Editor's note: Staff writer Mary Engel and photographer Robert Hood are in Uganda to report on the work of Fred Hutch's Program in Global Oncology and the Uganda Cancer Institute, particularly in the area of infection-related cancers.
KAMPALA, UGANDA -- Dr. Nixon Niyonzima is a magnet for children as he walks the grounds outside the pediatric ward of the Uganda Cancer Institute. The smallest ones hug him around the knees, taller ones swing on his arms. One shy 14-year-old girl kneels --a traditional way to show respect—and ducks her head, then reaches for his hand. He takes it, strokes her hair, and, speaking in Luganda, asks her mother how she’s doing since her treatment for Burkitt lymphoma, the most common childhood cancer in sub-Saharan Africa. From her mother’s beaming face, it’s clear she’s doing well.
Doctoring is up close and personal at the UCI, where Niyonzima worked before starting a doctoral program in molecular and cellular biology at the Fred Hutchinson Cancer Research Center and to which he plans to return full-time when he finishes his doctorate. Home for a three-week visit, he pitched in to help out.
“I love working here,” he said.
It’s obvious that patients and staff alike love having him back.
Niyonzima didn’t always feel this way. Earlier, he’d described feeling overwhelmed when he did a stint at UCI as a medical student. The sole cancer treatment center in a country of 36 million people was grievously understaffed and housed in an aging, poorly equipped facility. Today, a partnership with Fred Hutch is helping train Ugandan physicians such as Niyonzima to become cancer specialists and researchers and build a new outpatient and research facility, slated to open early next year. The Ugandan government is building a new in-patient cancer hospital.
To an outsider’s eyes, the old wards, with beds jammed in every available space, pallets on the floor, and a crowd outside waiting to be admitted, seem overwhelming. Yet Niyonzima is calm and good-humored as he greets patients and jokes with colleagues. When asked about this, he shrugs.
“You’d break down if you tend to get stressed about everything,” he said. “Here we have resource limitations, and so you have to work within them.”
Besides, the number of patients waiting to get in—which has grown even larger in recent years—is a testament that things are getting better, he said. One of the biggest challenges to treating cancer in Uganda and many other developing countries is that patients often seek care too late, when little can be done. There are numerous reasons for this, but one frustratingly circular one is a fatalistic conviction that cancer is invariably fatal.
But now, as more people are being treated and cured or maintained on treatment, pessimism is being replaced with hope.
Eleven-year-old Jeremiah is one example. Niyonzima had treated the youngster for leukemia in 2011. In the small-world of UCI patients, his mother had heard Niyonzima was back in Kampala, and brought Jeremiah by to see him.
“When you have a kid who was bed-ridden, and is now running around, they become ambassadors in the community,” Niyonzima said as the boy swung on his arm. “It rewards your efforts.”
Mary Engel is a former staff writer at Fred Hutchinson Cancer Center. Previously, she covered medicine and health policy for the Los Angeles Times, where she was part of a team that won a Pulitzer Prize for Public Service. She was also a fellow at the Knight Science Journalism Program at MIT. Follow her on Twitter @Engel140.