The Butaro Cancer Center at One Year

Posted on Jul 17, 2013

The Butaro Cancer Center at One Year
Fabrice, who recently completed chemotherapy for Wilms’ tumor, and his mother. Photo credit: Dave Shulman for Partners In Health.

This week marks the one-year anniversary of the Butaro Cancer Center of Excellence, located in northern Rwanda. Built by Partners In Health and the Rwandan Ministry of Health, the center opened in July 2012 and has registered more than 1,000 patients for treatment so far. Here is the story of one of those patients.

Three-year-old Fabrice was a bright-eyed, energetic boy when he began getting fevers daily. Worried, his mother brought him to a local traditional healer near their home on the outskirts of Kigali, Rwanda, who advised that they return home, find a cockroach, and return with it as part of a treatment.

But Fabrice’s symptoms quickly worsened, and his mother’s concerns deepened. She brought him to the nearest health center, where he was transferred to a hospital in Kigali. Fabrice was treated for malaria, but his fever persisted, and he began to have blood in his urine and abdominal swelling. An ultrasound eventually showed a large mass in his kidney. Finally, the physicians transferred Fabrice to a second hospital in Kigali, where he was diagnosed with Wilms’ tumor.

This disease can be cured with a relatively simple chemotherapy regimen and surgical removal of the tumor—survival rates exceed 90 percent in the United States and Europe. But without treatment, the prognosis is dismal. And in many countries where resources are limited, such as Rwanda, children don’t survive this treatable disease.

Fabrice’s mother struggled with her son’s diagnosis. She’d never met someone with cancer, and from what she’d heard, the diagnosis meant Fabrice would surely die.

"No more going to the hospital or health center,” she thought. “I should just wait for him to die." But when doctors transferred Fabrice to Butaro Cancer Center for chemotherapy, she decided it was worth trying.

"It was very difficult when I first got [to Butaro] because he was very sick and I was very scared," Fabrice’s mother says. His condition seemed increasingly dire each day, and she was in an unfamiliar place, away from her husband and her work.

Fortunately, there was no better facility in the region Fabrice and his mother could have gone to. Since its opening in July 2012, the cancer center has registered more than 1,000 patients. Their ailments range from breast cancer to acute lymphoblastic leukemia to Kaposi's sarcoma. Patients from every district of Rwanda, as well as several other countries, have been cared for by expert staff.

After a short while at Butaro, Fabrice’s mother connected with other parents whose children were sick. She even saw other children with Wilms’ tumor—many of whom recovered.

But periods of hopefulness were tempered with frightening moments as Fabrice became sick from his second round of chemotherapy. One of the scariest moments came when he was transferred back to Kigali for the surgical removal of his tumor. She worried he wouldn’t survive the operation.

Yet Fabrice recovered well and returned to Butaro for post-operative chemotherapy. Over the many months he and his mother visited the cancer center for chemotherapy, they connected with families dealing with cancer, receiving treatment, and improving. Her views on cancer evolved, and her hope for the future grew.

A year ago she would have said cancer meant death, but today she tells her friends and family a new, more hopeful story. She tries to fight the stigma that surrounds cancer in her community by explaining that cancer is not communicable like other diseases such as HIV and tuberculosis, and that it can be cured if proper medical care is delivered.

Fabrice has now completed chemotherapy.  He shows no signs of recurrent disease and is once again smiling and playful. Fabrice serves as a hopeful example that cancer does not need to go untreated in the poorest communities, and that cancer is not and should never be an automatic death sentence for patients in even the remotest corners of Rwanda.

PIH's work at the Butaro Cancer Center is supported by the Jeff Gordon Children’s Foundation.

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