September 2012

A monthly means to inform and inspire our TEAM

September 2012
Vol. 3, No. 9

A Lifetime Ago

Earliest photo of BL? (taken in 1934 in Shirati, Tanzania, by Ruth Mosemann, early Mennonite missionary.

Earliest photo of BL?
(taken in 1934 in Shirati,
Tanzania, by Ruth Mosemann,
early Mennonite missionary.

In 1934, villagers living around a bay on Lake Victoria in northern Tanzania (now Shirati Bay) were surprised by the arrival of white foreigners. Before that time, not many white foreigners had been seen in that part of the world. But these two young couples from North America had come with the mission of Christian evangelism along with the accompanying promises of education and health care.

With only minimal first-aid type training, the women did what they could to relieve the health problems they saw. And, in that first year, they recorded some of their work with photos. One of those photos shows a child with a very large invasive facial tumor. It was not until almost 20 years later that Dr. Denis Burkitt, working in Uganda across the lake from Tanzania, also observed children with these tumors and eventually described the cancer now known by his name - Burkitt’s lymphoma.

A close look at the photo (as far as we know the earliest known photo of BL) shows that the child is wearing thongs with amulets around his neck and left wrist in a desperate attempt to treat the illness. Now, almost 80 years later, some things have not changed enough. Just a few days ago, I received a new patient, who had been languishing for a month in the hands of traditional healers, who were trying to treat her BL with hot water massage of her back and legs because she had become unable to walk. They only succeeded in abrading her skin. She also had developed a jaw tumor and fluid with tumor masses in the abdomen. The uncle that brought her to me thought she had "polio".

The difference now is that there is effective treatment for BL and the disease can be cured much of the time. For my new patient, the miracle is happening again. Within 48 hours of the first chemotherapy, the abdomen is no longer distended with fluid, the tumor masses cannot be felt, the jaw tumor is shrinking, and the teeth in that area are firming up. We expect recovery, though more slowly, of her ability to walk as well. Before treatment, she was enrolled in the EMBLEM Study. Besides helping this child to get modern diagnosis and effective treatment, the EMBLEM Study will learn more about BL in order to bring even better treatment and the possibility of prevention in the future.

Dr. Esther Kawira - Editor


Ndhiwa area chief addressing EMBLEM cancer awareness meeting

Ndhiwa area chief addressing EMBLEM
cancer awareness meeting

EMBLEM Kenya has spotted 85 cases, of which 22 were Burkitt’s lymphoma. Fourteen (10 male, 4 female) have been enrolled in the study. Five were not eligible and 3 died before enrollment.

Community mobilization is ongoing with visits to Kakamega, Bungoma, Homa bay and Migori. The function at Migori was a free medical camp organized by Got Kacholla Community in conjunction with Ministry of Hope, a faith-based organization. The function was attended by officials from the Ministry of Public Health and Sanitation, Ministry of Medical Services, Health Care Providers, Community Health Workers, EMBLEM CAB members and local leaders. The EMBLEM investigators gave talks and the BL posters were distributed during these visits. These activities have enabled the study to achieve the weekly target of enrollment. It has also enabled us to receive the highest number of enrollment and referrals to the site compared with any previous month.

EMBLEM posters were also distributed during a door to door polio immunization campaign in Homa bay district in collaboration with public health and sanitation. The laboratory received 10 tru-cut needles from Uganda.

EMBLEM Tanzania

Installation of CO2 backup systems for specimen freezers at Bugando and Shirati labs proved problematic in some details and is being sorted out by biomedical engineer from Homa Bay Hospital in Kenya. Meanwhile, the Shirati lab centrifuge, microscopes, and QBC machine were tested and in working order, Tru-cut needles sent from Uganda were received at our Bugando office. Several more BL patients have been enrolled, for a total of 10 (4 males, 6 females). Preparations for a major EMBLEM seminar in Mwanza were also a major task in early September. New budget for 2012/13 was also finalized and submitted to AFENET, with a brief report of our past one year Tanzania EMBLEM activities.


Group photo of clinicians after the training

Group photo of clinicians after the training

A Community advisory Board meeting took place in West Nile at Kuluva Hospital. The study site at Lacor Hospital trained 30 grassroots clinical workers in order to boost case spotting outside of the hospital.

Control enrollment was ongoing in Ndriba Village in West Nile region. This is the 6th of 12 pilot villages. Eighty-five pilot population controls (45 males and 40 females) and 30 HC II controls (13 males and 17 females) were enrolled from the village.

wedding photo

At NCI, Ms. Christine Kiruthu, a Cancer Training Award pre-doctoral fellow, completed her 2-year fellowship at NCI, wedded in August, and started her postgraduate studies at George Washington University. In EMBLEM, Christine served an important role as EMBLEM Portal Use Assistant. We wish her success in hew new pursuits.

EMBLEM Newsletter is a monthly on-line publication based on contributions of the EMBLEM Study staff.
Editor: Dr. Esther Kawira
Reporters: EMBLEM Uganda – Isaac Otim; EMBLEM Kenya – Pam Akinyi Were; EMBLEM Tanzania – Josia Magatti