Clinical Oncologist Consultant at Gaborone Private Hospital (GPH), Dr Sebathu Chiyapo, is the first Motswana clinical oncologist. He talks to RACHEL RADITSEBE about one of the most dreaded diagnoses – cancer!
Let’s get to know you a little bit better. What brought you to Oncology? When did you realise that you wanted to help in this fight against cancer?
Chiyapo. I was born in Francistown many years ago. I am a Clinical Oncologist by training specialising in treatment of cancers using all available modalities. I did my undergraduate training in Trinidad and Tobago.
I had always wanted to be a surgeon. I was very good with my hands so I thought surgery was my calling. But when I was doing my internship at Nyangabgwe Hospital in Francistown I realised there was a gap in Oncology in Botswana and it was one of those specialties which was unknown in Botswana so I took the challenge. I decided to be an oncologist instead.
Describe the cancer landscape in Botswana?
I would say the landscape of cancer in Botswana is still at grassroots level. There is still a lot to be done. Currently for screening protocols the only programme in place is for cancer of the cervix. We still don’t have proper and adequate screening processes in place. Most of our patients – at least 65 percent or so – present to our services with stage 3 or 4 cancer. With these advanced cancer stages on presentation, the treatment outcomes will also be terrible. So there is a lot of work that needs to be done to our primary health care and public health care systems. There is need for proper consultation and involvement of all stakeholders.
What measures would you suggest to bring down the cancer ratio?
Globally the cancer incidence is increasing and the increase is more in developing countries. Most cancers and cancer related deaths are due to lifestyle and modifiable factors. These factors include things like excessive alcohol intake, smoking, dietary factors, sedentary lifestyles among others. These factors can be modified and that can help to reduce the incidence of cancer. The country also needs to establish some early detection and screening policies. These policies and guidelines may help health care workers and the public to work together in the fight against cancer. There needs to be some awareness campaigns and the parastatals organisations and the community needs to work hand in hand with the government in the fight against cancer.
Tell us something about your achievements. A case you are most proud of maybe?
It’s difficult to look back and point out to one single case and say wow! But generally, some of the things at which I will look back and be happy about will be the legacy I left at Princess Marina Hospital or some of the contributions I made; notably the establishment of the Multidisciplinary Clinics in Princess Marina Hospital which are still functional and improving the landscape of cancer clinics in Botswana. These are specialised clinics where all concerned specialists are in the same room and all seeing patients together and making treatment plans together. They include the Gynecology-Oncology clinic which focuses on female cancers; Breast Multidisciplinary Clinic which focuses on breast cancers; Head and Neck Cancers which focuses on all head and neck cancers.
In seeking the professional advice of a physician, patients typically experience certain levels of anxiety and emotional distress. And although any diagnosis can be a cause for worry, none is more feared than a cancer prognosis. Can you share your experiences/observations when dealing with cancer patients especially where the cancer is deemed terminal?
Rightfully said; after diagnosis of cancer, patients undergo variable anxiety, emotional distress, depression, emptiness and feelings of hopelessness among others. During consultations we do observe a lot of reactions to the diagnosis. Most patients start crying inconsolably during the consultation. We try to give them time and it’s usually easier when they come with a relative or caregiver for support. Some patients just stare and say nothing for a while and we have to give them that space to digest and accept the news. In its own right, cancer is a dreaded disease but it’s not always terminal. Depending on the type of cancer, the stage of cancer and other patient factors, most patients can actually go on to lead a normal life that is cancer-free. We do actually have patients who have been treated for cancer over 20 years ago and they are still alive and living their lives to the fullest.
Many people still see cancer as incurable or terminal; kindly share and elaborate on the advancements that have been made in the field of cancer prevention, screening and therapy over the years?
Cancer is still one of the leading causes of death globally, including in Botswana. With all the advances that have been made over the years, cancer mortality is sill very high. In developing countries the mortality is higher than in developed countries. There have been a lot of new developments in the newer treatments including chemotherapy, radiotherapy, surgical techniques and targeted agents. Nowadays we are trying to avoid the one-glove-fits-all type of approach in cancer management. We try to personalise the treatment to an individual based on their personal needs and disease characteristics. This has helped to improve the treatment outcomes. Technology has also improved quite a lot, which has also revolutionised our treatment approach and treatment plans.
What kind of therapy do you administer during pregnancy?
Cancer treatments usually have a lot of side effects. In pregnant women in particular, we face a unique challenge of having to try to minimise the potential harm to the unborn child from either chemotherapy or radiotherapy. In cases of pregnancy, radiotherapy or chemotherapy can be given with special considerations. The gestation period is very important in deciding to give chemotherapy or not. Chemotherapy is usually discouraged during the first trimester of pregnancy but can be given from the second trimester onwards. Radiotherapy to the upper abdomen and upper body can be given with special shielding to the pelvic area. We usually assess the type of cancer, the aggression of the cancer, the gestation period and assess if there’s any need for termination or if we can proceed with treatment.
Do you give recommendations on treatment options available to your patients? What are your thoughts on Naturopathy for example?
Yes we always do. We discuss all the available options with patients and with relatives or caregivers. All available options are discussed as well as their pros and cons. But unfortunately not all recommended treatment options are always readily available. So sometimes we have to work best with what we have and what is also recommended but ensuring patient care is not compromised. When it comes to Naturopathy, I have no formal training in that regard so it’s difficult to comment but usually if patients want to use some herbal products, I have no problem – as long as they don’t stop their prescribed cancer treatment. You have to look at the patient holistically and allow them also to practice their beliefs and religion but without compromising patient care.
What do you do when a patient does not want the conventional treatment? Chemotherapy for example, has a bad rap and some people even fear going through it.
Unfortunately we never force a treatment down any patient’s throat. It’s a dialogue that we involve the patient, caregivers or any other concerned people. We want the patient to feel they made the decision about their treatment at the end of the day, the patient must be part of that decision making process. There are many instances where patients refuse to do the treatment or part of the treatment either being chemotherapy, radiotherapy or surgery, especially if the surgery involves removal of very intimate parts of the body. We always make an effort to involve social workers, psychologists, psychiatrists if patients can’t make decisions. Sometimes we even recommend that they see another doctor for second opinion. But at the end of the day we respect what the patient wants even if it’s not a wise decision. If at the end of the day they come back, we receive them with open arms and proceed if they have changed their minds and want to start treatment.
VACANCY: President of the UDC
Botswana Movement for Democracy (BMD) President, Advocate Sidney Pilane says Umbrella for Democratic Change (UDC) does not have a President.
He revealed this week that UDC leader, Advocate Duma Boko was given the leadership of the coalition on a temporary arrangement. Advocate Pilane who was addressing the media this week, following the expulsion of his party from the UDC stated that in the buildup to 2014 general elections it was agreed that Advocate Boko should be presidential candidate for UDC, an arrangement that ended at the time when the UDC lost the 2014 general elections.
“It was decided that Botswana National Front (BNF) should be given the presidency so that Advocate Boko could be our presidential candidate. The late Gomolemo Motswaledi of BMD was to be his running mate. We made this arrangement in preparation to taking over state power.
So, all that has passed, we contested and lost so it is all in the past,” said the BMD leader. He stated that constitutionally, the UDC has no president because the president has to be elected during the UDC elective congress. Advocate Pilane pointed out that UDC according to the Constitution should hold its congress every three (3) years.
He stated that even all the members of UDC National Executive Committee have to be elected at the congress and as it stands, “there is no president or Vice Presidents because they were not voted into those positions.”
Advocate Pilane said instead of building the UDC brand their colleagues at Botswana Congress Party (BCP) and Botswana National Front have resorted to petty issues. He told the media that the leadership of the two parties have taught their members to insult BMD leadership and its members on social media and any other forum.
He had no kind words for the BCP, calling the party a divisive party that thrives on insults and divisive tendencies. He said the BCP leadership had encouraged its foot soldiers to use social media to insult him and members of the BMD.
According to Advocate Pilane, these are some of the things that have made the two parties remain in opposition for far too long without even coming close to toppling the ruling party. He described them as dishonest people who will plunge the country into chaos and that is why Batswana do not want to give them power.
VIDEO: A Gaborone hotel Prophet caught in the act
In a matter that closely resembles that of a South African Cabinet Minister, Melusi Gigaba’s masturbating video clip, a visiting Zimbabwean Prophet, Ronald El Melchizedek of Altar of Grace this week denied that he has been sending nudes to church sisters and demanding same from them.
In fact, the ‘man of God’ has earned himself the name, ‘Botswana’s Omotoso’ by girls that allege he has sexually exploited them. Pastor Timothy Omotoso is a Nigerian clergyman accused of sexually exploiting over 30 young girls from his church in South Africa.
“He is an Omotoso and even though they hide it at his church, some of us have received messages from him asking for our nudes. Actually, he has asked for my nudes several times,” says one church sister.
The Midweek Sun has gotten hold of a 34 seconds video clip of the youthful prophet playing with his manhood. Looking like he is in a hotel room, the man stands fully naked in a muted video that, depicts him speaking and teasing the recipient. In a standing position, he starts off by caressing his manhood, giving it a close up and ends up lying on the bed, facing up.
At least three young women say they received the video from the prophet and that he usually asks for nudes from them. One of them actually says he has been pestering her, demanding to have sex with her. “He likes to send me messages of how horny he is for me. But again, he likes asking for nudes from women.
Even married women at his church have fallen victims of his sexual harassment. I left the church because he disgusted me by doing such things yet calling himself a man of God,” she says.
The woman however says that Melchizedek, a Zimbabwean who holds services at Gaborone Hotel when he is in the country, is a man of accurate prophecies. “He moves mightily in the prophetic but he likes harassing church sisters. It is known in his church. He is married but controlled by the spirit of lust,” she says.
The Prophet responds
Melchidezek told The Midweek Sun that he was aware of the video of him doing the rounds through WhatsApp, but was quick to label the whole thing a scam.“Yes we are aware. Those are scammers from Benin who hacked into my wife’s Facebook account and phone and stole our videos and pictures. So they wanted to blackmail us and we refused, that is why they are doing that.
It is just an effort to harm the work of God but God is in control,” he told The Midweek Sun. He would not be drawn into responding to, or even discussing the allegations levelled against him by church sisters, but instead gave this reporter a mobile number of a person he said was his wife.
The said woman confirmed that the video was posted by scammers. “That was done by scammers. We have reported them to Benin police,” she said. She however would not give the name of the police station nor go into further details.
This incident follows on last week’s revelations reported by this publication, where several girls spoke anonymously about pastors, prophets and ‘men of God’who were using them sexually in church. Many were uncomfortable to reveal their names, forcing this paper to also conceal the identies of the accused churches and pastors involved in the dirty acts in the name of God.
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