Resources dooming Samoa to preventable deaths

Lacking resources and thinly-spread populations are combining to undermine Samoa’s ability to respond to the growing burden of cancer, according to a study byu Professor Diana Sarfati from the University of Otago.

Not only are the rates of cancer in the Pacific extremely high, but people are suffering from largely preventable cancers like cervical cancer.

Dr. Sarfati is the Director of the Cancer and Chronic Conditions research group at the University of Otago in Wellington. She was the principal of more than a dozen authors in a report cancer control in the Pacific for leading medical journal Lancet Oncology.

The report identifies a lack of resources as a key issue.

Samoa has one pathologist and two radiologists.

The report reveals there are just five physicians and 15 nurses per 10,000 people. Samoa also doesn’t appear to have a national cancer or non-communicable diseases plan, and no organised screening programmes for cervical, breast or bowel cancer.

"Cancer diagnostic services are largely unavailable in the region, which is “grossly [disproportionate] to the current burden of the disease in the Pacific region,” the report states.

“Outside of Guam and French Polynesia, over the entire Pacific, there's one medical oncologist, no radiation oncologists and no access to radiation therapy at all.”

A report in the same journal earlier this year forecast a sharp rise in cancer cases across the region: 84 per cent more incidences and 92 per cent more death between 2018 and 2040

The study highlights six ways to deal with the problem, largely by collaborating regionally and by focusing on preventative care, palliative care and of course, funding.

Preventing cervical cancer in particular is one of the six recommendations included in Dr. Sarfati’s report. 

Samoa should see improvements in this department, once the Asian Development Bank’s project to fund the vaccine in Samoa.

In November last year, the Bank announced Samoa would receive a US$7.5 million grant to fund vaccines against the human papilloma virus (which causes cervical cancer), rotavirus and pneumococcus conjugate, to fight diarrhoea and pneumonia.

The grant will finance purchasing the vaccines through the United Nations Children’s Fund supply facility. 

“Cervical cancer is one of the most preventable cancers and yet in the Pacific region it’s the second leading cause of cancer death among Pacific women,” Dr. Sarfati sid.

“Whereas here in New Zealand it’s very rare now, because we have a good  screening program and we have H.P.V. vaccination. 

“Both of those things need to be strengthened in the Pacific.”

Competing priorities mean Pacific Island countries struggle to put healthcare at the top of their list, but Dr. Sarfati believes the Pacific has recognised cancer prevention needs attention.

“The next thing is we've got a sort of a pan-Pacific meeting being held in Fiji in about a month to look at how we can accelerate the progress towards eliminating cervical cancer,” she said. 

Donors, funders and healthcare providers are focusing on cancer care and prevention too, Dr. Sarfati added.

“There has been [a] lot of progress in the region and lots of really fantastic initiatives.

“There have been really excellent pilot programmes in Papua New Guinea which have involved women self-sampling for H.P.V. and then being treated if they are positive all at the same time, so they only have to go [once]. 

“That has been very effective and very acceptable to women, it could be used across the Pacific.”

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