Chronic diseases and health promotion

Part Four - Taking action: essential steps for success

Chapter One: Providing a unifying framework - the role of government

Story of Mariam John: bone cancer

"I know I can make it": Mariam John, 13 years old, Tanzania, bone cancer

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." Sadly, Mariam died in March 2006 after her long battle.