Puzzle of small village riddled with cancer

Dorothy Kinyua is the chief of Ukuu Village. She is a cancer survivor herself and says she knows close to 15 other villagers who are at different stages of cancer treatment. [Gardy Chacha, Standard] At an event to commission the upgrading of the Ukuu Dispensary in Ukuu village, Meru County, dignitaries give speeches one after another. It's Dorothy Kinyua, the area chief's turn. "These people," she says, pointing at the villagers, "know exactly why we need this health facility." She explains how the village is experiencing a wave of illnesses. She mentions non-communicable diseases (NCDs) and then drops the C-word. "Cancer is now causing the most havoc in this village," she said as villagers nod in concurrence. Later, we pull the chief aside to ask what she meant by high cancer cases. "In this village alone, I know close to 15 people who are going through different cancer treatments," she says. The chief herself is undergoing cancer treatment. "My journey as a cancer patient began with a tiny dark growth on my big toe. It had bothered me for some time. So, I took time off and travelled to Meru to have a doctor remove it. He excised it and I went home. He told me to report back to him if it grows back. True to his suspicion, it grew back in a month or so," Kinyua narrates. "I went back and he asked me to undergo tests and scans." Ultimately, she was diagnosed with cancer. She does not know which particular type, but "Whatever the doctors saw was enough to put me through seven rounds of chemotherapy and one round of post-chemotherapy treatment." Dorothy is due to travel to Nairobi and undergo a PET (positron emission tomography) scan at Kenyatta University Teaching, Referral and Research Hospital (KUTRRH). "The scan will show if I need more treatment or if I am fully recovered from the cancer. As of right now, I feel fine," she says. Another medical camp attendee, Stanley Kanampiu, a 64-year-old, was recently diagnosed with cancer of the oesophagus. "It's my wife who pointed out to me that I had lost weight. I told her it was probably because of all the farm work I was doing on my own. But then, not long after, my palms began to swell. This would happen on and off. Still, I did not feel alarmed.," Kanampius says. "The first time I got worried, I had been given roasted maize to eat and I couldn't swallow it. Some days later it happened with rice," he narrates. "Whenever I ate meat, it would get stuck in my 'chest'. That's when I knew something was amiss somewhere." Earlier on in the year, tests, scans, and a biopsy, confirmed that Kanampiu had stage 3 cancer. He has just finished four rounds of chemotherapy and is due for some follow-up tests. Despite the uproar about cancer - and other NCDs - the village did not have a health facility that could examine and refer patients properly. The nearest public health facility is located 15Km away at Kanyakine, a nearby town. "This is a rural village. On average, not many people have the money to transport themselves to Kanyakine," Chief Kinyua says. "With cancer, if people could be seen [by a medic] earlier, perhaps the disease could be arrested much earlier." She adds that many sit on symptoms for a very long time until it is too late. The upgrading of Ukuu dispensary - funded by KPC (Kenya Pipeline Company) Foundation - from a sleepy two-roomed operation to a health facility with a pharmacy, consultation rooms, laboratory, an antenatal clinic and an ablution block, is of great relief according to the chief. "Perhaps, now, with an equipped health facility around, more people with cancer will be diagnosed early and referred to the advanced hospitals in good time," she says. The cancer scourge has particularly been hard-hitting to the family of Purity Kagweria Njogu, a 52-year-old resident of Ukuu. Both Kagweria and her daughter-in-law, Caroline Mugambi, are at different stages of cancer treatment. "I was diagnosed with cervical cancer in 2017. I remember being told that there were 'some things' in my uterus. It turned out to be cervical cancer," she says. Kagweria has had to undergo chemotherapy, radiotherapy and brachytherapy. To add on that, she has had surgery to take out the diseased womb. "The last time I was at my doctor's he said I am doing well. I am waiting for a PET scan - which should inform me on the next course of action," she says. Caroline is still in the thick of it. She has undergone 8 rounds of chemotherapy for what appears to be colon cancer. She was to undergo a PET scan in March but the 2024 doctors' strike made it impossible. Cancer prevalence and its ability to claim lives in Ukuu has left many worrisome, says Caroline. "The word itself sends shivers down many people's spine: not many are even willing to be tested for fear that it will turn out positive for cancer." Retired police officer Gideon Kimathi, 72, is now a community Health Volunteer (CHV). "After retiring, being of service to my people felt just right," he says. Kimathi was born and raised in Ukuu. In 2004, he lost his mother to throat cancer and in 2022, he lost a brother to the same disease. As an official CHV - paid a monthly stipend by Meru County government - Kimathi spends at least two days traversing the village, with his toolbox backpack. "In here I have a blood pressure machine, a weighing scale, a measuring tape, and a blood glucose machine. "I move around collecting news of any sick villagers; I advise them, I take their measurements, I listen to their disease history, and then I report to the county. Where possible, I refer them to a health facility. "I have listened to many cancer stories since I became a CHV. It is hard to find a family [in Ukuu] that has not been affected by cancer. Less than two months ago we buried a young man who had throat cancer. We don't know what's behind it. "We should be having scientists conducting studies to understand what is causing cancer in Ukuu - and perhaps the larger Meru County," Kimathi says. The mystery around cancer has left many speculating wildly. Kimathi himself has heard a school of thought that blames bilharzia. "They say the source of our water, from Mt. Kenya, feeding 15 rivers that all flow this way, is infested with snails and other vegetation that support propagation of bilharzia. And it is that bilharzia that sparks off cancer development in the body." Irene Riungu is the chairperson of Ukuu Methodist Church - whose compound hosts the newly commissioned dispensary. "Cancer is very rampant here. I suspect the food we eat," she says. "What could be wrong with the food?" we ask. She says: "We grow a lot of vegetables which are a key component in our diet. The problem is not the vegetables but the way we grow them: it is very common practice here that we spray pesticides on our vegetables. For obvious reasons - we want to maintain high yields because pests can wipe out an entire crop." Madam Riungu suspects that high pesticide residues in local's food systems are to blame for high cancer cases. Another resident told us that he suspects the colonial government must have dumped some toxic chemicals around Mt Kenya region. Dr Kanake Erastus, the Director of Medical Services in Meru County, said, "All we have now are theories and none has been authenticated." A family physician, Kanake says that cancer-causing agents (carcinogens) are known. "They include things like asbestos, some metals, and cigarette smoke." So far, Kenya has limited cancer research and no functional Population Based Cancer Registry, according to the National Cancer Task Force report published in July 2022. Cancer comes about because of the transformation of normal cells into abnormal (tumour) cells. The World Health Organisation (WHO) writes that three main factors are important in the development of cancer. They are physical (e.g ultraviolet and ionizing radiation), chemical (e.g asbestos, components of tobacco smoke, alcohol, aflatoxin and arsenic) and biological (e.g infections by certain viruses, bacteria, or parasites.) Tobacco use, alcohol consumption, unhealthy diet, physical inactivity and air pollution are also risk factors for cancer

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