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A while back, a young college lady presented to my clinic. 

She wanted me to check a lump in her left breast-for the umpteenth time. The lump sat just astride her nipple, on the periphery of that dark central part of the breast named the areolar. 

From history and examination, I could tell it was a harmless lump we call a fibroadenoma. Fibroadenomas are common among the young female patients. They move around and are difficult to pin down when examining. We like to christen them ‘the breast mole’

Despite the clinical certainty and assurance by the different doctors, my patient still wanted another opinion. 

I examined her and reviewed a fine needle aspiration (FNA) report she had carried. There was no cause for alarm, I re-emphasized. 

“I read your article cautioning us about sitting on breast lumps until it’s too late”, she remarked. 

I was impressed (both by the patient for taking my message seriously and myself for reaching another soul through the mass media advocacy). We decided to ignore the lump after ascertaining that it was not cancerous, and it did not cause her pain. We could always review it in another six months or so. 

The heightened sense of responsibility and concern around breast cancer that we witness in the month of October is an encouraging public health initiative. We have successfully leveraged on repetition and focus to concert our efforts towards breast cancer. We adorn the pink ribbon lapel pins and set aside prime time TV minutes to discuss the scourge. 

What about other non-communicable diseases? Can we harness the same spirit? With new World Health Observances being promulgated day in day out, we shall end up with each day of the year dedicated to a certain medical condition. There are more than 14,000 diseases categorizable under the 10th International Classification of Diseases (ICD-10). 

Do you want to wake up each day and celebrate cerebral palsy day, leukemia day, colon cancer day, boda boda accident day etc? probably not practical. 

What would be the alternative then? To leverage on the highly recognized breast cancer awareness month of October and rally every person to take it as their health check-up or physical wellness month. 

This will create a habit and conscience about one’s holistic health. The current targeted approach is brilliant in terms of breast cancer. We see health sector players offering free or subsidized consultation and imaging services to encourage patients to turn up for screening. The marketing flyers often have ladies’ pictures as their signature images. 

This can create a bias where the males ignore breast cancer. Afterall, from the look of things it seems like a ladies’ affair. Even for the ladies, they might forget other health complaints and report just breast problems. The subsidized rates do not often focus on other medical problems. 

What is the use of screening for one condition and releasing the patient with the believe that they are fully healthy as they were seen by a doctor during the breast cancer screening? 

The key players in the health financing sector should consider this as part of their insurance package cum Corporate Social Responsibility. That adults can have annual medical check-up in the month of October and have a prescribed subsidized cost for cancer, non-communicable diseases and nutritional status screening among others. The list of what to screen for could be easily established by our public health, data science and national planning specialists. 

The national and county governments can adopt this public health campaign and offer it political support. I would be excited to see synchronized wellness campaigns the same way we see vaccination drives choreographed across counties. 

Creating a habit takes time. But the power of habit is limitless. Having a health check-up in October can be established with the same fanfare as the immunization drives or the December festivities. 

Mobile clinics can be put up to reach people in their workplaces. Within 30 minutes, a Kenyan can have a doctor’s assessment, blood pressure and sugar measurement, weight measurement, breast and prostate exam, and targeted health education- all done behind a portable makeshift tent within their workplace. The list could be longer and priority areas tweaked to reflect the relevant demographic and epidemiology. 

Vaccine drives help curb infectious diseases. Let us adopt screening drives to curb the rising non-communicable diseases as an entity, not in silos.

Dr Aruyaru’s book, The Chronicles of a Village Surgeon is available on Nuria and Amazon

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About the Author

Dr. Stanley Aruyaru

Dr. Aruyaru is a Consultant General and Laparoscopic Surgeon and a Healthcare Manager. He has solid experience in managing busy surgical units and leading clinical teams to deliver in the lines of quality health provision and evidence based surgical practice.

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