Breast care, lessons from Elizabeth

Queen Elizabeth Central Hospital
Elizabeth (not her real name), aged 22, enjoyed good health after giving birth to a bouncy baby boy two years ago, but her life got a scare when she started feeling pain on her right breast.
This was months after she weaned her child. The lower part of her breast got a sore which oozed pus, later turned to multiple sores covering the whole breast.
The pain, according to Elizabeth, was unbearable and the local hospital in Rumphi district could only do simple dressing to clean the wounds but did not have the capacity to make proper diagnosis.
“For several months, my life depended on pain killers to get relief and proper sleep at night. But the whole breast now became fragile and producing bad odour which gave me a huge scare. I saw death,” Elizabeth narrated her ordeal.
“I was hopeless as every doctor attending to me came up with different medical opinions, while some thought it would be mastitis, others pointed to breast cancer. I remember one telling me that there is no any other option but surgery to remove the whole breast. I did not protest since I needed anything that could relieve the unbearable pain,” she defeatedly explained.
But in what she describes as divine intervention, another visiting doctor recommended a biopsy to determine the condition of the breast; unfortunately, that procedure could only be done at major referral hospitals, not even at the nearest Mzuzu Central Hospital, at that time.
This then meant she travels about 500 kilometers away to Blantyre, which had financial burden, in addition to costs for the biopsy procedure.
With support from family members, she managed to travel to Blantyre and reported at Queen Elizabeth Central Hospital for specialised medical attention.
But she explains that the biopsy procedure was not done promptly, she had several hospital visits for scanning and breast screening by specialists followed by daily wound dressing procedures.
Then came another challenge, she was supposed to pay K20,000 equivalent to $10 for the biopsy procedure at a private clinic, a cost that an ordinary Malawian could not afford.
“I was lucky to have supportive family members who paid for this bill. But I could see my fellow patients especially those from rural areas helpless due to poverty levels. This life is priceless but it is costly to maintain it,” she said.
After a week, the biopsy results ruled out cancer and she indicates that it was just an infectious abscess which was duly treated by suitable antibiotics. Now with that experience, she encourages girls and women to always seek medical attention and go for breast screening, insisting life is precious.
Elizabeth is just one lucky woman who managed to get proper medical care and services including breast screening, while some do not have access to such quality services as well as the needed health information.
An international organization, Breast Cancer Care Foundation (BCCF) is now bridging that gap by providing awareness messages to various age groups of girls and women through rural outreach clinics on breast care and screening to detect any breast condition including the one experienced by Elizabeth.
“It is very important for women to come forward for screening not just because they find something in their breasts but as a way of maintaining their health. Women at the age of 35 and above or have a history of cancer in their family, need to be coming for screening every single year,” says Tabitha Warwick, the founder of BCCF.
Warwick and her team, conducts free breast cancer screening and self-breast examination sessions at Dream Centre in Blantyre every Wednesday and Friday.
“We know women’s health is not a priority in Malawi and most women are not coming forward to seek services hence reaching out to them through the Dream Centre clinic and outreach clinics in the rural communities,” Warwick adds.
She reveals that in the past two and half years BCCF has managed to screen over three thousand people, and on average about 10 percent of people screened are in need of further medical management.
According to a survey by the Ireland’s Royal College of Surgeons, breast cancer is the third most common cancer among women in Malawi, with low survival rate from the time of diagnosis and fewer than ten percent of patients survive beyond 18 months.
Other statistics show that one in eight women are diagnosed with breast cancer in Malawi.
This is the situation in a country where mammography and chemotherapy services are limited in public hospitals as well as late detection of cancer conditions.