Testi Con Buchi-1

7/27/2019 Testi Con Buchi-1

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Uganda Fights Stigma and Poverty to Take On

Breast Cancer

KAMPALA, Uganda — Mary Namata ……………………. her dress in an examining room atMulago Hospital, revealing a breast taut and swollen with grape-size tumors that looked …………

if they might burst through the skin.

“How ………… have you had this?” a doctor asked gently. Ms. Namata, 48, an elegant woman

with stylishly braided hair and a flowing, traditional Ugandan …………….., looked away,

shamefaced.

“………………. a year,” she murmured. The …………., she admitted later, was closer to four

years.

Such enormous tumors, rare in developed countries, are ……………… here. Women in Uganda,trapped ………. stigma, poverty and misinformation, often do not see help for breast cancer

…………… it is too late.

For Ms. Namata, though, there was ………….. hope that the cancer had not yet spread beyond the

breast, her doctors said. Treatment could prolong her life, maybe ……………… cure her — if it

started soon.

But ……………. she be treated in time? Women in Africa often face perilous delays ……….

treatment as a result of scarce resources, incompetence and corruption. Would Ms. Namata wind up

……………. so many women here, with disease so far gone that doctors can offer nothing ………..

surgery to remove rotting flesh, morphine for pain and antibacterial powder to …………. the smell

of festering tumors that break through the skin?

Cancer has long been neglected in developing countries, overshadowed by the struggle ……………

more acute threats like malaria and AIDS. But as nations …………… the continent have made

remarkable progress against infectious diseases once thought …………. daunting to tackle, more

people are living long …………….. to develop cancer, and the disease is coming to the forefront.

Given the strides poor countries have made against other health problems, they ……………… also

be able to improve the treatment of cancer, public health experts increasingly say.

Two years ………., the United Nations began a global campaign against noncommunicablediseases — cancer, diabetes, heart and lung disease — noting that they hit the poor ……………..

hard. Worldwide, at least 7.6 million people a year die ……….. cancer, and 70 percent of those

deaths occur in poor and moderate-income countries, ……………… to the World Health

Organization.

Breast cancer takes a particularly harsh toll. It is the world’s …………… common cancer in women

and their leading cause of cancer death, with 1.6 million cases a year and ………….. than 450,000

deaths.

Survival rates vary considerably from country to country and even ………….. countries. In the

United States, about 20 percent of women ………….. have breast cancer die from it, compared……………. 40 to 60 percent in poorer countries. The differences depend heavily ………….. the

status of women, their awareness of symptoms and the availability of timely care. At the same



……………, scientists’ deepening insights into the genetic basis of cancer have introduced a

complicated new dimension …………….. the care of women globally.

Uganda is ……………. to improve the treatment of all types of cancer in ways that make sense in a

place with limited resources. A new hospital and clinic, paid ……….. by the Ugandan government,

have been added to the Uganda Cancer Institute in Kampala, ……………… they have not yetopened, for …………… of equipment. A research center is ………………. built.

But women like Ms. Namata, with breast cancer ………………. advanced that there is just a tiny

window of time, if ……………., in which to save their lives, will be among the toughest challenges

here.

“The terrible part about breast cancer is that if we just did what we already know how do in other

places, we could make major shifts in survival,” said Dr. Benjamin O. Anderson, who heads the

Breast Health Global Initiative, based at the Fred Hutchinson Cancer Research Center in Seattle.

There is a pressing need for action because breast cancer is “escalating,” the initiative …………, predicting that incidence and death rates in developing countries will increase ……….. more than

50 percent in the next 20 years.

The breast cancer rate in Africa seems …………. be increasing, though cervical cancer kills more

women in the sub-Saharan regions. It is not clear ……………… breast cancer is actually becoming

more common, or is just being detected and reported ……………….. often, but physicians consider

it a looming threat. Compared with breast cancer patients in developed …………………, those in

Africa tend to be younger, and they are more …………… to die, in large part because of late

diagnosis and inadequate treatment.

Doctors also suspect that more aggressive ………………….. of tumors may be more common in

young African women, as they appear to be in young black women in the United States, though

there is not enough pathology data from Africa to know for …………….. Among women who die

young (ages 15 to 49) from breast cancer, 72 ………………… are in developing countries, and

many leave small children.

“The story of breast cancer here is a miserable …………….,” said Dr. Fred Okuku, an oncologist at

the Uganda Cancer Institute in Kampala, which treats about 200 women ………….. year for breast

cancer. “There is little information for the people …………….. need to be helped. Only a few know

………………. to read and write. Many don’t have TV or r adio. There is no word for cancer in

…………………. Ugandan languages. A woman finds a lump in her breast, and cancer ……………… cross her mind. It’s not in her vocabulary.”

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As Search Goes On for Queens Boy With

Autism, Adults at His School Face Questions

Eleven days…………………………….

a teenager with autism walked away from his school in Queens in themiddle of the day, a senior police commander, Chief of Department Philip Banks III, said …………………….

Tuesday that an intensifying search ……………………….. failed to turn up even a trace of the student.

As the effort to locate the boy, Avonte Oquendo, continued, a lawyer for the family and advocates for

children with disabilities said they were ………………………………….. troubled by a prior mystery: How did the

14-year-old get out of the school to begin ………………………..?

The lawyer, David H. Perecman, said he ………………… exploring several apparent breakdowns

in the moments ……………. and after Avonte left the Riverview School on Oct. 4, his

disappearance …………………… the streets of Long Island City captured in a portion of

surveillance video footage.

“What happened here was clearly a ……………….. of mistakes,” said Mr. Perecman, who has filed

a claim against the city ……………….. behalf of the family. “His mother was under the

understanding that Avonte would be …………………. constant supervision.”

He and others, ………………………… advocates for special-education students, said they wanted

more information on the actions of adults supervising Avonte, on how the boy ……….. past a

school safety officer who was guarding a side door and …………….. it took school officials

between 45 minutes and an hour to contact the police and the boy’s mother, Vanessa Fontaine.

“No student …………….. ever get away,” said Maggie Moroff, the special-education policycoordinator at Advocates for Children of New York, a nonprofit legal group.

Schools Chancellor Dennis M. Walcott has said the episode has prompted a review of protocols and

procedures for …………….. emergencies. But a spokeswoman for the city’s Education De partment

declined on Tuesday to …………….. specific questions about the matter, citing the continuing

investigation.

The city school system has been carrying ……………… significant reforms of special education

that are intended to reverse a longstanding practice of segregating those students in ……………

own classrooms and schools. Several advocates hailed the effort, known …………………

mainstreaming. Still, many wondered whether the policies attending the effort, begun in earnest last

year, were adversely affecting some children, particularly …………….. with the most severe needs.

“This is not a clear case of reform gone bad,” said Jean Mizutani, an education team leader with

Resources for Children with Special Needs, a nonprofit ……………………. “But the policies of

reform ……………… affect programming and development and the plans made ……………. these

students. Any child should be entitled to be in any school, but at the ……………… time if the

school is not ……………….. to support that child successfully, that child should not be there and

that is the gap we ……………. in now.”

The program Avonte is enrolled in serves only special-needs children but is housed in a buildingwith typical students from two ……………. schools, said Mr. Perecman, who questioned whether

…………………… in the building was as familiar as necessary with the special-needs population.



Avonte, who has severe autism and is nonverbal, has an Individualized Education Plan, …………..

as an IEP, calling for him to be in a class ………….. one teacher and one paraprofessional for every

six pupils. This was his first ……………….. at Riverview, Mr. Perecman said.

On Oct. 4, Avonte ……………… his home in Rego Park and boarded a special bus for Riverview,

which is at 1-50 51st Avenue in Long Island City. That day, Avonte ………….. to lunch, Mr.Perecman said, “and apparently, based on accounts up to now, was noticed missing by his teacher

when class was …………………. to begin again.”

He “wandered off the line, he ran,” said Mr. Perecman, who said the boy’s past educational plan

noted how he …………………. run in the hallways between classes and that a goal this year was to

work ……………… that problem. Avonte encountered a security guard who later told the boy’s

grandmother that she ……………….. him a question and when he did not reply, she …………….

him leave the building, Mr. Perecman said.

The police said Avonte was last …………….. at 12:38 p.m., dressed in a gray striped shirt, black

jeans and black sneakers. Ms. Fontaine ……………. called at 1:40 p.m. and arrived at the school at2:40 p.m., when school officials asked her to “call out to her son” over the school’s public address

system, Mr. Perecman said. The police were first notified sometime ………………….. 1:35 p.m.

and 1:45 p.m., Mr. Perecman said, which he called a “preposterous” delay.

Because Avonte likes trains, fliers with his face have ………………. plastered throughout the

transit system. Subway riders are …………… announcements that begin “Police are seeking a

missing child, Avonte Oquendo, 14. He suffers ………….. autism and cannot communicate

verbally.”

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