A Growing Crisis Hidden Behind Hospital Walls
Every year, hundreds of Ugandan families begin a battle they never expected — the fight against childhood cancer.
Many of these cancers are curable. Yet too many children are still dying.
Experts now warn that one of the most alarming threats is not just late diagnosis or lack of drugs, but children dropping out of treatment before completing care.
During February’s Childhood Cancer Awareness Month, specialists raised concern over persistent gaps in care, cultural misconceptions, and systemic challenges that continue to cost young lives.
What Is Cancer? Understanding the Disease in Children
Cancer is a disease that occurs when cells in the body begin to grow uncontrollably.
Normally, cells grow, divide, and die in an orderly way. In cancer, this process breaks down.
Abnormal cells multiply rapidly, form tumors, invade nearby tissues, and sometimes spread to other parts of the body through blood or the lymphatic system.
In children, cancer differs significantly from adult cancers. Most childhood cancers are not linked to lifestyle factors.
They are often caused by genetic mutations that occur early in life, sometimes even before birth. The exact causes of many childhood cancers remain unknown.
However, risk factors can include inherited genetic conditions, environmental exposures, certain infections, and immune system disorders.
Treatment for childhood cancer typically includes chemotherapy, surgery, radiotherapy, immunotherapy, or a combination of these approaches.
Chemotherapy uses powerful medicines to kill rapidly dividing cells. Surgery removes tumors where possible.
Radiotherapy uses high-energy radiation to destroy cancer cells. Immunotherapy strengthens the body’s immune system to fight cancer.
When detected early and treated properly, many childhood cancers have survival rates above 80 percent in high-income countries.
In low- and middle-income countries, survival can fall below 30 percent.
Uganda’s Childhood Cancer Burden Compared to Africa and the World
According to data from the Uganda Cancer Institute, the most common childhood cancers in Uganda include leukemia, kidney cancer (often Wilms tumor), Burkitt lymphoma affecting the lymphatic system, and rhabdomyosarcoma affecting muscles and soft tissues.
Across sub-Saharan Africa, similar patterns are observed, particularly high rates of Burkitt lymphoma, which has been linked in part to malaria prevalence and Epstein-Barr virus infection.
Globally, about 400,000 children and adolescents develop cancer each year. In high-income countries, survival rates exceed 80 percent.
In many African countries, including Uganda, survival rates are significantly lower due to delayed diagnosis, limited access to specialized care, treatment abandonment, and shortages of supportive services.
While Uganda has made notable progress in drug availability and cancer infrastructure compared to some neighboring countries, experts say treatment completion remains a major hurdle.
The Treatment Abandonment Challenge
Speaking at a meeting to raise awareness about childhood cancers, Dr. Banabus Atwiine, a pediatric oncologist at Mbarara Regional Referral Hospital, revealed that although there is no nationwide survey tracking children who drop out of treatment, hospital records show many cases of children unable to continue care.
“Through awareness campaigns, people have learnt about cancer in children. From time to time, they drop out seeking alternative interventions in churches and others in witchcraft, especially when pain intensifies.”
Dr. Atwiine explained that across the country, children’s cancer patterns remain largely the same.
He noted that the major variation lies in delayed diagnosis in some regions, which reduces survival chances even though most childhood cancers are highly curable.
He urged parents and caregivers to be vigilant.
He emphasized the importance of noticing hard and firm painless swellings that appear on any part of the body.
He explained that most childhood cancers present this way.
He warned that ninety percent of such painless swellings in children end up being confirmed as cancer.
The Overlooked Role of Palliative Care
Shortly after Dr. Atwiine’s remarks, Betty Agaba, a palliative care nurse, addressed another critical misconception.
She revealed that both caregivers and some health workers wrongly believe children do not need palliative care.
She explained that many assume palliative care is only meant for adults approaching the end of life.
She said that children who access palliative care services, they respond better and remain on treatment.
Palliative care focuses on relieving pain and improving quality of life during treatment.
For children undergoing aggressive chemotherapy, pain management, emotional support, and psychological counseling are essential to ensure they complete therapy.
Beyond Medicine: The Human Side of Healing
Moses Echodu, who survived Burkitt Lymphoma as a child, offered a survivor’s perspective.
Echodu, now Director of the Uganda Child Cancer Foundation, acknowledged government efforts in supporting pediatric cancer care.
He said the government is currently providing up to eighty percent of all the medicines children need for treatment of cancer.
However, he emphasized that treatment requires more than stocked drugs.
He noted that children need play therapy alongside the often tough treatment regimens.
Play therapy helps young patients cope emotionally with prolonged hospital stays, painful procedures, and the fear associated with cancer treatment.
It restores a sense of normal childhood in an otherwise clinical and intimidating environment.
A Call for Urgency
The warning from experts is clear. Childhood cancer in Uganda is largely curable when detected early and treated consistently.
The tragedy lies not in the disease alone, but in preventable treatment interruption, delayed diagnosis, and persistent myths.
As awareness grows, specialists are urging stronger community education, expanded regional diagnostic capacity, psychosocial support services, and better national tracking of treatment outcomes.
Because for many Ugandan children, survival does not depend solely on medical science but on whether they are given the chance to complete the journey of care.
