CAPTION: Hilowhe Mocow with his daughter, Najima, at the Tygerberg Children's Hospital in Cape Town. Since December 2010, Najima has been receiving treatment for kidney cancer, which later also spread to her liver. She is one of only 700 cases of childhood cancer being diagnosed and treated every year in South Africa - it is estimated that there are 2 500 new cases every year. Photo by: MORNE SLABBERT

HILOWHE Mocow knows every farm animal and cartoon character adorning the corridors and wards of the Tygerberg Children’s Hospital. During the last two years he has also got to know the doctors, nurses, and even the cleaners doing their rounds in the children’s cancer ward in the Cape Town academic hospital.

Nurse Nelia teases him about the woman from the newspaper liking him so much she wants to take his picture, and though the corners of his mouth curl up in a shy smile, his eyes seem tired and worried.

In late December last year his four-year-old daughter Najima completed her second round of chemotherapy and they returned back home to Malmesbury, a small town in the Swartland region about 70km north of Cape Town.

Since she was diagnosed with kidney cancer shortly after her third birthday in December 2010, they have probably made this trip a hundred times for Najima’s three days of treatment, every week. “It has been very difficult,” admits Hilowhe, who has been guarding over his daughter night and day from a bed-side chair while the chemotherapy battles the cancer inside her little body.

He worries not only for Najima, but also for his wife back home in Malmesbury who has to bring up their five other children on the money he makes from working in a friend’s shop on the days when he is home.

Hilowhe is cautiously optimistic. After completing her first round of chemo, Najima fell sick again and in January last year they heard that the cancer has spread to her liver.

“I was very scared and confused. I was very sad because this is a dangerous thing,” says Hilowhe, explaining his disbelief when doctors told him that his little girl had cancer. “I’ve never seen it before. Nobody in my family has had cancer.”

Hilowhe remembers it as if it was yesterday. Najima had been ill for days and wasn’t getting any better. “She wasn’t eating and her stomach was swollen. So we went to the clinic where they took her blood. The doctor there didn’t know what was wrong with her so they sent us to Groote Schuur (Hospital in Cape Town) and after a few days they said she had cancer,” recalls Hilowhe. Najima was admitted to hospital and immediately underwent surgery to remove the tumour from her kidney.

The treatment was then followed up by weekly chemo sessions.

However, Najima is in a way one of the lucky ones. It is estimated that in South Africa about 2 500 children develop cancer every year, but less than a third (700 children) are actually diagnosed and treated.

The main cause for the under- diagnosis is a lack of awareness. With the large majority of cancer cases occurring in adults, especially the elderly, many people don’t realise that children can be affected too, and even fewer know the symptoms of childhood cancer.

This ignorance is also found among health-care workers, often resulting in months of misdiagnosis before the actual cancer is identified and treated.

Professor Christina Stefan and her colleagues from Stellenbosch University conducted a study to determine the causes behind the spate of childhood cancer cases only presented for treatment at an advanced stage of the disease, making it more difficult to treat.

“We always assumed it was due to the parents or the caregiver, their lack of education or their social situation. But to our surprise our study found that the delay in diagnosis was due to us – the health-care professionals,” says Stefan.

Stefan says the tragedy of childhood cancer in South Africa is not a lack of medicine or long waiting-lists. All the drugs are available and free of charge for children below the age of six years,” says Stefan.

The tragedy is children who need treatment simply don’t access it. – Health-e News