Face to face with cancer

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Maria Saloniki, United Republic of Tanzania: Barriers to health care


Inadequate access to good-quality health care often means that breast cancer is not detected until it is too late

Maria Saloniki can hardly remember how many times she went to the local traditional healer, how many doctors in clinics and dispensaries she consulted between two hospitalizations, how many words she used to describe her pain. But one thing she clearly remembers is that each time she returned home without receiving adequate treatment and care. Today, this livestock keeper and mother of 10 children is fighting for her life at the Ocean Road Cancer Institute in Dar es Salaam. It took Maria more than three years to discover the words to describe her pain – breast cancer – and to receive the treatment she desperately needs. “It all started with a swollen armpit and a bad fever,” she recalls.

In fact, between these first symptoms and chemotherapy treatment, Maria was prescribed herb ointments on several occasions, has been on antibiotics twice and heard from more than one health professional that they couldn’t do anything for her. The 60-year-old even travelled to Nairobi, Kenya to seek treatment, but it wasn’t until later that a biopsy revealed her disease.

Maria’s story is sadly common in the understaffed and poorly equipped hospital ward she shares with 30 other cancer patients. Her husband, who now works day and night to pay for her medicine and feed their children, can’t afford both the treatment costs and the bus fare to come and visit her. The family has one year to pay back a substantial loan to its tribe.

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Mariam John, United Republic of Tanzania: "I know I can make it"


The failure to use available knowledge about chronic disease prevention and control endangers future generations

Mariam John is 13 years old and already knows what she wants to be when she grows up - "a health minister can help others and wants everyone to be healthy," she says. "I have good grades, I know I can make it," she adds proudly.

In February 2005, soon after her knee started to swell to the point that it became difficult to walk, Mariam was diagnosed with bone cancer. She has been receiving chemotherapy and radiotherapy treatment since then – an almost unbearable experience. “I am willing to have my leg amputated if it can take my pain away,” she concedes.

The day she was photographed, Mariam couldn’t have her radiotherapy treatment owing to a power failure at the Dar es Salaam Cancer Institute. She had crawled painfully out of bed with her grandmother’s help and been sitting crying in a wheelchair for half an hour, with nothing to support her swollen leg, before the news came.

Despite this terrible ordeal and great fatigue, Mariam remembers how to smile. Her best friend and classmate Maria is a fabulous supporter. “What cheers me up is when she writes me letters. She believes that I can be cured. I wish more people would think like her.”

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Sridhar Reddy was on the telephone to his wife when the photographer entered his hospital room. “I’m sorry,
it’s rush hour, I’ll be with you in a minute,” he excused himself. His wife runs their restaurant while he’s undergoing chemotherapy treatment at the Chennai Cancer Institute.

Sridhar had a first malignant tumour removed from his right cheek last year and a second one from his throat earlier this year. It’s his third hospitalization so far. “Renowned oncologists work here, I’m paying a high price, but I know I’m in good hands,” he says, before having a severe coughing fit. His doctor doesn’t sound as optimistic. Cancer has spread to Sridhar’s lungs and liver. “His tobacco use and drinking habits are to blame,” the oncologist says, and gives him a year to live at best. Sridhar has been chewing tobacco since his teenage years and drinking alcohol every day for more than 20 years. “Too much stress,” Sridhar explains.

Below the surface, Sridhar knows that the future doesn’t look bright. He has been borrowing money to pay for his medical bills and now worries that he will never be able to repay the loans. Sadly, Sridhar died only a short time after he was interviewed.

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