Chronic diseases and health promotion

Part Two. The urgent need for action

Chapter Two. Chronic diseases and poverty

Story of Maria Saloniki: breast cancer

Barriers to health care: Maria Saloniki, 60 years old
United Republic of Tanzania

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, in Dar es Salaam, 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.