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Cancer in Developing Countries

  • Kartonierter Einband
  • 188 Seiten
This book does not attempt to cover all aspects of cancer in developing countries, this would require many volumes. Instead, it co... Weiterlesen
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This book does not attempt to cover all aspects of cancer in developing countries, this would require many volumes. Instead, it consists of a series of essays or "flashes", each of which illustrates an aspect of cancer in developing countries seen from the author`s perspective. Some of these flashes illuminate a very specific and limited issue, while others address more general problems. One hopes that some, at least, will lead to flashes of insight, not only into the problems discussed, but into other, similar problems that permeate cancer in developing countries. And if the book succeeds in stimulating some of its readers to want to know more, or to contribute in some way to improving cancer control in countries with limited resources, then it will have made a valuable contribution.

Prof. Dr. Stephan Tanneberger war Direktor des Zentralinstituts für Krebsforschung der DDR, wirkte im Auftrag der WHO als Onkologe in verschiedenen Entwicklungsländern, ist seit 1993 Professor an der Universität Bologna, die ihm 2012 die höchste Auszeichnung, das Silbersiegel der Universität, verlieh.

II.7 CanSupport: Pioneering Domiciliary Palliative Care in Delhi (p. 97-98) Harmala Gupta and Inder Raj K. Grewal II.7.1 Introduction India is a vast and diverse country with a population that officially crossed the one billion mark on May 11, 2000 (1). Though India continues to be predominantly rural (in 1991 only 26% of the population lived in urban areas) the last couple of decades have seen a substantial growth of urban metropolises (cities with a population of several million) (2). Today Delhi is the third largest metropolis in India, after Mumbai and Calcutta and is growing rapidly (3). According to the most recent Census held in 2001, the population of Delhi has exceeded 13 million. The demographic evolution of the city of Delhi, which is situated in North West India, owes as much to its geographical location as it does to its place in history. Delhi is situated at the heart of a tightly knit group of towns of various sizes, to the west of an immense, fertile and densely populated plain which stretches from the Pakistani frontier to the Gangetic Delta. This part of the Indo-Gangetic plain is constituted mainly by the Punjab, which was 'partitioned' between India and Pakistan at the time of Independence. The Indian side of the Punjab was later subdivided to form the states of Punjab and Haryana and it is to the south east of these that the National Capital Territory of Delhi is situated. After Independence in 1947, Delhi became the capital of the newly formed Indian Union and faced a massive influx of population from the Pakistani part of Punjab soon after. This led to the spatial expansion of the city in all directions, including east of the Yamuna river. The urbanization of the rural hinterland, as well as the emergence of satellite towns that form a ring around the administrative limits of the National Capital Territory, are a result of this. However, Delhi continues to represent a classic model of population density gradients with high densities in the urban core and a sharp decline towards the periphery, In this connection, it is interesting to note, that though 54% of the total area of 1483 square kilometers of Delhi's National Capital Territory is presently defined as rural, it is the urban areas of Delhi that still harbour 90% of its population (4). In the last two decades, there has been a concerted attempt by the Delhi Development Authority to move the population to the periphery. Their housing schemes have, however, been confined to the middle and upper middle classes with the result that large sections of the lower middle class have had to resort to illegal construction on agricultural land not officially authorized for this purpose, while the poor live in precarious squatter settlements known as jhuggi-jhonpris, to be found all over the city. In 1994, according to official estimates, about 481,000 fami lies lived in 1,080 jhuggi-jhonpri clusters, which varied in size from a dozen dwelling units to 12,000. They form about 25% of the total population of Delhi (5). More recent migrants to the city have no option but to live in peripheral areas around Delhi, as most people cannot afford to buy property or pay the high rents within Delhi's urban agglomeration (this excludes the rich who are moving out to live in luxurious "farm-houses" as a lifestyle choice). This, however, has not eased the in-migration flow into the centre of the city. It has, instead, intensified commuting between these areas and the metropolitan centre where most offices and businesses, and therefore employment opportunities, continue to be located. As a consequence, given the lack of a mass transit system in Delhi (only 9 km of a metro rail line have been constructed so far), there has been a massive increase in the number of vehicles on the road as people have invested in their own means of transportation or are ferried ba

1;Preface by the Editors;6 2;Acknowledgement;6 3;Contents;8 4;Contributors;10 5;Foreword;12 5.1;Developing Countries;12 5.2;An Unequal World;15 5.3;Challenge and Opportunity;18 5.4;Cancer in Context;20 5.5;The Coming Plague;23 6;I. Introduction;28 6.1;References;31 7;II.1 The Cancer Problem in Developing Countries;32 7.1;References;36 8;II.2 Some Observations on the Geography of Lymphoid Neoplasms;37 8.1;II.2.1 Global Distribution and Pathogenesis of Lymphoid Neoplasia;37 8.2;II.2.2 BurkittÌs Lymphoma;41 8.3;II.2.3 Acute Lymphoblastic Leukemia in Young People;45 8.4;II.2.4 Follicular Lymphoma;47 8.5;II.2.5 T Cell Lymphoma;48 8.6;References;50 9;II.3 Bridging the Childhood Cancer Mortality Gap between Economically Developed and Low- Income Countries: Lessons from the MISPHO Experience;53 9.1;II.3.1 Introduction;53 9.2;II.3.2 General Framework;54 9.3;II.3.3 What Can be Done and How? The Model Case of Nicaragua.;55 9.4;II.3.4 MonzaÌs International School for Pediatric Hemato-Oncology (MISPHO);61 9.5;II.3.5 International Initiatives;65 9.6;II.3.6 Lesson from the Experience;68 9.7;II.3.7. Conclusions;69 9.8;References;70 10;II.4 Transfer of Medical Technology to Developing Countries: Nicaragua - Success and Failure;72 10.1;II.4.1 Introduction;72 10.2;II.4.2 Nicaragua: Geographical and Political Facts;72 10.3;II.4.3 Programme Background;73 10.4;II.4.4 Cervical Cancer in Nicaragua;74 10.5;II.4.5 The Swiss-Nicaraguan Project for Secondary Prevention of Cervical Cancer;76 10.6;II.4.6 How Political Upheaval Influences Health Care: Patients Pay the Price;76 10.7;III.4.7 Conclusions;77 10.8;References;77 11;II.5 Oncology in Serbia in the Last Ten Years: 1990-2000;78 11.1;II.5.1 General Remarks;78 11.2;II.5.2 Some Epidemiological Characteristics of Cancer in Vojvodina;84 11.3;II.5.3 Environmental Pollution;89 11.4;II.5.4 Summary;93 11.5;References;94 12;II.6 Oncology in Albania in the Last Ten Years: 1991-2001;97 12.1;II.6.1 General Overview;97 12.2;II.6.2 Actual Situation of General Health Care in Albania;98 12.3;II.6.3 Oncological Care in Albania;100 12.4;II.6.4 Different Points of View Regarding the Oncological Situation in Albania;104 12.5;References;107 13;II.7 CanSupport: Pioneering Domiciliary Palliative Care in Delhi;108 13.1;II.7.1 Introduction;108 13.2;II.7.2 The Cancer Scenario in India;109 13.3;II.7.3 The Situation in Delhi;110 13.4;II.7.4 The Burden of Cancer for Palliative Care Services in Delhi;111 13.5;II.7.5 CanSupport: The Conception;114 13.6;II.7.6 CanSupport: The Organization;116 13.7;II.7.6 CanSupport: Our Initial Experience;117 13.8;II.7.7 CanSupport: The Future;120 13.9;References;120 14;II.8 Developing Palliative Care in Kerala;121 14.1;II.8.1 Introduction;121 14.2;II.8.2 Methods;121 14.3;II.8.3 Results;122 14.4;II.8.4 Discussion;125 14.5;References;130 15;II.9 Breaking the Vicious Cycle that Hinders Cancer Control in Developing Countries;132 15.1;II.9.1 Introduction;132 15.2;II.9.2 The Vicious Cycle Encountered in Developing Countries;133 15.3;II.9.3 Addressing the Problem;135 15.4;II.9.4 Simplifying Therapy Ò Realistic or Retrogressive?;138 15.5;II.9.5 The Importance of Clinical Research in Developing Countries;142 15.6;II.9.6 The Need for Cooperation;143 15.7;II.9.7 Summary;145 15.8;References;146 16;III. Audit in Oncology in the Third World;148 16.1;III.1 The Growing Burden of Cancer: Incidence and Mortality;148 16.2;III.2 Risk Factors and Prevention: Do We Use the Chance?;153 16.3;III.3 Cancer Detection: Early or Too Late?;162 16.4;III.4 Treatment of Cancer: A Perspective;168 16.5;III.5 Palliative Care: The Most Urgent and Most Rapid Way to Less Suffering;173 16.6;References;176 17;IV. Conclusions and Strategies for Reducing Cancer Mortality in Developing Countries;182


Titel: Cancer in Developing Countries
Untertitel: The Great Challenge for Oncology in the 21st Century
EAN: 9783886038305
ISBN: 3886038300
Digitaler Kopierschutz: Adobe-DRM
Format: Kartonierter Einband
Genre: Medizin
Anzahl Seiten: 188
Gewicht: 333g
Größe: H228mm x B152mm x T15mm
Veröffentlichung: 01.01.2004
Jahr: 2004