Journey of Hope Botswana
Journey of Hope Botswana, focuses on bringing Breast cancer awareness to women in Botswana and assists with treatment and care of Breast Cancer Patients. Website: The Journey of Hope Botswana
History of the organisation
In May 2008 a group of women, some of whom are themselves Breast Cancer survivors, were informed of a breast cancer patient who could not afford the necessary and urgent treatment. Immediately, these women were compelled to help and together they raised the necessary funds to help this woman fight Breast Cancer. Soon, other similar cases came to their attention and once again these women rallied together and enough money was raised to help with treatment.
It became apparent that there was a that there was huge ignorance AbOUT the disease and the potential for its cure and that many women in Botswana were unable to finance and would not consider breast cancer treatment. In 2009 the voluntary work these women were undertaking in regards to Breast Cancer was formalised with the creation of an NGO "Journey of Hope Botswana". This Charity was registered as a non-profit organisation in Botswana - registration number CR 8865 with The Primary objective of educating our people about breast cancer and its treatment and a secondary objective to provide financial assistance to breast cancer sufferers.
During our well-attended breast cancer awareness events it was obvious that Journey of Hope Was not only having a profound and life changing effect on women diagnosed with breast cancer, but also on those who attended these events as spectators and contributors. In our early days we were able to encourage two women identified by us as having breast anomalies to go for medical reviews – a process they would never have undertaken willingly. We supported these two women through their reviews and one was diagnosed with Breast Cancer, the other with Ovarian cancerand, thankfully due to early detection and timely treatment, they are still with us today. Our first tangible outcome! This cemented the notion within Journey of Hope that our singular most important function lay with helping to raise Awareness of a disease that can be so easily treated if detected early.
the Big Journey
The Journey of Hope awareness campaign came into being with the central annual event called the Big Journey.
Piggybacking on similar ‘pink’ campaigns internationally we raised sufficient funds to buy 12 pink Vespas and we trained a pool of ladies across our community to ride the Vespas. The impact on our mainly semi rural communities of a fleet of pink scooters being ridden by ladies in pink helmets and pink jackets is huge; we draw great attention.
These Vespa’s are our marketing tool. On all Journeys the riders are accompanied by support vehicles, an ambulance, and a team of nurses – all of this being provided by our community for no financial remuneration.
Testimonial appearances, talks, breast examinations and awareness workshops are held in our communities, spreading the message of knowledge and hope about this highly treatable disease across the country.
Areas of operation: The Big Journey 2010, 2011 and 2012
In 2010
the first Journey was undertaken across the North East district of Botswana, from Maun to Gaborone, via Francistown. This group gave awareness talks along the way.
In 2011
the Big Journey was made once again this time across the North West district of Botswana from Gaborone to Maun via Ghanzi. Visiting major towns and villages, approximately 2000 men and women were reached and over 800 free breast examinations were provided to those who attended the awareness talks.
In 2012
the Journey route started in Maun on 24 August and proceeded through the central district of Botswana via Rakops, Mopipi, Orapa, Letlhakane, Serowe, and Mahalapye ending in Gaborone on 31 August.
In total we have covered almost 3 000 km in Botswana.
Awareness talks were held in all venues, leaflets, pamphlets and t-shirts were disseminated to the public and clinics. Posters were given to public and health facilities. In 2012 alone a total of 1 638 breast exams were performed, of which 232 were male and 1406 were female. 47 individuals were referred to their local Clinic or Hospital to report a suspicious symptom, for further diagnosis. 2 cases that we consider urgent have been scheduled for urgent referral to Bokamoso, where Journey of Hope will assist with making appointments, transport, accommodation and reasonable financial assistance where necessary.
Treatment assistance
The work of supporting Breast cancer patients has been on-going throughout, with a total of 9 women benefitting from our assistance. The money we spend on medical sponsorship is relatively little; it’s not our main objective, as we live in a country where there is state funded medical service. Our main objective is in promotion of awareness of the disease and the fact that there are steps that can be taken, that in many instances will cure the disease.
However there are always cases where assistance is needed. In 2011 we spent P153 835 on treatment related expenses and in 2012 we have spent P 83 158 to date.
Our primary financial objective is to build up a pot of at least P1 million so that we are able to meet any urgent treatment needs – it is essential that we are financially capable of completing any treatment once we begin it; our secondary financial objective is to raise funds that enable us to undertake our promotional and educational tours and to equip us with facilities that enable dignified, non-threatening breast examinations.
Going forward
Our organisation is growing and building up a diverse and committed stable of regular volunteers and partnerships.
We have worked closely with the University of Pennsylvania School of Nursing, who provided trainee nurses on the first two Journeys in 2010 and 2011.
In an effort to localise our campaign, we are proud to have had 4 Batswana nurses on the Journey in 2012. UPenn has remained involved in on going communication and involvement in pre-Journey breast exams and awareness talk workshops, with all our volunteers and nurses. Not only do the nurses perform the breast exams along the way, but the riders and crew have been trained to do them also. Any suspicious or concerning cases are verified by a registered Nurse before a referral is issued. It is important to remember that our primary focus is awareness education and as such we will not diagnose.
We have begun a partnership with Bokamoso Private Hospital in Gaborone, who provided us with two of the nurses for 2012. These nurses are able to share with their colleagues in the more rural areas a higher standard of training and improved examination techniques. These nurses are able to communicate with the population in the local language and in the local customs, eliminating the need for translations.
We expect that our relationship with Bokamoso Private Hospital will grow to include their involvement in timeous diagnosis and treatment of the cases that need our assistance. We already have a relationship with an oncologist who practises from this hospital. This surgeon has in the past brought to our attention any patients who are in need of financial assistance and support, and we have referred patients to him in return.
As we continue with our awareness campaign, it is becoming evident that our education policy is effective with many of people monitoring their breast health and becoming aware of anomalies; however they are being frustrated by the lack of access to the next step; medical support and diagnosis.
Breast cancer in Botswana
Botswana has a relatively good health care system, offering access to basic treatment to all. However, sophisticated treatment is generally only available in the two main cities – we have received reports that in the more remote areas patients can be turned away with instructions to only return when the discovered lump is much larger or they are in pain. In addition many patients elect to be treated in non-Government Hospitals using their medical aid insurance – often depleting their medical aid benefits before the completion of treatment.
Even if the patient elects to use State run hospitals the cost of travel from the remote area and the cost of staying in the city whilst undergoing treatment is often beyond their means and this can result in them foregoing treatment.
Most of the poor care and neglect is unintentional, through ignorance and lack of resources.
General in-depth information about the health of our people is scant and very biased towards the two main cities.
Breast cancer is certainly a widespread disease in Botswana and if detected early the need for more costly treatments decreases. In a country where the HIV AIDS epidemic has robbed far too many children of their parents, it is unacceptable to allow another evil to do the same, especially when it is preventable.
Our own data collection reflects that, (arising only out of our 2012 journey), of the 47 referrals we issued, 3 were male. This has reinforced our belief that breast cancer awareness cannot be limited to women alone and that men must play a part in our campaign by taking the conversation to the traditional tribal meetings, legitimising the issue for women who are led by this patriarchal system of rule.
In 2010 we began with only awareness and self-diagnosis education, in 2011 we added breast exams and this year (2012) we have added further value by being able to issue a referral for further medical interrogation where necessary. Any anomaly discovered by our testing was verified by a registered Nurse and a referral note given to the person in question, for them to take to a local Clinic or Hospital for further investigation. Where possible we have taken the contact details of all those in need of care and we will follow these cases up during the year, ensuring that any necessary treatment is made available to them.
We also invited the local clinics and hospitals to attend our visits, and where possible we provided training on breast exams to nurses who were unsure of the techniques we use, and in some instances, had the local nurses join us in examining the people they serve. Our experience indicates that there is future scope for more focused training for nurses on breast examinations.
Cancer Statistics in Botswana
The Botswana National Cancer Registry indicates that of the 14 668 cancer cases registered between 1998 and last year, 4 079 (28%) have succumbed to the disease during the same time period. Among the registered cases, mortality is higher in males (53%) than in females (47%) even though the most affected are females (55%) compared to males (45%). Though cancer has been diagnosed in children, it is more common in the age group 19 years and above.
The ten most common cancers in the female population in Botswana affect the cervix (2 062), skin (1 480), breasts (1 331), eyes (341), lymph nodes (302), uterus (239), oesophagus (234), blood (206), ovaries (193) and liver (188).
As awareness centred organisation, we see our responsibility as a voice for those who understand and support our message. With more effective data collection coupled with the on-going awareness, we feel that we can stand together with the nation and demand immediate medical attention for this treatable disease.
Track record
In 2010 the first Journey was undertaken across the North East district of Botswana, from Maun to Gaborone, via Francistown. This group gave awareness talks along the way.
In 2011 the Big Journey was made once again this time across the North West district of Botswana from Gaborone to Maun via Ghanzi. Visiting major towns and villages, approximately 2 000 men and women were reached and over 800 free breast examinations were provided to those who attended the awareness talks.
In 2012 the Journey route started in Maun on 24 August and proceeded through the central district of Botswana via Rakops, Mopipi, Orapa, Letlhakane, Serowe and Mahalapye ending in Gaborone on 31 August.
In total we have covered almost 3 000 km in Botswana.
Target audience/beneficiaries
The key to successful breast cancer treatment is early detection. Being breast aware simply means knowing what your breasts look and feel like normally, being on the lookout for any unusual changes and being checked by a doctor or clinic. We teach people how to perform self-breast examination, and inform them of the signs and symptoms of breast cancer.
Traditionally women over the age of 40 are focussed upon as being at greater risk for developing breast cancer. Our experience has found young women in their 20’s with breast cancer. We believe in teaching and encouraging a habit of awareness that should be entrenched at an early age.
The entire population of Botswana is our target audience. Botswana has a relatively small population of just over 2 million but the distances involved are great. Cellular communication is the primary method of communication in Botswana.
Fundraising
We fundraise throughout the year and also benefit from fundraisers held by others for us.
Our major expenses throughout the year over and above treatments are costs related to the Big Journey, the production and printing of awareness materials, and running costs related to the maintenance and upkeep of our Vespa’s and office.
We have been very fortunate in that Komatsu has agreed to become a main sponsor undertaking to donate sufficient funds to enable us to employ our co-ordinator, meet various administration costs and to rent modest premises.
We are supported by many volunteers who give of their professional time freely.
Support sponsorships or partnerships are in place with the media, allowing radio and press coverage and our web presence.
We have many other sponsors that contribute to the costs either in cash or kind. A recent example of this is the provision of our Medical Examination Gazebos by Botswana Life Insurance Limited.
Other sponsorships in the form of support include Barloworld Limited, who provides support vehicles on the Big Journey and Rescue One who provide an ambulance and two staff members.
References
Examples of the kind of printed information we disseminate can be viewed online:
External links
Some recent articles in the press about our activities can be viewed here:
2011 Botswana Population and Housing Census: