Cancer. This disease has touched all our lives in some way – whether it is a friend, a close family member, or you yourself who has suffered. “Suffer” is the only word that can really be used when talking about cancer. It is not only the disease, and its treatment, that cause an acute degree of pain over an extended period of time, but it is also so difficult for friends and family to see how it affects their loved one.
Imagine having to fight this disease without the aid of morphine.
For the majority of cancer sufferers in Senegal, this is their regular plight. A recent Human Rights Watch report, “Abandoned in Agony: Cancer and the Struggle for Pain Treatment in Senegal”, reveals some harrowing truths about the treatment of cancer in Senegal.
Morphine, in oral form, is an inexpensive drug. It costs less than US$1 per week to comprehensively manage pain with this medication. Despite this, the Senegalese government only imports 1kg of morphine per year. By way of comparison, Belgium, a country with a similar size of population, imports 81kg each year. Furthermore, the world average of morphine use is 5.96 mg per capita, Senegal uses about 0.01 mg per capita. This 1kg is enough to treat around 200 cancer patients.
70,000 Senegalese require cancer palliative care each year.
To further accentuate this shortage of supply, the government has made it extremely difficult for hospitals to purchase this medication privately. Hospitals have to go through at least three different government agencies, with the accompanying red-tape and administrative hurdles, to simply purchase more. The consequent affect of this is that morphine is only available in the capital city of Dakar, and even there shortages exist. Stories from inside Senegal tell of families who travel for as much as 10 hours to the capital to get morphine, only to be told that there is non-available. Another man, one of 170 Senegalese cancer sufferers interviewed by Human Rights Watch, has prostate cancer and said,
“I am in pain 24 hours a day…You cannot believe the pain I have all over my body. It is in my bones. I cannot have a real life without my medication. I try to bear the pain for 2 or 3 days, and when I cannot handle it I will take one pill … I went to all the pharmacies and they do not sell it.”
When the morphine supply runs out, it runs out. All patients, families and health workers can do is wait for more to come available. This wait, as you may possibly be able to imagine, is excruciating for everyone. Where this occurs, patients have to go back to trying to manage their pain with woefully ineffective paracetamol. If they have previously been on morphine, the experience of then going without it makes the pain even more unbearable.
This suffering could be easily alleviated if the Senegalese government simply changed their inexplicable and inexcusable policies towards the buying of morphine. They need to buy more and allow hospitals to also do so more easily.
There is simply no reason why they shouldn’t.