Visibly feeble and hopeless, is Mphatso Josamu from Yolamu village in area of Traditional Authority Lukwa in Kasungu district, about 150 kilometers away from Lilongwe. She is among cancer patients requiring chemotherapy treatment at least twice a month. 
This is the treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or stopping them from multiplying.
Josamu, 39, was diagnosed with the disease some years ago. Unavailability of required services at her district health facility left her with one option, thus traveling twice between Kasungu and Lilongwe for chemotherapy treatment at Kamuzu Central Hospital in Lilongwe.
“I was hopeful of radiotherapy treatment when I heard that cancer centre was opened for the public, but little did I know that the radiotherapy section was left out.
“I have suffered enough. Traveling between Lilongwe requires resources and with my status I cannot ably engage in viable economic activities. Government should have fast tracked the project,” says Josamu, the mother of three.
Another cancer patient who shares her story is Agness Mkwate. She resolved to stay at a guardian shelter at the referral Queen Elizabeth Central Hospital in Blantyre where she is getting chemotherapy treatment, twice a month as well.
Mkwate hails from Kabuluzi village, in the area of Traditional authority Mulolo in Nsanje district, 128 kilometers away from Blantyre. She is equally needing radiotherapy.
She has been at this facility for over a year.
“The idea to have the Cancer centre was good but I don’t understand why the project has taken years to be completed. If government was serious enough, the project would have been completed by now,” laments Mkwate.
For now, Josamu and Mkwate say they don’t know where to channel their concerns or press for speedy construction of the facility.
However, health rights activist George Musowa says people can always query or push for completion the facility through their Members of Parliament, who allocate funds for such projects.
“People can always demand answers through their MPs. Public officers have to be held accountable. MPS are supposed to serve and advance interests of the people. MPs should push for the completion of the facility and shouldn’t allow any delays,” says Musowa.
Annually, Malawi registers over 19,000 cancer cases with cervical and breast cancers topping the list. The national cancer centre receives clients from across the country and those needing radiotherapy and other specialized cancer treatment are referred to Tanzania or India.
Oncologist and Head of the Cancer Centre in Lilongwe, Dr Richard Nyasosela, admits that the cases are increasing and that the situation is bad due to, among others, inadequate cancer diagnostic and surgical lab services.
In November last year, government, through the ministry of health, signed an agreement with Plem Construction Company to start the construction of Radiotherapy and Brachytherapy Bunkers at National Cancer Centre in Lilongwe for a period of six months.
Bunkers are rooms that contain machines for radiotherapy treatment and made of reinforced concrete, tailored to absorb all types of radioactive radiation, but the construction of the K7.5 billion radiation rooms at the centre stalled at foundation level as treasury was allegedly yet to release funding the for the project.
Plem construction workers and their machinery have been on site since last November, but could not tell why the project stalled but inside sources claim consultants were holding on to the drawings of the project as one way of pushing for their payment from government.
Efforts to reach out to the consultants in question proved futile, but one of the Plem Constructions workers on site, who asked for anonymity, backed up the story.
MBC also understands that government already secured 7.1 million US dollars radiotherapy machines, which will remain abroad until the bunkers are fully constructed.
Head of Infrastructure Development in the Ministry of Health, Dr Anderson Kuyeli concedes that delayed funding halted the project.
Kuyeli describes as untrue claims that the consultants were holding on to the designs for the project over unpaid fees.
Oncologist and Head of Department at the National Cancer Centre at Kamuzu Central Hospital in Lilongwe Dr Richard Nyasosela believes the cost of the project will go up given prevailing challenges including shortages of foreign currency.
“I don’t have concrete figures, but certainly the cost of the project has gone up. The contractor has been at the site all these months and has been charging and government will have to pay him and all those rendering their services. They did not cause any delay, so government cough more resources on the project,” says Nyasosela.
He then calls on government to settle the payment so that the contractor can complete constructing the bunkers, which he said, will help reduce the money government spends on treatment of patients abroad.
“Government has shown great commitment by providing all the necessary resources. Once completed, government is expected to save over K10 billion annually which is used to treat cancer patient outside the country,” says Dr. Nyasosela.
Governance expert, Willy Kabwandira, who is also the Executive Director for Centre for Social Accountability, equally warns of potential costs and implications of delayed projects.
He equally says authorities should be taken to task on some delayed developmental projects across the country, saying they lack transparency and accountability.
“Any project has to be completed with specified duration. Delays result in mismanagement of funds, corruption and burden the tax payer. This is why we have made little progress in infrastructure development including schools and health facilities. There a lot of unfinished projects due mismanagement of resources,” says Kabwandira.
The construction of the National Cancer Center started in February 2017 and it was phased. The first construction phase was made up of chemotherapy suite, administration and consulting block and three wards, and uncompleted two-each Radiotherapy and Brachytherapy bunkers.
In May 2021, a contract was awarded to a new consultant to design and supervise the construction of 4 external beams Radiotherapy and Brachytherapy.
The project was allocated K800 million in this year’s financial year to cover construction, consultant, training and project management.
On financial performance, according to published reports, the consultant contract sum is US$488,315 equivalent to K500 million and has been paid 4 invoices amounting to US$276,467.95 equivalent to K300 million for Civil works.
On the other hand, the Ministry of Health has paid US$1,312,205 equivalent to K1. 5billion to the contractor for Civil works took place from the total sum of US$7,709,477.39, which is about K8 billion.
For now, as various governance and health rights activists are pushing for a responsive, transparent and accountable government and duty bearers, Agnes Mwate remains stuck in the guardian shelter, where unavailability of running water, poor management and uncollected garbage is concern, this is now her home, away from her children and relations.
