In Zimbabwe’s many bustling city streets and communities, a silent killer lurks in the shadows, claiming the lives of thousands of women every year.
Nyarai, a 35-year-old mother of two, felt a lump in her breast during a self-examination. Fearful of the unknown, she delayed seeking medical attention. Months passed, and the lump grew. Finally, she visited a local clinic, where she was diagnosed with stage III breast cancer. Nyarai’s story is all too common. Lack of awareness, limited access to screening services, and socio-cultural barriers hinder early detection and treatment. Breast cancer is a disease often shrouded in stigma, myths and misinformation, and has become a scourge on the nation. Many women in Zimbabwe attribute breast cancer to witchcraft or bad luck, leading to the delay in seeking medical help. According to the Zimbabwe National Cancer Registry, breast cancer accounts for 22.5% of all cancer cases in the country, with approximately 2,000 new cases diagnosed annually.
Breast cancer’s effects extend far beyond the individual, with families torn apart, children left motherless, and communities shattered. The economic burden is substantial, with patients often selling assets or taking loans to cover treatment costs. The Zimbabwean government, non-governmental organizations (NGOs), and healthcare providers are working together to try and combat breast cancer by introducing screening programs through mobile clinics and community-based screening initiatives countrywide in a bid to increase early detection. Awareness and advocacy efforts targeted at dispelling myths and promoting breast-health have been carried out including educational programs and media outreaches. Support groups, like those provided by the Zimbabwe Cancer Association, offer emotional support and counselling, over and above the upskilling of healthcare professionals through capacity-building initiatives to enhance diagnosis and treatment capabilities.
Despite the tremendous progress made by science in the care of women with breast cancer over the past few decades, most women in Zimbabwe are yet to benefit from this progress. There is poor access to modern screening methods, quality chemotherapy drugs, and reliable radiotherapy services, and a lack of evidence-based medicine derived from local settings. Out-of-pocket payments for healthcare are still the major health-funding model, denying most women access to quality and appropriate healthcare services. Limited resources, including inadequate funding, equipment, and personnel, severely hinder effective cancer care. This shortage is particularly acute in rural areas, where specialized care is scarce, forcing patients to travel long distances or abandon treatment altogether. Moreover, stigma and cultural barriers, fueled by misconceptions and fear, continue to impede early detection and treatment. Adding to this, inaccurate or incomplete data collection further hampers effective planning and resource allocation making breast cancer a significant burden to the healthcare system in Zimbabwe.
Dr. Thokozani Khupe’s journey is a poignant real-life example of the importance of early testing and accurate diagnosis in the fight against breast cancer. Initially misdiagnosed with ovarian cancer in Zimbabwe and South Africa, it was only through advanced combined CT and PET scans in the UK that she received the correct diagnosis of lobular breast cancer. Speaking in an interview with CITE, she said, “Come 2023, the cancer came like a thief. I told my young sister that this was not normal. I thought perhaps it was Kwashiorkor as I was thinking of so many things. I had gone out for (election) campaigns and I thought I had an infection.”
Her experience underscores the critical role of advanced medical technology and the challenges faced in regions with limited healthcare infrastructure. As the Patron of the Thokozani Khupe Cancer Foundation, she now dedicates herself to raising awareness about cancer in Zimbabwe, emphasizing that early detection can lead to successful treatment even in resource-limited settings. “In Zimbabwe, we have CT scans, but they sometimes give you the wrong diagnosis, which is what happened to me,” she explained. “In the UK, with the combined scans, you get an accurate diagnosis.”
Dr. Khupe’s story is a powerful reminder of the resilience and strength needed to fight cancer and the importance of support systems and access to advanced medical care. While resources for breast cancer management in Zimbabwe remain far from adequate, an increase in the number of medical specialists treating breast cancer over the past 10 years has resulted in a slight improvement in diagnostic and treatment capability in the country. Universal health coverage (UHC), if achieved through the drive to attain the 17 Sustainable Development Goals (SDGs), will improve care for breast cancer patients.
Meanwhile, as Nyarai undergoes treatment using the limited resources she has locally, she has become an involuntary advocate for breast cancer awareness for all women in Zimbabwe. Nyari’s story serves as a stark reminder that collective action and awareness is needed as new breast cancer cases have steadily increased making it the second most common cancer among female Zimbabweans since 2016.
