Battling Breast Cancer in Ethiopia

When Dr. Carol Harris arrived for an early morning meeting this summer at Black Lion Hospital in Addis Ababa, Ethiopia, dozens of weary patients and their families huddled together in dark stairwells, or on wooden benches lining the hallways outside the dimly lit oncology ward. One patient lay motionless, shrouded in a colorful sheath, surrounded by family.

(From left) Drs. Aynalem Abreha, Carol Harris and Agonafer Tekalegne at Black Lion Hospital, in Addis AbabaAs Ethiopia's main cancer referral hospital, the government-run facility offers the only sliver of hope for more than 200 new patients who arrive every day from around the sub-Saharan nation. Each year, Black Lion gets about 6,000 new cancer cases, most of them poor individuals traveling from distant villages by bus, foot, bijaj, or even donkey cart.      

On this rainy day at 8 a.m., the lights flickered and the radiation machine was shut down—a frequent occurrence with the rolling power outages that regularly occur.    

"The lack of infrastructure and shortage of basic services is overwhelming," said Dr. Harris, as she comforted a frail woman receiving a chemotherapy infusion on one of the 18 beds reserved for cancer patients.

The hospital employs only three adult oncologists—who represent all such specialists in the nation—and endures a chronic shortage of chemotherapy drugs. It has the only working radiation machine for the entire country—with a population of roughly 90 million—requiring patients to wait up to six months for treatment of their diagnosis.

Despite no assurance of a cure, desperate families sell their livestock and even their homes to afford the trip to Black Lion, which represents their only glimmer of hope.

Recognizing a Need

A professor of clinical medicine within the division of infectious diseases and director of Einstein's Institute of Global HIV Medicine, Dr. Harris has been working with Ethiopian caregivers and leaders since 2002, when she established a global health program to address the nation's HIV epidemic. She has helped establish an expansive network of programs and services throughout Ethiopia—all focused on capacity building.

(From left) Einstein medical students Corey Fulcher, Vivy Tran, Joann Anthonypillai, Kedong Wang and Audrey Chan stand in front of a traditional Tukul hutShe turned her attention to cancer in 2012, to address the growing number of Ethiopians who are living with—and dying from—a disease that has not been a priority in sub-Saharan Africa.

"Cancer is a noisy disease and it's shouting, but nobody is listening," said Dr. Aynalem Abreha, a palliative care oncologist at Black Lion with whom Dr. Harris works closely. "People go home to die because there is no treatment. Chemotherapy drugs are in short supply because the government has not listed them among essential drugs."

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