I was recently working with my student volunteers when one of them asked me, “Ms. D from what I’ve learned from you, breast cancer awareness should be a daily occurrence, why is October the month for breast cancer awareness?” Did I realize that maybe other people may also be wondering, why October? Breast Cancer Awareness Month is a global campaign lasting the month of October, intended to increase global awareness of breast cancer. The first organized effort to bring widespread attention to breast cancer occurred as a weeklong event in the USA in October 1985. Since then, campaigns to increase awareness of this disease, to educate people about methods of prevention, early detection, and to raise money to support research have extended to countries around the world. Today, nonprofit organizations, government agencies, medical institutions work together to promote breast cancer awareness. People choose to Walk, Run, Cheer, and innovate ways to show support for a great cause.                                                                      

A Pink Ribbon symbolizes breast cancer awareness hence all the pink you see around you.  For me, pink has become my life-purpose since I met breast cancer head-on – it killed my sister; I survived it and in defiance of it and memory of my sister, I become a fiercely passionate advocate against breast cancer. When you see me, you see pink, a permanent reminder of the urgent need to fight this disease until we find the cure. BCIEA is the vehicle through which this fight is conducted.

The purpose of Breast Cancer Awareness Month is to increase attention and support for the importance of early detection, treatment as well as palliative care of this disease. According to the World Health Organization (WHO), breast cancer is the most common cancer among women worldwide, and in low-income countries like Rwanda, it is the second cancer killer next to cervical cancer. According to RBC and the new Rwanda Cancer Registry. 52% of breast cancer patients present their cancer with stage III and 24% with stage I, this is due to patient-related delays (not being aware of the importance of early detection, not being able to afford transportation) or system delays in diagnosis due to inadequate infrastructure and specialization. Because of BCIEA’s campaign, mobilization, and community outreach-education, breast cancer awareness is gaining ground in Rwanda but much more remains to be done.                                  

BCIEA’s revamped innovative project called Fighting Breast Cancer One Smartphone per Village that integrates the technology of a smartphone, BCIEA Breast Health Educational App, and implemented by a medical student and Village Ambassadors will boost awareness starting from the village level. There is no confirmed cause of breast cancer and this makes early detection the cornerstone of breast cancer control. It is a known fact that when breast cancer is detected early, with adequate, timely, and accurate diagnosis and treatment, it can be cured. If detected late, curative treatment is difficult or impossible and palliative care becomes the option for the patients and their families. The majority of deaths, annually 269,000 in low income countries (WHO) are due to lack of awareness, early detection, and disparities in the health care systems and services.

BCIEA’s Logo carries a meaning that illustrates the determinants of low survival rates in underserved settings of the world like Rwanda.

Our pink Logo is in harmony with the universal fight against breast cancer.   

It also symbolizes the African woman who is ever so busy, that she never has time for herself.

She is at the forefront of the physical, emotional, and spiritual needs of her family. 

She strives and toils to meet the needs of her children and the whims and desires of her husband. 

She is far too busy to afford time off.

Sick leave is not an option.

She is afraid to express her weakness for this makes her vulnerably replaceable –         “What about my children?” constantly haunts her and she must hide her pain.

Her socioeconomic status does not include any health care insurance, so                         “Why bother about what’s wrong with me if I have no power or means to change it?” She laments.

Her situation is compounded by geography, the few ill-equipped health clinics in the rural area are where she lives, so even if she visited the clinic nothing much would be done to help her.

This woman’s dilemma is real.

She must learn to take charge of her health.

She must be empowered to change so that she can truly play her role as the backbone of her society.

Ben Franklin said, “An investment in knowledge always pays the best interest.”  

Although breast cancer remains a big challenge, Rwanda has made major strides in addressing cancer in general.

  • Strategies for early detection with the awareness of early signs, symptoms, screening by Breast Self-Exam, and Clinical Breast Exam Practice are integral to the BCIEA program.

Cancer awareness for the general population is gaining government attention

  • Promotion of comprehensive breast cancer control as part of the 5 year National Cancer Control Plan (NCCP), launched March 4, 2020.
  • Cancer patients are receiving chemotherapy at Butaro Cancer Center, and Radiotherapy at the Rwanda Cancer Center in Kanombe which has greatly reduced the need to refer patients outside the country
  • Now we have Butaro Cancer Center of Excellence, Rwanda Cancer Center in Kanombe and the five major hospitals with specialized staff—of course, we need more medical infrastructure and capacity building, but it is incredibly inspiring to know that a breast cancer patient no longer has to leave the country for treatment.
  • Expanded availability of surgery, chemotherapy, and radiation therapy services means that Rwandans have the option to receive treatment at home. However, the cost of cancer care remains a major challenge. The community-based insurance pays only 90% of non- chemotherapy medical bills and the remaining 10% still remains unaffordable to many patients with breast cancer. For example, Monique’s bill was 1,800,000 Rwf for which she had to pay 180,000 Rwf that she could not afford. Fortunately, through vigorous fundraising, we were able to meet her 10%, got her treatment, and now alive and well.
  • A cancer registry has been established and with increasing interest in research.

COVID19 affected breast cancer care in many ways: because of its highly contagious nature, any medical procedure considered elective or not necessary to save life was canceled or delayed. Because of this, some patients developed anxiety, fear, stress, and panic in addition to their cancer. One patient called complaining that if prompt treatment is important if her surgery is delayed, won’t her cancer move to her other organs? The most important message for the patients is the reassurance that whatever recommended course is, they are not put at risk. This disruption never experienced before requires immediate management and long-term solutions to the moderate crisis in the future.

In practical terms, the impact is heavy this October; without our annual Ulinzi Walk and Ulinzi Fundraising Dinner, our major Awareness Events, and source of funding, it is going to be tough on the program. It is a fact; cancer does not stop when a crisis happens. In fact, the crisis amplified and exposed our shortcomings. Social distancing and lockdown severely disrupted our work in promoting awareness prevention and treatment. The majority of program activities are community-based interactions, with social distancing, they all came to a standstill the essential human connectivity suffered especially for rural beneficiaries without cell phones.                                                                                                                              For patients, it increased behavior risk factors: physical inactivity, unhealthy diets, delayed regular check-ups/follow-ups, depression, and mental issues.                                                                                    This calls for everybody on an individual basis, to pay more attention to the 2020 October Breast Cancer Awareness Campaign Clarion call during this unprecedented time of a New Normal.

  • Early detection remains is crucial
  • Raising Awareness is a must
  • Reducing risk factors necessary
  • Financial support for the above issues is essential at the individual, local, national, and international levels: we are all in this together.

For how you can get involved in what BCIEA Inc. is doing to address Breast Cancer in Rwanda and beyond, please visit our web site: