Doctor attacks South African government for failing women while spending billions on arms deals

able," he said, alluding to reports of the alleged roles of the country's deputy president, Jacob Zuma, and politicians, Toni Yengeni and Mac Maharaj, in the arms deal and their financial relationships with the arms dealer and suppliers involved in the transaction.

He pinpointed a number of other factors that have contributed to the lack of a coherent breast cancer care policy: "Large-scale emigration of health professionals to other English-speaking countries, equipment and medicine costs spiralling out of control with the currency devaluation, the challenge of AIDS, and a national health care policy motivated by political rather than pragmatic decision-making."

Prof Apffelstaedt's solution to the problems in South Africa and in other African countries where resources are limited is to go back to basics. "Training should be according to 'Western' guidelines adapted to regional availability of resources. It is important that the basics of cancer diagnosis and therapy are taught properly there is no point in treating patients with expensive chemotherapeutic agents, exhausting resources while, for example, the staging of the patient is incorrect. Health authorities are obliged to achieve the greatest good with the limited resources available; this may mean that there should be strict cost-benefit analyses and treatments decided upon by the authorities in collaboration with the health service providers. This approach necessarily leads to the centralisation of experience and equipment in diagnostic and treatment centres, but these centres will fertilise the areas around them. In the end this achieves equitable treatment for all patients."
Abstract no: 235 (14.15 hrs Thursday 18 March, Hall 8)

In Egypt, the Cairo Breast Screening Trial (CBST) has shown that when hard-to-reach women are personally invited for clinical breast screening conducted by female doctors, a high rate of breast cancers can be detected.

Dr Salwa Boulo

Contact: Emma Mason
Federation of European Cancer Societies

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