Blog de Dr Mateus Sahani

RAPPORT DE SENSIBILISATION SUR LA PREVENTION DU CANCER DU COL UTERIN: AU CENTRE DE SANTE VIRUNGA

2011-07-07T02:55:00.000-07:00

Rapport de formation et workshop sur la prévention du cancer du col utérin: diagnostique et traitement des lésions précancéreuses. Contexte Au mois de Janvier 2011, AGIR ENSEMBLE a organisé une formation et un workshop a l’intention des médecins et infirmiers de la ville de Goma avec l’appui financier de l’UICC. Ces activités ont porté sur la prévention du cancer du col utérin: Diagnostic et traitement des lésions précancéreuses. Mais jusque la, nous n’avons pas la machine de cryothérapie, ce qui constitue un obstacle pour la mise en œuvre effective du programme de screening dans nos hôpitaux. Justification Le cancer est devenu la grande priorité de santé publique et tue plus que le HIV, Tuberculose et malaria mis ensemble. Il a été établi qu’il y a 28 millions des personnes atteintes du cancer dans le monde avec une prévalence de 12 millions chaque année et une mortalité de 8 millions chaque année. Le cancer du col de l’utérus vient en 2e position dans le monde en ce qui concerne la mortalité et en 1ere position dans le pays en voie de développement. Il a été démontré que le cancer du col utérin peut être prévenu à 100% avec des moyens très simples: screening, traitement et vaccin anti-HPV. Objectifs 1. Former 8 professionnels de santé (4 médecins et 4 infirmiers) en dépistage et traitement des lésions précancéreuses. 2. Tenir un «workshop» de 2 jours pour former 28 professionnels de santé en matière de screening et traitement des lésions précancéreuses pour la sensibilisation continue des mamans lors des séances de CPN et de vaccination. Résultats atteints A. Formation de 2 jours: 8 professionnels de santé ont été formés avec succès sur la matière susmentionnée dont 3 médecins et 5 infirmiers: Tous les participants ont réussi le post-test avec plus de 76% et tous ont signé le feuillet d’engagement pour la lutte continue contre le cancer comme une grande priorité de santé publique. Indicateur1: 3 médecins formés/4 attendus= 75% Indicateur2: 5 infirmiers formés/4 attendus=125% En bref, l’objectif a été atteint à 100% : 75+125 divisée par 2= 100% A l’issue de cette formation 8 professionnels de santé de la ville de Goma sont maintenant compétents à réaliser le dépistage pour le cancer du col utérin et livrer le service aux mamans pour prévenir à 100% le cancer du col de l’utérus. Un module de formation est disponible comme livre de référence pour les professionnels de santé. Il est vrai qu’il s’agit d’une nouvelle matière pour les professionnels de santé congolais et ce document va être une bonne source d’information pour le développement des capacités. B. Un workshop de 2 jours s’est tenu comme prévu et 25 professionnels de santé ont participé activement à ce workshop dont 5 médecins et 20 infirmiers. Tous les participants ont été actifs dans les travaux en groupes et tous ont signé le feuillet d’engagement pour la lutte continue contre le cancer comme une grande priorité de santé publique. Indicateur 1: 25 participants/28 attendus= 89.3% Indicateur 2: 25 personnes ont participé activement à l’adoption du guide/ 25 attendus = 100%. A l’issue du workshop, un guide du sensibilisateur vient d’être adopté et mis à la disposition des institutions de santé pour usage dans la sensibilisation continue des mamans pour qu’elles demandent le service de screening aux professionnels de santé. Cela permettra la disponibilité du service de screening et le plaidoyer pour la disponibilité du service de traitement (achat de machine de cryothérapie). Tous les participants ont reçu chacun une copie du guide. Pour ce workshop, un rappel de quelques sujets de formation a été donné notamment sur les démarches diagnostiques des lésions précancéreuses, le traitement par cryothérapie, l’épidémiologie et l’histoire naturelle du cancer du col utérin. Ce rappel consiste à la mise en niveau des participants du workshop qui n’ont pas suivi la formation. Ainsi donc tous les participants à ce workshop sont aussi capables de pratiquer le screening et le traitement des lésions précancéreuses. Les facilitateurs ont donné les orientations nécessaires pour le déroulement des travaux mais en gros les travaux se sont faits en groupes. Quatre groupes ont été formés dirigés chacun par 2 cadres qui ont suivi la première formation. Ce programme va se poursuivre avec la sensibilisation dans 3 centres de santé de la ville de Goma pour informer les mamans de l’importance du screening pour prévenir à 100% le cancer du col utérin, leur permettre de demander le service de screening et d’adhérer au programme quand il est disponible. NB: Le grand obstacle pour la mise en œuvre effective de ce programme est le manque des moyens pour le traitement des lésions précancéreuses: la machine de cryothérapie et cela doit être une matière de plaidoyer pour chacun de nous tous pour éviter aux mamans de faire de longues distances Goma-Kampala ou Goma-Kigali pour le traitement.

Fait à Goma, le 01 Février 2011 Dr Mateus KAMBALE SAHANI Directeur du Département de Santé AGIR ENSEMBLE/RDC.

Agir Ensemble comments for Civil Society Interactive Hearing for UN summit on NCDs

2011-06-09T10:57:00.000-07:00

On behalf of AGIR ENSEMBLE, a NGO based in Goma/DRC, member of UICC and FCA, I would like to share with you our views on the possible outcomes of the Summit and propose the following specific recommendations to be incorporated in the final Outcomes Document that will be endorsed by UN member states at the High-level Meeting on NCDs. Our organisation has been extensively involved in cancers and tobacco controls. From our own experience, we believe that civil society has been instrumental in promoting strong cancer and tobacco control measures, overseeing their implementation, and fostering public support for governments’ cancers and tobacco control policies. Yet more needs to be done. More than 8 million people die each year by cancer and 6 million annually due to global tobacco use and WHO-GLOBOCAN data base shows that cancer is the leading cause of mortality in developing country including DRC and cervical cancer takes the first place. Cervical cancer is 100% avoidable but it continues to kills women in developing countries; so programs of screening and vaccination against HPV must be implemented in all countries to avoid these avoidable deaths. Tobacco use is the only risk factor common to the four major groups of NCDs. As a result, implementing the tobacco control measures specified in the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) – which has more than 170 Parties representing 87% of the world’s population – is one of the best ways to tackle NCDs. The UN Secretary-General Report on NCDs reaffirms the effectiveness and efficiency of the key interventions in the WHO FCTC. We would like to strongly encourage all UN member states to adopt an outcomes document that reflects positions adopted by the civil society movement - the NCD Alliance - and specifically: · Calls on countries that have not yet done so, to ratify the FCTC. Key tobacco control interventions of the WHO FCTC are not only highly cost-effective but also cheap, feasible and culturally acceptable to implement. · Commits member states to ensure that their government cooperates actively to accelerate the implementation of the strategies to control and treat NCDs. · Sets a short-term global target for prevalence of NCDs and tobacco use that is both ambitious and achievable and calls on all governments to set national/regional targets which should be revised regularly. Monitoring trends and progress is essential to ensuring that commitments are honoured. · Calls on all governments to integrate NCDs in all relevant national plans for health, development and poverty reduction, and strongly encourages global investment in some key strategies to reduce prevalence and incidence of NCDs like FCTC implementation, screening for cervical cancer, vaccination programs for HPV and HBV including technical and financial assistance and scientific research. · Calls on all governments to recognise the importance of NCDs and all risk factors to the achievement of the Millennium Development Goals (MDGs), integrate FCTC implementation, screening for cancer, vaccination programs for HPV and HBV into development assistance programmes and the planning processes of UN, bilateral and multilateral development agencies. NCDs are a growing threat even in the poorest countries in the world, with socioeconomic impacts that threaten the attainment of the MDGs. Full-scale action on NCDs and the development of global and national targets and indicators are crucial steps to prevent the NCD epidemic from becoming a severe health emergency. Best regards, Mateus Kambale Sahani, M.D.

AGIR ENSEMBLE/DRC

WHO NCDs Consultation meeting-Brazzaville

2011-05-24T07:58:00.000-07:00

Dear all, We have been in Brazzaville for the consultation meeting and the voice of cancer has been head. We have insisted that HPV, HBV and vaccines to be included in the outcome document, NCDs to be included in future MDGs and our position has been taken in consideration. More information will be found in the meeting report that I have a hard copy and I’ll order an electronic copy that I’ll send to you (It is a big copy of 32 pages). Specifically for Africa, other main health issues have been added in the declaration: mental health, violence and injuries. I think that at this stage, we have gained a sufficient success but many things remain to be done. As all NCDs are together in the same program, I have fear that the program of cancer has to be forgotten in the national level as many policy makers and stakeholders don’t know more about cancer. The next step will be Moscow meeting for all ministers of the world. I would like you to be present at this meeting to make sure that something important didn’t be omitted from the document and finally in New York for the summit. UICC is a big institution with more than 300 member organizations in more than 100 countries; I think that at this stage missing UICC representative offices (Africa, Asia, Europe, Latine America, etc.) is a weakness for the UICC as a union. I get accommodation at Royal Hotel which doesn’t have a restaurant and I could find my breakfast and diner outside the hotel, arrival on April 3, 2011 at 12H20 and departure April 7, 2011 at 10H30. I have sent you also, in attachment, the reimbursement form and I would like you to take 500$ US for AGIR ENSEMBLE membership dues payment for 2011 year and send the difference. I have sent you also some photos of the event, other photos will be sent after. Thank you and best regards, Dr Mateus Kambale Sahani Agir Ensemble/DRC.

Agir Ensemble will be implenting new program for cervical cancer prevention

2010-12-14T03:54:00.000-08:00

AGIR ENSEMBLE, in its efforts to prevent cancer, will be implementing a new program for cervical cancer prevention. It is a campaign for cervical cancer prevention during 6 months from January 2011 which includes a training of doctors and nurses in cervical cancer screening. This program is financially supported by UICC Cancer Campaign. Thank you. Dr Sahani.

Capacity Building Workshop Training of UICC in Cape Town

2010-12-14T03:45:00.000-08:00

A workshop training in cancer prevention including social marketing for Tobacco control has been held by UICC in Cape Town/South Africa in March 2010. AGIR ENSEMBLE has been represented as a member of UICC by Dr Mateus Kambale Sahani. Thank you, Dr Sahani

Capacity of health professionals in cervical cancer screening in Goma/DRC M. Kambale Sahani1,2, M.M. Mutumwa3, P.K. Mukama4

2010-12-14T02:15:00.000-08:00

Capacity of health professionals in cervical cancer screening in Goma/DRC M. Kambale Sahani1,2, M.M. Mutumwa3, P.K. Mukama4 1Health Department, AGIR ENSEMBLE, 2Virunga General Hospital-GOMA, 3Clinic Chaine de l'Espoire-GOMA, 4Centre Medical Belle vue, GOMA, The Democratic Republic of the Congo Overview Cancer is now the leading cause of death worldwide, 28 million of people live with cancer in the world and 8 million die each year by the disease. In DRC, cancer killed approximately 33,000 people in 2005 and cervical cancer was the killer no 1 among women and prostate cancer among men. If nothing is done now, this figure will reach 65,000 in 2030. Source: WHO infobase In DRC no woman has access to cervical cancer screening in all the life (service not available in all the country, a country of more than 70,000,000 people). Objectives This research project aims to know the degree of understanding and competency of health professionals (doctors and nurses) in screening methods (VIA and VILI) to make sure that the screening can be initiated without any difficulty in the city of Goma and, if there are difficulties, how they can be solved to this services being accessible to people. To measure also their capacity of using cryotherapy for treatment of precancerous lesions. Method We used the STEPS Method of the WHO, especially Step 1 using questionnaire and interview of 50 doctors (general practitioners) and 500 nurses in the city of Goma. Sample was constituted from all public and private hospitals and health centers of the city. We used comparative statistic test among people who know the method and those who don’t know it. Hypothesis Our study was focused on the following hypothesis: - Health professionals know well the usage of VIA and VILI methods, - Health professionals usually educate their patients on prevention of cervical cancer, - Health professionals know how to use cryotherapy to treat precancerous lesions. Results At the end of our study, we found that: 1. 85% of doctors (43) never understand about VIA and VILI methods and 98% of nurses (490) are too. 2. 10% of doctors (5) have understood about the methods but don’t know how to proceed and 1% of nurses (5) are too. 3. 5% of doctors (3) know the substances used for VIA and for VILI but don’t know how they are used and 1% of nurses (5) are too. 4. 10% of doctors (5) give an education message to their patients (avoid genital infections) and 2% of nurses (10) do too. 5. 10% of doctors (5) are aware of HVP vaccine to prevent cervical cancer and no nurses (0) know that. 6. No health professional (doctors or nurses) knows that precancerous lesions can be treated and no one knows how to use cryotherapy. 7. No health professional (doctors or nurses) has participated in a campaign for cervical cancer prevention. 8. No health institution in Goma has a screening service. Conclusions Health professionals in the city of Goma don’t have sufficient skills in cervical cancer screening and HPV vaccine. This constitutes a need for training in this area and it is also a big challenge to the availability of the service.

Raising Awareness Session in Goma/DRC

2010-05-27T08:10:00.000-07:00

1. Introduction On April 24th, 2010, AGIR ENSEMBLE has organized a Raising Awareness Session (RAS) on tobacco control for youth in the church community (CBCA KESHERO) in the city of Goma. We had planned to join together 50 young people of the community church and inform them that tobacco is dangerous for their health and explain them the strategies used by the industry to grow its clients. This session took place normally as expected and got the audience of 59 young people joining the meeting. The duration of the event was 2 hours from 2:00 pm to 4:00 pm. 2. Objective of the session AGIR ENSEMBLE, in its commitment of spreading information which can save lives and maintain the health of population in the community, settled following objectives for this session: - Bring together a group of 50 young people from KESHERO CBCA community church, who can receive the message that tobacco is a global priority of public health, - To teach to the group how to protect himself and to protect others against tobacco smoking, the reason of not begin smoking and at the end of the session at least 95 % of participants will know correctly the importance of not to begin smoking. 3. Context of organization Considering the financial difficulty, the event was held in the worship hall of KESHERO CBCA CHURCH from 2:00 pm till 4:00 pm. The event has been attended by 59 persons among whom 38 females and 21 males. We didn’t find possibility to make T-SHIRTS for participants. 4. Progress of the event The event took place around the subject: "Tobacco and youth", the role of youth in tackling tobacco usage. The moderator of the session was Mr. Alphonse KAVWIRWA, president of the Board of AGIR ENSEMBLE and the speaker was Dr Mateus KAMBALE SAHANI, the director of the Health Department of AGIR ENSEMBLE. The session began with the allocution of the president of AGIR ENSEMBLE, Mr. Alphonse KAVWIRWA who welcomed all participants to the session of the day and presented the missions of AGIR ENSEMBLE. Then Dr Mateus SAHANI began explaining the background of the event and presented the relevance of acting against tobacco. “Most importantly, our collective voice must show our commitment to fight tobacco in our community and worldwide and it must be a global priority for the public health” he said. After this, the speaker began the session “Tobacco and Youth, the role of young people in the fight against tobacco” in which he gave the place held by tobacco as a big public health threat. “Tobacco is the first Risk factor of cancer and kills each year 5.4 million people worldwide and cancer is becoming the leading cause of death worldwide. We know that cancer kills 8 million people each year and if nothing is done by now cancer will kill 12 million of people. Every one may act by now if you want to save the 28 million of people living with cancer in the world and if you want to address the cancer burden worldwide. The voice of each one is needed for the fight”, he said. Then some questions were asked and answered by the speaker. All participants were interested by the session of the day and 15 questions have been received. Almost all questions were well answered. After this a cocktail was offered to participants. 5. Participants In total 59 people attended the meeting among whom 38 females and 21 males and were interested by the theme of the day. 6. Evaluation of the session. We expected 50 people for the meeting and brought together 59. This objective was reached in 118%. The second objective was reached in 90%. In all our performance was 104%. The main barriers for us to reach our maximum of goals were the background of the organization of the event, and missing financial support and we didn’t be able to organize transport for participants. 7. Questions and recommendations Some pertinent Questions - What is the importance of tobacco for community and for smokers? - If tobacco kills 5.4 million of people each year, why is it allowed to be selled? - Are governments aware that tobacco kills people and cause diseases? What are they doing to protect people? - What can be our attitude as young people towards our parents who smoke? - What is the good strategy we can use to sensitizer our parents who smoke? - What can be the attitude of a wife towards her husband who is smoking? - Why industry targets young for its activities? Recommendations At the end of the event, participants have recommended: - To organize multiple sessions like this one to allow spreading the message that can save lives of population. - To choose a place and a moment which allow more people to attend the event for the next time. - Such events need financial support for a real success: media campaigns, advocacy with politicians, etc. Can LAF help us? 8. Conclusions Generally the activities of the planned were well realized and it was a real success even if there were some difficulties. All was done as planed and our objectives were reached. Participants were satisfied by the event and the message was new for almost 97% of them. They recommend us to them more information and strategies to allow them to sensitizer their parents who are smoking and they ask us to give them some posters to be used in their living rooms. Goma, April 24th, 2010. Dr Mateus KAMBALE SAHANI AGIR ENSEMBLE/DRC

World Cancer day, 4 February 2010 in Goma

2010-02-20T22:44:00.000-08:00

AGIR ENSEMBLE has organized a public debate on cancer focusing on the campaign slogan: “cancer can be prevented too”. The target people were teachers of Visoke institute. The event took place in one of the classrooms of the school (Visoke Institute) on February 4th, 2010 directly after courses from 12:45 – 16:00. The official langage of the event was French. The event has begun with presentation of participants and a little presentation on mission of AGIR ENSEMBLE. The moderator was Mr Paul and was in charge of taking picture. The speaker was Dr Mateus Kambale Sahani (in yellow T-SHIRT). After presentation, the speaker begun with the topic: “Cancer, a global priority” and after he continued by giving the key messages of the campaign through the topic: “Cancer can be prevented too”. The speaker has insisted on some simple measures to prevent cancer and this was received by participants as good news because all of them didn’t know that it could be possible to prevent cancer. Then, the moderator opened the debate and 15 questions have been received and all found responses. At the end, Dr Mateus gave the press release, key messages and the Diary notes to the headmaster of the school (Visoke institute). After this, some recommendations were given by participants: 1. for next time, to invite more people and look for a common moment and sufficient time to allow people to understand better the matter of cancer, screening for cervical cancer, breast cancer, tobacco control, etc. 2. the headmaster has asked to AGIR ENSEMBLE to do more sessions of raising awareness for their pupils and said that they need more posters for their classrooms and the public room of teachers. Some key outcomes: At the end of the day activities: 1. All participants have understood and convinced that cancer can be prevented too (this was the first time for them to understand that cancer is also preventable), 2. All participants have made commitment to sign the world cancer declaration, 3. All participants have made commitment to spread this message to their pupils but they need some materials as posters and some modules.

World Cancer day, 4 February 2010: Call for support

2010-01-31T13:04:00.000-08:00

In a few day, it will be the world cancer day celebrated on February 4th,led by UICC an international NGO with more than 300 member organizations in more than 100 countries. We need support from every one worldwide to address cancer mater. Cancer is becoming the leading cause of deaths worldwide and the action of each one is needed. You can help us tackling this problem by signing the world cancer declaration on the UICC website at www.uicc.org. Thank you, Dr Mateus Kambale Sahani AGIR ENSEMBLE/UICC-DRC

World Cancer day, 4 February 2010: Press release

2010-01-31T13:00:00.001-08:00

Address: AGIR ENSEMBLE, Avenue LUSAKA, Commune de Goma Q. KESHERO, GOMA/RDC Date: Le 30/01/2010. Request for your support for World Cancer Day 2010 Dear Sir(s)/Madam(s) On behalf of AGIR ENSEMBLE, NGO OF DRC, I would like to ask for your support of World Cancer Day 2010 which takes place on 4th February and is led by the International Union Against Cancer, the leading international NGO which unites 300 member organizations in more than 100 countries including AGIR ENSEMBLE in the global fight against cancer through the implementation of the World Cancer Declaration. By working together our goal is to eliminate cancer as a life-threatening disease for future generations. This is an ambitious target as globally one in eight deaths are due to cancer. If no action is taken, the worldwide burden is projected to reach 26 million new cancers in the year 2030 and 17 million deaths with the most rapid increases occurring in those countries lease prepared to deal with them. Approximately 40% of cancers are potentially preventable and the good news is that we now have more knowledge than ever on how to bring cancer under control. Under the slogan “Cancer can be prevented too”, the 2010 World Cancer Day campaign will focus on how the risk of developing cancers related to tobacco use, heavy alcohol consumption, excessive sun exposure and obesity can be significantly reduced by avoiding these risk factors and encouraging healthy behaviour such as regular exercise and eating healthily. In this light, we would be very grateful for your support for this year’s campaign. This could be by taking part in a photocall or public event that we are organizing, by signing the World Cancer Declaration (see www.uicc.org), by putting your name to a quote that we use in media materials, or in any other way that you’d like to discuss. Example quotes that could be tailored and attributed to you in World Cancer Day 2010 media materials: “I know that one third of all cancers can be prevented through simple steps. I am reducing my risk and my family’s risk by not smoking”. “I know that regular exercise and eating healthily reduces my risk of developing cancer.” “I know that one third of all cancers can be prevented through simple steps. My young daughter has been vaccinated against HPV”. We very much hope you will support us and look forward to hearing from you. Yours sincerely, Dr Mateus KAMBALE SAHANI AGIR ENSEMBLE/UICC-DRC

World Cancer day, 4 February 2010: key messages

2010-01-31T12:57:00.000-08:00

WORLD CANCER DAY 2010 KEY MESSAGES FOR MEDIA MATERIALS AND SPOKESPEOPLE Message one (painting the picture) Each year, 12 million people receive a cancer diagnosis and 7.6 million people die of cancer. If no action is taken, the worldwide cancer burden is projected to reach 26 million[1] new diagnoses in the year 2030 and 17 million[2] deaths, with the most rapid increases occurring in low- and middle-income countries. Message two (insight and umbrella message) The good news is that experts estimate that approximately 40% of cancers are potentially preventable. You can significantly reduce the risk of you or your family developing cancers related to tobacco use, heavy alcohol consumption, excessive sun exposure and obesity by avoiding these risk factors and encouraging healthy behaviour such as regular exercise and eating healthily. Message three (preventing cancers caused by infections - the focus for World Cancer Day 2010) In addition, some cancers such as cervical, liver and stomach cancers are known to be caused by chronic infections. Prevention of these infections is possible through interventions such as vaccination, antibiotics, improved sanitation and learning simple avoidance strategies. Message four (the vehicle) World Cancer Day, under the campaign slogan “Cancer can be prevented too”, is led by the International Union Against Cancer (UICC), the leading international NGO which unites over 300 member organisations in more than 100 countries in the global fight against cancer through the implementation of the World Cancer Declaration. Support World Cancer Day 2010 - February 4th. Visit www.uicc.org

World Cancer day, 4 February 2010: diarry note

2010-01-31T12:54:00.000-08:00

DIARY NOTICE FOR FORWARD PLANNING DESKS WORLD CANCER DAY – 4th FEBRUARY 2010 Each year, 12 million people are diagnosed with cancer and 7.6 million people die of cancer. If no action is taken, the worldwide cancer burden is projected to reach 26 million new diagnoses by 2030 and 17 million deaths, with the most rapid increases occurring in low- and middle-income countries. The good news is that approximately 40% of cancers are potentially preventable. The risk of developing cancers related to tobacco use, heavy alcohol consumption, excessive sun exposure and obesity can be significantly reduced by avoiding these risk factors and encouraging healthy behaviour, such as regular exercise and eating healthily. World Cancer Day, under the campaign slogan “Cancer can be prevented too”, is led by the International Union Against Cancer (UICC), the leading international NGO which unites over 300 member organisations in more than 100 countries in the global fight against cancer through the implementation of the World Cancer Declaration. Launched on World Cancer Day the 2010 report will focus on preventing cancers caused by persistent viral and bacterial infections through measures such as vaccination, antibiotics, improved sanitation and learning simple avoidance strategies. Activities run by International Union Against Cancer members for World Cancer Day will include educational events, walks, runs, public talks, scientific forums, exhibitions, concerts, sporting events and much more. Support World Cancer Day - February 4th. Visit www.uicc.org. For information on activities planned on World Cancer Day by UICC members in your country, please contact Aline Ingwersen: Direct line: +41 22 809 1811 Mobile: +41 79 568 5070 Email: ingwersen@uicc.org Press contact: Sophie Laird, Cohn & Wolfe Public Relations Tel: +41 22 908 40 73 / email: Sophie.laird@cohnwolfe.com

LIVESTRONG DAY IN GOMA/DRC, October 2, 2009

2009-11-08T06:42:00.000-08:00

1. Introduction On October 2nd, 2009, AGIR ENSEMBLE, planned to organize a Raising Awareness Session (RAS) on cancer with a group of 15 couples in the city of Goma. At first, we had planned a scientific debate with doctors and nurses of the city of Goma, but considering the not availability of doctors for a working day (Friday), we saw have changed the target of our meeting. So we invited 15 couples of parents to attend the meeting this to mean a total of 30 persons among whom 15 men and 15 women. This session took place normally as expected supporting the activities of Lance Armstrong foundation the day of anniversary of the diagnosis of Lance Armstrong and the month of raising awareness on the breast cancer, the month of October. The duration of the event was 3 hours from 1:00 pm to 4:00 pm. 2. Objective of the session On October 2 of every year is a historic date for LAF and for Lance Armstrong and finally for the whole world generally. October is also a month of raising awareness on breast cancer. So AGIR ENSEMBLE wanted to join other partners of the world acting in the FIGHT AGAINST CANCER and supporting activities of LAF to make our contribution and commitment in spreading information which can save lives and maintain the health of population in the world. For this session, AGIR ENSEMBLE settled following goals: - Bring together a group of 30 relatives (parents) gathered in 15 couples who can receive the message that the cancer is a global priority of public health, - To teach to the group how to proceed to the Breast Self Examination (BSE) for early detection and at the end of the session at least 95 % of participants will know correctly this technic and the importance of the BSE. 3. Context of organization Considering the financial difficulty, the event was held in one of the classrooms of Mont Goma Institute just after the courses from 1:00 pm till 4:20 pm. The event has been attended by 23 persons among whom 6 females and 17males. We have made T-SHIRTS (in yellow) for the participants. 4. Progress of the event The event took place around these subjects: "The cancer, a global priority ", "The Prevention of the breast cancer ", “Integrate good food customs for the prevention of the cancer ". The moderator of the session was Mr Alphonse KAVWIRWA, president of the board of AGIR ENSEMBLE and the organizing committee was composed by Mr. Paul LUGHEMBE and Mr Jonathan VALIHANO. The main speaker of the session was Dr Mateus KAMBALE SAHANI, the director of the Health Department of AGIR ENSEMBLE. The session began with the allocution of the president of AGIR ENSEMBLE, Mr Alphonse KAVWIRWA who has welcomed all participants to the session of the day and presented the missions of AGIR ENSEMBLE. Then Dr Mateus SAHANI began explaining the background of the event and presented the relevance of the LIVESTRONG Day. “October 2 is the date that Lance Armstrong got his diagnosis of cancer and he begun the battle for life and founder the Lance Armstrong Foundation. It’s a historical date celebrated by LAF and its partners worldwide. Our event is one of thousands of events around the globe. This year there are events on every continent (even Antarctica!) and in all 50 states in the U.S. LIVESTRONG Day is a day to celebrate, it is a day to educate and it is a day to advocate. But most importantly, it is the day our collective voice will show the world that cancer must be a global priority” he said. After this, the speaker began the session “Cancer, a global priority” in which he gave the place held by cancer as a big public health threat and the cancer burden worldwide. “Cancer will be soon, in some year, the leading cause of death worldwide. We know that cancer kills 7.9 million people each year and if nothing is done by now cancer will kill 11.5 million of people. Every one may act by now if you want to save the 28 million of people living with cancer in the world and if you want to address the cancer burden worldwide. The voice of each one is needed for the fight”, he said. The speaker explained also the role of bad habits in developing countries, the habits of not consulting early when people are sick. He asked to people who were listened to him to abandon these bag habits to help the world becoming “a world without cancer”. This will allows early detection and screening for cervical cancer and breast cancer. As it’s the month of October, a session on “Prevention of Breast cancer and early detection” has been developed. The speaker gave more detailed explanation of the method of Breast Self Examination (BSE), its advantages, technic and warning signs, etc. Some factors of risk for breast cancer have been given and now the speaker concluded the session by showing some pictures of sicks treated surgically for breast cancer and who developed metastasis and are taking palliative care. Then some questions were asked and answered by the speaker. All participants were interested by the sessions of the day and 20 questions have been received. Almost all questions were answered with satisfaction of the attendees except one which was: a woman with breast cancer can continue breasting the baby with sick breast? Now the speaker proceeded to an exercise of question-answer to the public to evaluate the degree of understanding of the lesson by participants especially concerning the technic of Breast Self Examination (BSE) and this was satisfactory. After this a cocktail was offered to participants and during the cocktail a module on “Healthy eating and energetic balance” was developed by Mr. Alphonse KAVWIRWA. A sery of 3 questions were asked and answered. During the session, 2 walking people passed in front of the meeting room and were also interested by our message and now the president asked them to join us in the room because the voice and action of every one are needed. See 2 gentle men in black T-SHIRTS on photos. 5. Participants In total 23 people attend the meeting among whom 6 females and 17 males and were interested by the activities of the day. 6. Evaluation of the session. We expected 30 people for the meeting and brought together 23. This objective was reached in 76.66%. The second objective was reached in 100%. In all our performance was 88.33%. The main barriers for us to reach our maximum of goals were the background of the organization of the event, the moment and missing financial support. Doctors didn’t find time to join us because of their job at hospitals and we didn’t be able to organize transport for participants. 7. Questions and recommendations Questions - What is cancer ? - What is the cause of cancer? - Is there a link between sexual course and the disease? Does exist a sexual transmission of cancer? - A woman with breast cancer can continue feeding her baby with the sick breast? Is there a transmission to child? - From when are statistics of 7.9 millions of deaths/year by cancer and 5.4 millions of deaths/year by tobacco? - A person with cancer can still alive how many years? - Where do you place hard work of teachers? Can this replace physical effort to address risk of cancer? - With physical activities, how can some one know that he is making balance between eating and spending energy? - How to get medicines of cancer in our community? - Test VIH, TB, etc. exist; is there a test for cancer? - What are symptoms of cancer? - What to do to avoid overweight for children? - What to say to a sick of cancer considering that medicines are not available in our community? - Can a man proceed to the BSE of his wife? - Can the breast feeding influence the volume of the breasts? If a child uses preferably one breast than another, this can create difference between the 2 breasts? - There is a woman without child who presents bleeding of the nipple; this can be a sign of breast cancer? - Is there a link between medical family planning and cancer? - Prostate cancer can be linked to sexual courses? - What type of cancer is more fatal than other? Recommendations At the end of the event, participants have recommended that: - It is important to organize more events like this one to allow spreading the message that can save lives. - To choose a place and a moment which allow more people to attend the event for the next time. - Organize such event for all NGO which are members of RACID Network to permit them understanding the problem. - Choose a moment for women and young girls to explain them the modes of prevention of cervical cancer and screening. - We would like that Lance Armstrong Foundation play the role of funds mobilizator to allow support of such events for a real success. 8. Conclusions Generally the activities of the day were well realized and it was a real success even if there were some difficulties. All was done as planed and our goals were reached. Participants were satisfied by the event and the message was new for almost 95% of them. They wished us to invite more people for the next occasion. Goma, October 7th, 2009. Dr Mateus KAMBALE SAHANI AGIR ENSEMBLE/DRC.

AGIR ENSEMBLE joined LIVESTRONG Global Cancer Summit to make cancer a global priority

2009-11-08T06:39:00.000-08:00

AGIR ENSEMBLE JOINED THE LIVESTRONG Global Cancer Summit to make cancer a global health priority

Summit Inspires New Resolve to Fight World Cancer Problems

28 September 2009

Dublin – AGIR ENSEMBLE/GOMA-DRC joined the Lance Armstrong Foundation (LAF) and other key international health organizations from August 24-26 at the Irish capital for the first LIVESTRONG Global Cancer Summit, designed to raise awareness and mobilize support to fight the growing global cancer crisis.

LIVESTRONG is a valuable opportunity to raise international public awareness of the cancer epidemic, especially in developing countries, and we are pleased to have taken part in this first Summit.

LIVESTRONG attracted more than 500 participants from some 65 countries around the world. They included world leaders and policymakers, NGOs, business executives, cancer professionals and advocates.

IAEA has a mission to bring more attention and resources to the global cancer fight through its Programme of Action for Cancer Therapy (PACT). PACT, a LAF partner, is the IAEA's umbrella programme for cancer control efforts in developing countries. But till there nothing has been done by IAEA in DRC, a country which has 60,000,000 people and without any program of fight against cancer.

“When people leave here, we know that change will be effected and that lives will be affected. We know that lives will be saved because of the programs that are created and dreamed up here,” said summit organizer Lance Armstrong, at the opening of LIVESTRONG.

Seven times winner of the world renowned Tour de France bicycle race and founder of LAF, Armstrong is a survivor of a severe testicular cancer, diagnosed in 1996, which later metastasized to his lungs and brain.

On the first day of the event, Werner Burkart joined a panel of experts to discuss the Global Impact of Cancer. Chaired by CNN's medical correspondent Sanjay Gupta, the panel included John Seffrin, CEO of the American Cancer Society (ACS), Christopher Wild, Director of the International Agency for Research on Cancer (IARC) and Lynn Faulds-Wood, President of the European Cancer Patient Coalition (ECPC).

The IAEA provides developing countries with technical expertise and equipment related to radiation medicine – a vital component in the treatment of cancer. The IAEA is working in partnership with the global health leader, the World Health Organization (WHO) and other international partners to bring more attention and resources to the global cancer fight. Our government must do more efforts and show its commitment for our population to benefit this technical expertise and equipment.

Speaking after the event, Burkart said: “The IAEA, after decades of experience helping developing countries cope with the burden of cancer, has been advocating for cancer to be added to the global health agenda, and ultimately become part of the Millennium Development Goals. The Summit was an important opportunity to make the case, together with our partners, on an international stage.”

A highlight of the Summit's second day was the presentation of a special report on the economics of cancer prepared by the Economist Intelligence Unit for LAF with support from the ACS. Entitled Breakaway: The global burden of cancer – challenges and opportunities, the report estimates that there will be 12.9 million new cancer cases globally this year alone, representing an immense economic burden of US$305 billion.

Commenting on the report, Dr Ala Alwan, the World Health Organization's Assistant Director-General for Non communicable Diseases and Mental Health, said: “These new data delineate a stark trajectory for cancer if immediate action is not taken. The rise of cancer creates an enormous burden on health systems around the world. But this is not just a health challenge; it undermines economic growth and acts as a chronic poverty trap for the poorest countries.”

And it is in developing countries that the cancer burden shows the steepest increase. Evidence shows that nearly half of all new cancer cases this year will be in low- and middle-income countries, and that figure is likely to increase dramatically over the next decade to as much as 75%. Yet currently only five percent of global resources for cancer are spent in the world's poorest nations.

Among the most important outcomes of the Summit were the need to make cancer a global priority, the need for greater financial investment in cancer, and the need for assessment of countries' national cancer control plans.

The main goal of our government could be the building of international partnerships with IAEA and others partners to help our country establishing healthcare systems that provide early detection and timely and effective treatment for all cancer patients everywhere in the country and to concept a National Cancer Control Plan (NCCP).

AGIR ENSEMBLE would like to alert all of conscientious leaders in DRC especially doctors and all health care professionals to put cancer on their agenda of priority because if leaders as us don’t speak about cancer, other people don’t pay attention on it.

By now it is known that 30% of cancers are preventable and 30% other are curable. We may prevent the preventable and cure the curable but this demands our commitment to act and raise awareness people and to educate policy makers to make cancer a global priority.

Thank you.

Dr Mateus K. SAHANI, AGIR ENSEMBLE.

Breast cancer awareness month at Goma

2008-11-08T05:26:00.000-08:00

Une seance de sensibilisation sur le cancer du sein a été réalisée a Goma avec les éleves de 6e années de l'Institut Mont Goma dans le cadre du programme Pink October de l'UICC. Cette séance avait pour but de tenir informer les jeunes filles de l'ampleur du probleme du cancer du sein et leurs expliquer les methodes de prevention ainsi que celles permettant la détection precoce du cancer du sein. Le rapport complet avec photos sera publié dans les jours qui suivent. Dr Mateus SAHANI.

Le combat contre cancer du col, une priorite pour AGIR ENSEMBLE

2008-09-19T12:27:00.000-07:00

Aujourd'hui le cancer du col uterin est repute etre la 2e cause de deces par cancer dancer et constitue l'un des cancer les plus frequents dans le monde. C'est ainsi que AGIR ENSEMBLE/UICC-DRC se fixe pour mission prioritaire de combatre ce probleme en se lancant dans la prevention par la campagne de sensibilisation de la masse feminine sur les signes d'alerte, le programme de depistage des lesions precancereuses. Ce programme pourra etre effectif au debut de l'annee prochaine, 2009.

Merci,

Dr Mateus SAHANI.

La Tuberculose, une malade a combattre energiquement

2008-04-20T13:29:00.000-07:00

Rapport synthétique des activités anti-TB La TB est une maladie infectieuse contagieuse et se transmet d’une personne infectée a une autre saine par contact via les gouttelettes de Pfludge. Nos activités anti-TB se regroupe en 2 types : préventives et curatives. Dans nos activités préventives, nous procédons surtout a l’éducation de la masse populaire sur le mode de vie et les mesures pour se protéger contre la contamination tuberculeuse et le mode de vie d’un tuberculeux vis-à-vis de son entourage : éviter de cracher n’importe ou, mettre la mais sur la bouche quant on tousse ou quand on baille, la position a adopter quand on s’assoit avec une personne infectée. Ces activités se font a travers une organisation de la société civile dont je suis membre et directeur du département de Santé. Cette ONG s’appelle AGIR ENSEMBLE basée à Goma/RDC. Dans nos activités curatives, nous recevons en consultation au moins 1 a 2 nouveau(x) cas par jour de malades avec une toux chronique suspecte de TB, ce qui nous pousse a faire les investigations. Nous avons à peu près une moyenne de 40 malades suspects de TB par mois parmi lesquels quelques uns sont perdus de vue au cours des investigations si la 1ere et 2e série de crachat n’est pas positives. Pour le moment nous avons, à notre charge 20 personnes sous traitements anti-TB dont 13 adultes et 7 enfants sous prophylaxie a l’INH. Ces 7 enfants sont issus de 3 familles en raison de 3-2-2 ayant été en contact avec leurs mères avant la découverte de la maladie. Parmi les 13 adultes 8 sont de sexe féminin et 5 de sexe masculin. Trois malades sur 13 sont co-infectes par le VIH et a ce stade ils suivent le 2 types de traitement. Parmi les 13 malades, 11 suivent le traitement en ambulatoire et 2 sont hospitalises car leur état de permet pas la réussite de la stratégie DOT que nous appliquons. Sur 13 cas, 10 ont été diagnostiques TPM +, 3 TPM- par Rx confrontee a la clinique. NB : ce mini rapport ne concerne que les malades que je suis en train de suivre à la polyclinique du Carrefour à Kigali/Rwanda. Le chiffre est tellement grand pour l’hôpital de Virunga à Goma/RDC. A ce rapport je joint un cliché d’un malade TPM+ dépisté a partir du 11 Avril 2008 et qui a commencé le traitement aujourd’hui le 14 Avril 2008. Dr Mateus SAHANI AGIR ENSEMBLE/ STOP TB PARTNERSHIP

Une surprise desaggreable:tumeur de la vessie.

2008-03-15T02:38:00.000-07:00

Une surprise m'a ete desagreable lors de l'operation de cesarienne avec comme indication un dysproportion cephalopelvienne, en decouvrant fortuitement un tumeur de la vessie en per aperatoire. Mais une chose qui tique est qu'avant le debut de l'intervention, a apparue une deformation abdominale faisant penser a un syndrome de prerupture uterine mais les signes n'etaient pas tous reunis pour conclure. Ce qui m'amenait a croire qu'il s'agissait d'une deformation de l'uterus.

Apres l'ouverture de la paroi abdominale en pleine intervention, nous avons decouvert une grosse tumeur vessicale molle, hypervascularisee. Heureusement que nous avons pu trouver un endroit pour l'incision uterine sans toucher la tumeur et nous avons extrait un nouveau ne vivant, de sexe feminin, pesant 3kg et 400g.

Dans notre hopital, nous n'avons pas tous les necessaires pour faire la biopsie et nous avons pu fermer sans rien faire pour la tumeur.

Merci.

Dr Mateus SAHANI.

Hépatocarcinome

2008-02-14T07:30:00.000-08:00

Un homme de 62 ans, brulant 1 paquet par jour s'est présenté à l'hopital de Nyanza avec une hépatomégalie dépassant l'ombilic, sensible, de suface rigueuse, avec un amaigrissement prononcé.

Les investigations parasitaires et infectieuses n'ont donné aucune particularité, ce qui nous a poussé à penser à une tumeur neoplasique du foie et faire l'exlporation echographique. Celle-ci a réveler une tumeur probablement maligne de la partie inférieure du lobe gauche.

Comme nous sommes limités dans les investigations, nous l'avons envoyé à l'hopital universitaire de Butare.

Ce qui est sure est que même dans cet hopital universitaire, il n'y apas d'autres types de traitement en dehors de la chirurgie malgré la présence des spécialistes. Si c'est pouvé stade anvancé, inopérable ils nous renvoient tout simplement le malade pour un traitement d'accompagnement.

Le traitement des cancer est encore un probleme sérieux dans nos régions, le dégré d'accessibilité au traitement est encore trop bas, un défi qu'il faut chercher à combattre à tout prix. Comment? Question posée à tout activiste et tout bienfaiteur.

Dr Mateus SAHANI.

La pauvreté, un facteur aggravant dans le traitement des cancers

2008-02-14T06:53:00.000-08:00

Une dame de 47ans s'est pr��sent��e �� l'hopital de Nyanza avec une grosse masse abdominale prennant pratiquement toute la partie sus-ombilicale de surface rigueuese, dure, sensible qui venait de faire 6mois.

Faute de moyen, elle a s��journ��e chez un tradipraticien qui a tentait de lui donner des produits naturels �� base des feuilles non idenfi��es sans succes. C'est ainsi qu'elle se pr��sente avec une douleur, un ��tat g��n��ral alt��r�� par amaigrissement.

Pire encore la malade se trouvant dans un endroit assur�� par la mutuelle de sant��, couvrant les frais de soins �� 90%, ayant sa mutuelle de sant��, elle n'a pas pu consulter en temps pour permettre un traitement chirurgical, le seul existant et disponible �� notre niveau.

En poussant loin l'anamnese, elle nous revel�� qu'elle ne serait pas en mesure de payer les 10% de sa facture. Comme �� ce stade, on se sent impuissant d'agir on se d��cide de faire un transfert �� l'hopital universitaire pour une profonde investigation et prise en charge appropri�� mais la patiente procede �� un r��fus total seulement manque de moyens pour son s��jour dans milieu qui lui est ��trange.

La malade est hospitalis��e sous un traitement palliatif fat de tramadol, prednisolone et alimentation par sonde nasogastrique.

Malheureusement l'hopital ne peut pas trouv�� le tramadol, ce qui fait qu'elle est oblig��e de l'acheter sur ordonnance m��dicale dans une pharmacie priv��e, ce qui est un deuxieme dileme pour la patiente.

C'est toujours, presqu'en 95%, le genre des malades canc��reux qui nous arrivent; au stade tardif.

En effet, tout cela est le mal de la pauvret�� et de la sous information. Ces deux ��l��ments constitueraient la plus grande priorit�� sur laquelle il faut agir dans les pays en voie de d��veloppement pour lutter efficacement contre le cancer. D'ou il faut mettre en place des systemes de prise en charge des malades avec cancer ainsi qu'un programme renforc�� de sensibilisation sur les l��sions pr��canc��reuses,les signes d'alerte pour le cancer, lutte contre le tabagisme et d'autres facteurs.

Merci,

Dr Mateus SAHANI.

La journée internationale contre le cancer s'est bien déroulée à Goma/RDC

2008-02-09T13:16:00.000-08:00

Rapport de la journée Internationale contre le Cancer : activités réalisées à Goma/RDC du 03 au 04 Février 2008 Dans le cadre de la journée mondiale contre le cancer, AGIR ENSEMBLE a organisé 2 séances de sensibilisation des jeunes dans le but de les stimuler à une auto protection contre l’exposition à la fumée du tabac et à la protection des enfants dans leurs ménages respectifs (parents ou non). Une séance s’est déroulée le dimanche 03 Février 2008 dans la chapelle de l’église CBCA Katoyi réunissant 107 participants dont 45 de sexe masculin et 62 de sexe féminin. Parmi eux, 61 étaient de jeunes non mariés, 20 enfants de moins de 10ans et 26 jeunes mariés. La séance a commencé à 12h00 juste après les activités de l’église par un mot introductif du président de AGIR ENSEMBLE, Mr Alphonse KAVWIRWA qui, ensuite a donné la parole à l’orateur du jour, Dr Mateus SAHANI, qui à son tour a développé le thème : Le Tabac, un danger pour la population adultes et enfants après avoir passé à revue l’épidémiologie du tabagisme durant 45 minutes. Par la suite, une série des questions a suivi et toutes les questions ont trouvées des réponses à la satisfaction du public. La séance a ainsi pris fin à 14h00 après une série de recommandations. Une 2e séance s’est déroulée le lundi 04 Février 2008 à l’Institut Majengo, une école secondaire de la ville de Goma, avec les élèves finalistes de 3 classes de 6e années. Un total de 76 élèves étaient sensibilisés, parmi eux 41 sont de sexe masculin et 35 de sexe féminin. Le but de cette séance était de rendre les élèves responsables dans la protection de leur santé ainsi que celle de leur famille vis-à-vis de la fumée du tabac, de sensibiliser leurs parents à prendre des décisions pour des foyers 100% non fumeurs protégeant ainsi les enfants contre ce fléau. La séance a commencé à 12h00 juste après le déroulement des examens par une brève présentation des sensibilisateurs par le préfet de l’école, Mr KAMBALE NZUGHUNDI, puis le modérateur du jour a pris la parole donnant des aspects généraux du problème du tabac ainsi que les aspects épidémiologiques. Il s’agit de Dr Anicet MASHAURI. Ensuite l’orateur, Dr Guy MUHINDO, en utilisant une méthode participative, a commencé par poser quelques questions aux participants pour tester leur niveau de connaissance du problème de tabac sur la santé. Apres avoir constaté que 95% d’élèves ne comprenaient pas que le tabac constitue un problème sérieux de santé publique, il a développé le thème : ‘Le tabac, un danger pour la santé de la population’ Par un enseignement imagé, il a cité un gamme de maladies liées au tabac dont certains types de cancers. Apres une série de questions a suivi avec réponses, et par la suite, les recommandations. Comité d’organisation :1. Mr Alphonse KAVWIRWA 2.Dr Mateus SAHANI, 3. Mr KAMBALE NZUGHUNDI, préfet. A la fin de chaque présentation, les orateurs insistaient sur le message clé à adresser aux parents pour protéger les enfants de l’exposition à la fumée du tabac préparé par l’UICC : Il n'y a pas d'exposition à la fumée passive sans danger. Parce que vous vous souciez de leur santé, protégez vos enfants de la fumée passive Enseignez aux enfants à se tenir éloignés de la fumée passive Ne fumez pas et ne permettez pas que quelqu'un fume chez vous ou dans votre voiture, même si votre enfant n'est pas présent. Ne fumez pas si vous êtes enceinte ou à proximité de quelqu'un qui l'est. Privilégiez les garderies et écoles sans fumée pour vos enfants. Évitez d'amener vos enfants et votre famille dans des restaurants ou d'autres lieux publics fumeurs, Si vous êtes fumeurs, demandez à votre médecin comment vous pouvez faire pour arrêter. Devenez un modèle pour votre enfant, ne fumez pas! Les deux orateurs ont plus insisté sur le rôle des parents dans la protection des enfants. Conclusion: D’une manière générale, les deux séances se sont bien déroulées avec le dynamisme de tous (organisateurs et participants) et surtout les sensibilisés qui étaient jusque là dans l’ignorance à la matière. Recommandations générales pour les 2 séances Apres avoir passé à revu toutes les recommandations formulées au bout de 2 séances, le condensé se présente comme suit : 1.Durée suffisante avec explications suffisantes pour la prochaine fois. 2.Il faudra à la prochaine fois distribuer des dépliants et des autocollants à afficher dans les lieux publics ou chacun dans sa parcelle pour protéger les enfants. 3. Il faudra avoir des T-SHIRTS pour les participants pour leurs permettre de jouer le rôle de véritables sensibilisateurs au sein d’une population presque complètement ignorante. 4. Les séances ont été organisées au moment ou les gens n’ont plus de concentration (de 12h-14h). A la prochaine fois, il faudra une bonne préparation financière pour que les activités s’organisent pour toutes la journée. NB : Les photos pour la séance du lundi 04/02/2008 ne sont pas encore disponibles. Fait à Goma, le 08/02/2008 Dr Mateus KAMBALE SAHANI, Département médicale de AGIR ENSEMBLE.

Métastases du cancer du sein

2008-02-09T02:26:00.000-08:00

Le cancer du sein a laissé des métastases difficiles à gérer chez une dame de 41ans qui a été opérée il ya 2 ans. Cette dame nous arrive tous les 4 mois avec des douleurs qu'il faut prendre en charge palliativement. Heureusement que l'annonce du diagnostic a été facile pour nous et a accepté son état.

Dr Mateus SAHANI.

Le traitement de cancer dans les pays en voie de developpement semble etre un scandale pour les médecins

2008-02-04T06:38:00.000-08:00

Une dame de 65ans avec cancer de l'estomac diagnostiqué à l'hopital universitaire de Butare au Rwanda et declaré 'cancer au stade avancé, donc inopérable est décedée dans une situation inacceptable dans un hopital de district. Cette situation a beaucoup ambarassé les médecins de la clinique universitaire; ne sachant pas quoi faire, ils se sont tout simplement décidés de la sortir de l'hopital lui donnant un message verbal d'aller se faire soigner dans un hopital de district proche de chez elle mais aucune prescription ne lui a été administrée, c'était donc une façon d'abandonner et de se debarasser de la patiente. Arrivée à l'hopital de district de Nyanza/Rwanda sans bon de sortie ni prescription, elle a été reçue au service de Médecine Interne qui, apres un séjour de 2 jours sans aucune prescription pour les soins palliatifs appropriés, ce service s'en est aussi débarassée pour l'amener au service de Chirurgie, transfert non justifié pour un cancer inopérable. C'est aussi une 2e façon de fuir la patient. Pire encore, la pharmaçie de cet hopital n'a même pas les antalgiques puissants appropriés pour le traitement palliatif comme tramadol, pentazocine, pethidine,... Apres 5 jours d'hospitalisation inutile, elle décedée sans avoir reçu un traitement d'accompagnement. En bref, é tous les stades parcourus, - pas de chimiothérapie disponible, -pas de radiothérapie disponible, -malades arrivent souvent au stade inopérable, et à ce moment, le chirurgien devient impuissant face à sa maladie. Le cancer est vraiment une maladie stessante pour le personnel soignant dans les pays en voie de dévéloppement. Le diagnostic est difficile à poser et quand il est là, le traitement n'est pas accessible. Il y a donc beaucoup à faire pour les pays en voie de dévéloppement en matiere de cancérologie, multiplier les formations et les pratiques. Dr Mateus SAHANI.

Le cancer du poumon en RDC, un mystere pour le personnel soignant

2008-01-28T05:39:00.000-08:00

Le Cancer du poumon en DRC: un obstacle de Screenning Le Cancer du poumon dans les pays en voie de développement semble être un mystère pour le personnel soignant. La plupart ont tendance à croire qu’il n’existe pas dans la région alors que le tabagisme y bat son record sans contrôle : 1 fumeur tous les 5 m2 et même dans les lieux publics. Une question peut être posée :’pourquoi le cancer du poumon n’existerait pas dans un milieu sans contrôle du tabac ?’ La réponse claire é cette question est qu’il s’agirait d’un problème de poser le diagnostic : manque de matériel approprié, de formation continue pour poser le diagnostic. Pour cela, nous avons observé quelques cas cliniques l’hôpital de NYANZA/Rwanda et à l’hôpital de Virunga à Goma/RDC : 1. Un homme de 68ans, grand fumeur depuis 20ans, prenant en moyenne 1paquet/jour, avec toux productive depuis 6 semaines, amaigrissement, parfois fièvre et transpiration nocturne, anorexie. Hypothèses : - TBC pulmonaire - Cancer du poumon -Pneumonie atypique Matériel disponible pour investiguer : La Radiographie, examens de laboratoire Résultat : Ziehl 3xNEG, Rx : atélectasie du lobe supérieur droit. Soigné aux AB 10 jours sans succès. En comparaison, son cliché donne le même aspect que celui d’un malade de cancer du poumon diagnostiqué à France avec scanner, bronchoscopie et Rx. Dx : Cancer du poumon 2. femme de 42ans, dont le mari est fumeur depuis 25ans. Toux productive et intermittente depuis 2mois, transpiration nocturne, amaigrissement. Labo : VS=80mm/h, Crachat 3x NEG Hypothèses : - TBC pulmonaire - Tumeur (Cancer) RX : Opacité arrondie au sommet gauche, homogène, bien délimitée, très volumineuse. Ces caractéristiques radiologiques sont celles d’une tumeur et non celles de TBC. 3. Homme de 56ans, fumeurs depuis des années, tousse depuis 4mois soigné plusieurs fois sans succès. Amaigrissement progressif, Anorexie, dyspnée parfois. Labo : VS=133mm/h, VIH neg, Crachat 6x NEG. Hypothèses : - TBC pulmonaire -Cancer RX : Opacité rétractile du lobe moyen droit partielle (atélectasie partielle). En comparaison au cliché d’un malade cancéreux de l’Hôpital de Meulan /France, ce cliché présente les mêmes caractéristiques radiologiques. Dx : Cancer bronchique. Notre observation sur une période de 6 mois a donné 88 malades avec clichés suspects de cancer dont 57 sont fumeurs actifs soit 64.7% et 31 sont fumeurs passifs soit 35.3%. 78 avaient des signes pouvant susciter la demande de la Rx soit 88.6% et 10 ont fait des RX fortuites soit 11.4% Selon le sexe, nous avons reçu 65 personnes de sexe masculin soit 73.8% et 23 de sexe féminin soit 26.2%. Noter que pour tous nos cas, nous n’avons pas de moyens de poser le diagnostic avec certitude (pas de biopsie, de scanner, bronchoscopie,…). Le diagnostic a été trouvé par comparaison sur base de la clinique et de la Rx. Tous ont été transféré à l’hôpital universitaire. Pas de traitement approprié : chimiothérapie non disponible, pas de radiothérapie, chirurgie thoracique difficile à notre niveau. CONCLUSION - La plupart de médecins dans nos pays ne posent pas le diagnostic par connaissance limitée et manque de moyens appropriés mais les malades avec cancer du poumon sont nombreux et passent toujours dans nos consultation sans qu’on arrive au diagnostic. -Diagnostic posé, le traitement est presque inaccessible au malade, d’ou il faut insister sur la prévention : donc lutte énergique contre contre le tabagisme actif et passif. - Il faut donc assurer une formation continue au personnel médical et infirmier pour arriver au diagnostic. Dr Mateus SAHANI