some states in landmass, and is the second-largest county in Kenya. But that hasn’t served it well. It is a politically and historically alienated place where nothing “good”, according to the Kenyan state, ever seems to emerge.
It is supposedly a wasteland. In the past five years the Kenyan state has begun looking to the north as a bargaining chip in engagements with the global donor and investor communities.
The story of mega investments in Marsabit is separate in trajectory from the violent neglect that the place wallows in.
Safia, my younger sister’s friend, used to pass by our home every day on her way to school. Their friendship was exhilarating. It went further: Safia’s parents were friends with my mum.
Then suddenly Safia stopped passing by. Concerned, I asked my sister about Safia’s whereabouts, and she said, “You know she’s sick”
My sister then told me the story of how her friend had been taking TB medication in school, hiding it from classmates. A growth in her neck had been diagnosed at Marsabit General Hospital as tuberculosis. The growth in her throat felt like tonsillitis but much harder and persistent.
Even after completing her TB medication, the growth and resultant pain wasn’t going away. An alarmed mother took her to Murugu Hospital in Meru where the doctors told her it was a case of tonsillitis that could be removed through a simple surgery.
They operated on her and unlike a tonsillitis the lump in her throat bled. The doctors stitched her up and that was it. She returned to Marsabit and after some more time her mother took her to Kijabe Hospital then to Nairobi where it was finally diagnosed as cancer.
A doctor in Marsabit told me that cancer mimics other pulmonary infections and that they treated patients for simple infections like flu and monitored the patient’s response to medication.
Theirs is a trial and error mechanism. Just like Safia ,many were victims of an agonising error, forced to take TB medication as their responses were monitored.
Immediately after the correct diagnosis life changed for Safia, as she now had to stay out of school. Her parents exhausted all their savings, health insurance and appealed to family and friends for chemo costs.
She bore her suffering in private.
There are no reliable statistics on the exact number of people who have died from cancer in the region because there isn’t any systematic data collection mechanism in place. The true magnitude of the cancer menace is therefore unknown.
Conservative estimates have it that at least one or two people died every week from cancer in the Chalbi area and its environs in the past two decades or so.
This means a high level of mortality from the disease. The reporting of the cases and discussions surrounding the epidemic have, however, been at best erratic with no consistent follow-ups both by the media and government agencies.
On the eve of Mashujaa day in 2015 a stunned country watched a people and place ravaged by cancer through a KTN documentary titled “Desert of death”. It was shocking. It showed sad images, including those of a defaced woman and a child with a distended belly who we were told died some months after the interview. This was followed up by a newspaper article titled “Manyattas of Death”.
That night and the next day the top trending social media tag in Kenya was #DesertofDeath. Kenyans asked questions and expressed their frustrations.
There was nothing new in this. It was an all-too-familiar narrative. The images bore the hallmark of northern Kenya tragedies. The documentary followed a familiar arc-; reinforcing an image of famine, animal carcasses, wars and massacres.
The silent violence could not be delinked from the North’s other miseries. Cancer was portrayed as a continuum of sorts – a landscape from which such calamity was expected.
In this ad hoc response lies something more insidious and historically linked to the overarching narrative that further reduces taking the matter beyond news coverage and reports on shelves to actual policy decisions.
The short-lived public outcry marked the beginning of the conversation and the end of it. Nothing came out of the thousands of tweets calling on the government to act on the cancer issue.
That is how the conversation was structured; to self-consume. The paucity in the debate is a deliberate machination.
The obsession with the notion that Amoco Kenya Ltd- and their oil exploration in the 1980s or the “burial” of nuclear wastes is the cause is choosing an easy exit.
The Kenyan government seems to realise that to own up and claim responsibility for its neglect is to open the Pandora’s Box that it would rather it remained sealed and hidden.
For the Kenyan masses in their collective amnesia, every #November comes with its flurry of activities akin to a festival. Pink ribbons and #NoShaveNovember hashtags become trendy. But the media-friendly and “exciting” pink ribbon movement shortly passes, eliciting little honest conversations, while oversimplifying the problem.
And if you walked among the villages of Chalbi and Kargi in Marsabit you saw how all these was shadow boxing, a little sideshow outside the main arena. For a month meant to create awareness on cancer, November didn’t speak to the people of Marsabit.
My friend says cancer in our region seems to be accelerated; today you hear so and so has cancer and in less than three months they are gone. He tells me people don’t even go to hospital any more. Relatives start crying the moment you are diagnosed with cancer. Funeral plans start early as you waste away waiting for a sure death.
Arrangements are made for burial goats to be brought closer home from the foras (satellite camps) and burial clothes are bought.
In his State of the Nation address on March 15, 2017 President Uhuru Kenyatta kept repeating how “we have kept that promise” in different sectors.
I watched in disbelief, knowing that with respect to cancer in Marsabit County no promise has been kept.
I wished that the Kenyan president could show the same enthusiasm to the cancer problem as he does granting concessions and licences for oil exploration, and issuing titles for large tracts of land to wind farms.
In the land that Kenya now sees opportunity, peddled as “New frontier of development” the larger horror was the trust that no longer existed between man and his dwelling, where once spirituality connected the people to the land now that bond is uncertain and broken.
The writer is a Soial Commentator based in Marsabit