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Smoking is the leading risk factor for lung cancer. There is still a long way to go for us to start harvesting the fruits of the Tobacco Control Act, 2015. Massive sensitization still needs to be done.

Compiled by Syndia Chemutai

Since its inception in 2012, World Lung Cancer Day has been observed every August 1 with the aim of shining a light on this deadly disease and giving hope to those who are battling it. According to the latest WHO data published in 2018 Lung Cancer Deaths in Uganda reached 439 or 0.17% of total deaths and Uganda ranks at number 150 in the world. 

Smoking is the leading risk factor for lung cancer. Research from the American Cancer Society has it that about 80% of lung cancer deaths result from smoking and according to Tobacco Induced Diseases (TIB), 62.2 % of daily smokers used manufactured cigarettes. There is a high prevalence of tobacco use in Uganda with almost 1 in every 10 Ugandans using tobacco products daily. Statistics from the Uganda Cancer Institute also indicate that 25 % of lung cancer patients were tobacco users.

Globally, tobacco kills nearly 6million people worldwide including 600,000 non smokers exposed to second hand smoke. Uganda ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2007. The Convention was negotiated as a Global Intervention to protect present and future generations from the devastating health, environmental and socio-economic effects of tobacco. One of the steps in fighting Lung cancer besides investing in research and improving on health infrastructure to treat Lung cancer is regulating the causes and tobacco use is one of them. It is linked to 71% of lung cancer cases. 

Uganda passed the Tobacco control Act 2015 and the Tobacco Control Regulations 2019 aimed at controlling the demand for the consumption of tobacco and its products and in the long run, promote the health of persons and reduce tobacco related illnesses and deaths. The law bans smoking in all indoor places and workplaces, on all means of public transport, and in specified outdoor public places, it also bans all tobacco advertising, promotion, and sponsorship, including product displays at points of sale. It prohibits the sale of tobacco products in specified places (health institutions, schools, prisons, and other places), among others.

I commend the government upon taking the initiative as there is an impact created by the Tobacco control Act for instance non-advertisement and promotion of tobacco has been achieved. There are however instances where the provisions have not been upheld, shisha, smokeless, and flavoured tobacco are still being consumed and people can still be seen smoking on the streets and nothing is done about it. Albeit the promulgation of the laws, their enforcement and sensitization of the masses about them should be accelerated. There is no benefit of having good laws only on paper with little or no impact at all on ground. 

There is still a long way to go for us to start harvesting the fruits of the Tobacco Control Act, 2015. Massive sensitization about it should be done, and enforcement of the same should be felt because much of the population is not aware of its existence, some still ignorantly break the laws and since they are not held accountable, they get away with it but the harm is already done. Incentives should also be given to tobacco farmers so they can channel their energies elsewhere, you cannot block their source of livelihood without giving them an option, they should also be clearly educated about the harm that they are causing the world by embarking on tobacco farming. These among other measures can go a long way in the fight against lung cancer.

The writer is an Intern in the Strategic litigation programme at the Center for Health, Human Rights and Development (CEHURD).

”This time I waited for the results with a little bit of excitement because I was sure they would be in my favour. But alas! they still came back positive. At this point I wondered what I was not doing right.”

By Mariana Kayaga

Before I got the COVID test (yes, that irritating nasal swab), I was really fine but as soon as our Human Resources Manager asked me to get a COVID test, fear overtook me, not because I was afraid of testing positive but because I had had a bad experience the last time I tested.  

As soon as the test was finalised, my fears unfolded, I got a running nose and a very painful headache (the kind that hurts just above your eye).

On my way back from buying a handkerchief a friend called, saying she wasn’t fine and that she needed someone to talk to. When I left office I went straight to her place in Kisaasi and spent the night with her as we talked. 

That Saturday morning at around 12pm,  I received a call from the Human Resources Manager 

HR: Hello Mariana, how are you? 

Me : I’m fine, how are you? 

HR : Munange the test came back positive.

Me : Thank you. Have a great weekend. 

HR : If you need any help don’t hesitate to call me. 

At that moment my friend and l were still in bed and I told her my result. Her response wasn’t what I expected because of the stigma that comes with having a positive Covid results. She instead requested me to stay at her place,saying she would look after me. 

I later called my mum, broke the news and told  her where I would be spending the rest of my week. I also called my Manager to inform him about the results and that I wouldn’t be able to go to the office. I can only imagine how he felt given the fact that my seat is next to his.

This COVID thing hits different. After being home for more than three weeks, treating an illness that almost got me stuck to a wheelchair, my anxiety was off the roof. 

The first seven days were the pits with chest pain, a constant headache, terrible flu and a burning sensation in my throat…Ugh! I did some steaming with plain water in a bucket at least twice a day and that went along with some concoctions which included lemon, ginger, garlic and raw pepper. I still wonder why I was adding pepper to the mix because it only fuelled the burning sensation and made my nose run even more.

On top of the random fevers, running nose and headaches, I lost my sense of taste and smell. For some time, I felt like a non-living thing! I could see food but I could not taste or smell it and the top tier was that I was always hungry. 

In my mind I knew things had gone bad and that was the worst feeling I have ever had. I later returned to my place and was by myself with no one to talk to apart from following / engaging in online conversations. It felt really terrible and sometimes I would find myself crying hysterically. The thought of my lungs failing me on one random morning and ending up on a life support machine made my stomach hurt, given the gaps in Uganda’s health care system. I was extremely worried with thoughts of ‘’what if I don’t make it?’’, ‘’what if I get to hospital and it’s crowded without a bed for me?’’ as tears rolled down my cheeks.

Meanwhile, I took COVID tests hoping for negative results, looking forward to days free from the steaming which had even bruised my fingers.

The results still came back positive. Whenever the HR Manager gave me the results, I could hear the worry in her voice.To allay her worries, I always told her I would be fine. During the call she advised that I go get a second opinion and later buy more vitamins (vitamin D3, E, C) and Zinc to boost my immunity.

I went for another test at Norvik Hospital and of course paid  Shs 200,000 but again the result came back positive. To say that I felt terrible when the doctor broke the news is an understatement. 

While I was struggling with all the other symptoms that came with COVID, Azithromycin gave me an extremely painful stomach ache and the only consolation I had was that it was a three days’ dose, so I hung in there. 

After seven days of taking vitamins, I regained my taste buds but couldn’t smell a thing. I went for another test. At this moment, I was desperate for a negative result! This time I waited for the results with a little bit of excitement because I was sure they would be in my favour.  But alas! they still came back positive. At this point I wondered what I was not doing right.

In all this, my father never got tired of calling and checking no my progress. When my mother called and I told her the same results, she decided to send me fruits everyday, saying “Kilabika wetaga bibala” (it seems you need fruits). She sent the fruits till I got a negative result, seven days later. 

The truth is COVID treats everyone differently, some people don’t even notice that they have it (asymptotic), others battle it silently like I did and others get unto life support but we can all get through this. 

My prayer is that we all follow the Ministry of Health guidelines and stay safe. Let us not wait for the people we know to drop dead before we take COVID seriously. If you get it, stay positive and believe you can beat it no matter how frustrating it feels in the moment. 

Ms Kayaga is a Programme Officer in the Community Empowerment Programme.