NYARUGUSU REFUGEE CAMP, Tanzania – “I discovered I had breast cancer when I was here at the camp. I had felt pain even before I arrived here, but I did not know what it was,” said Ester Irankunda, 44, sitting on a woven mat in a small section of the large, sweltering tent that has been her home in the Nyarugusu refugee camp for the past year. “I was paralyzed in my left hand and had pain in my breast. When I reported it to the health officials here, they checked me and diagnosed me with breast cancer,” she said. Irankunda, who fled to Tanzania from Burundi last year, has already had one mastectomy several years ago.
Tucked away in the northwestern corner of Tanzania, not far from the border with Burundi, Nyarugusu is home to over 130,000 refugees and is desperately overcrowded and hugely underfunded. Living in those conditions on a diet consisting mainly of flour, rice and beans, Irankunda knows the odds are stacked against her in her battle with cancer. The camp’s doctors prescribed her a course of chemotherapy and told her she needs to eat healthily. “There aren’t favorable conditions for the medicine to work well,” she said. “We sleep on the floor, we don’t eat well. There are no vegetables, no fruit.”
Breast cancer, which kills around half a million women globally each year, is the most common cancer to affect women worldwide. While incidence rates are still relatively low in sub-Saharan Africa, they are increasing. Even at the best of times, many parts of the region lack the resources, funding and expertise needed for proper diagnosis and treatment of the disease. But in countries wracked by conflict and in refugee camps crammed with people competing for space, food and medical attention, women trying to survive breast cancer face a seemingly insurmountable challenge.
Irankunda arrived in Tanzania on July 4 last year, fleeing the violence that has spiraled out of control in Burundi since incumbent president Pierre Nkurunziza announced he would run for a controversial third term, violating the Burundian constitution. Protests in the capital, Bujumbura, were met with a lethal police response and the crackdown on dissent was ramped up after a coup attempt failed in May 2015.
Irankunda’s husband was shot by security forces in Bujumbura and later died from the infected gunshot wound. On July 3, 2015, while she was out running errands, she received a phone call from a neighbor, telling her that there were a lot of police around her house. “You can’t come home, they’ve already killed your neighbor,” the caller told Irankunda. “The situation is so bad, it’s not safe here.”
Three of Irankunda’s five children were up-country, at boarding school. “The two youngest ones were at home, but I couldn’t go there,” Irankunda said. Afraid for her life, she fled to Tanzania. “Until now, I haven’t had any news from any of my children.”
When Irankunda arrived, alone, at Nyarugusu, she was directed to a mass shelter and allocated a room she now shares with Miandabu, a Congolese refugee. “I do not have my children with me here, but I have my friend who gives me everything,” Irankunda said. “She fetches water and helps me prepare food.”
But Miandabu has come down with typhoid and malaria – a dangerous combination for Irankunda’s fragile immune system.
“After my chemotherapy, I was advised to try to keep away from other people to avoid catching infectious diseases, but it is difficult to avoid people here,” she said. The tent Irankunda lives in is divided into a dozen or so rooms, each housing several people. A sheet of tarpaulin is all that separates families from one another, with a piece of draped fabric acting as a door. Just outside Irankunda’s room, another Congolese refugee plaits her granddaughter’s hair as they sit on the dusty floor, and further down, a man holds up a broken shard of mirror and dry shaves his chin, his children huddled on the ground beneath him.
It is fitting that Irankunda’s best friend in the camp comes from Congo. Irankunda’s life has long been intertwined with the country. In 1972, her mother fled the genocide that ravaged Burundi, after her husband – Irankunda’s father – was killed in the capital. She escaped to neighboring Congo, where she gave birth to Irankunda, who spent the first 14 years of her life living in exile. She moved to Burundi in 1986, but two years later, when 25,000 Hutus were massacred, she fled back to Congo, where she stayed for two more years before returning “home.” Irankunda became involved in politics, campaigning for women’s rights, and bounced between Congo and Burundi for several years before ending up in Tanzania last year. “I’m a woman who has grown up in exile,” she said. “I don’t want to go back to that country [Burundi]. I can’t, I’m so tired.”
Last October, many of the Burundian refugees in Nyarugusu were transferred to the newly opened Nduta refugee camp, a few hours’ drive down a bumpy dirt road. Over 55,000 refugees live there now. Families have their own tents, and aid agencies have installed water points. “When it was time for people to be taken to Nduta, I missed the chance as I was in hospital,” Irankunda said. She has to stay in Nyarugusu while undergoing treatment, as it’s the only place with sufficient health facilities to care for her. At first, she found comfort in the fact that, if she had to stay, at least she would be there when other refugees from Burundi arrived, and maybe members of her family among them.
But now new arrivals from Burundi are no longer being brought to Nyarugusu. If her relatives have fled to Tanzania, it is likely they have ended up in Nduta.
“I hope that one day, miraculously, I find my children,” she said. “I have so many challenges: I left my home, I lost my children, I lost my husband and I have cancer. But it is the hope that keeps me alive.”
The names of the people in this article have been changed to protect their identities.
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