By Elizabeth Mehren
Just about everyone in town knows by now that Marty Walsh is the son of Irish immigrants, a former labor organizer, a recovering alcoholic and a man who is happily unmarried to “the love of my life.” But it’s possible that few outside a rather eccentric quartet of Boston University researchers took note of one particular item in the biography of Boston’s new mayor.
Walsh is a survivor of Burkitt’s Lymphoma, a virulent variety of pediatric cancer that is rare in North America. Walsh is living proof that this fierce form of non-Hodgkin’s Lymphoma — known to be the fastest-growing human tumor — responds well to early diagnosis and chemotherapy.
But in sub-Saharan Africa, where Burkitt’s is the most widespread type of childhood cancer, the outcome is often less rosy. Burkitt’s Lymphoma represents half the number of childhood tumors treated at regional hospitals in Kenya and Uganda. Experts say the disease — first identified in 1958 — is on the rise. Diagnosis is challenging. Treatment is costly. In Africa, treatment often is difficult to obtain because so few facilities are equipped to address Burkitt’s Lymphoma.
Like most Americans, I was unaware of the fatal grip Burkitt’s Lyphoma holds on much of Africa. Then last May, I traveled to western Kenya as part of the aforementioned quirky quartet of four professors. We had joined forces to look at the intersection of public health and journalism, particularly at times of crisis and disaster.
Our goal, with funding from the Bill and Melinda Gates Foundation, was to set up a global student news network dedicated to telling the stories of foreign aid from the point of view of the recipients. And so we brought eight B.U. students together with 10 students from two Kenyan universities in Nyanza Province, Kenya’s westernmost province, and set about uncovering narratives about health, education, employment and other areas. To demonstrate our cross-cultural intentions, we named our project Pamoja Together. Pamoja is the Kiswahili word for “together,” so what we were saying was “Together, Together.”
I learned about Burkitt’s Lymphoma as we conducted research in advance of the trip, to a region that lies close to the Ugandan border, high on the banks of Lake Victoria. One of the stories that one of our Kenyan students, C.J. Ouma, reported on concerned a hospital — one of the few in Kenya that treats this difficult disease.
Chronic malaria abounds in equatorial Africa. For children, this condition can be linked to the development of Burkitt’s Lymphoma. The African strain of Burkitt’s also is closely associated with the Epstein-Barre virus, the main cause of infectious mononucleosis. Burkitt’s is especially prevalent in Kenya’s malaria-prone lake regions.
The disease often starts with swelling in the neck, groin, face or under-arm areas. In Africa, lumps on the skin can result from many causes, including insects, parasites, allergic reactions and random rashes. But Burkitt’s distinguishes itself further because these can grow rapidly, sometimes doubling in 18 hours.
Pamella Adhiambo Otieno, mother of a 2-year-old Burkitt’s Lymphoma patient, Christine Achieng, said, “The symptoms started at six months, and we assumed it was a simple growth.”
So Otieno took her daughter to a traditional herbalist who operated on the lump on the child’s skin. “But it grew and grew,” Otieno said.
Without meaning to sound flippant, it is safe to say that every African village does not have its own resident oncologist. Treatment facilities are scarce, and costs are high. Patients in the region where we were working — seven hours by bus from Nairobi — must be transported to the one teaching hospital in the area that is equipped to diagnose Burkitt’s Lymphoma.
While undergoing chemotherapy, young Marty Walsh wore a wig specially woven to match his red hair. He missed much of second and third grade, and repeated the fifth because the treatment so debilitated him. But while no one is fortunate to endure any form of cancer at any age, Walsh was lucky enough to live in a city with one of the world’s most sophisticated and advanced medical communities.
As Walsh himself demonstrates, chemotherapy can reverse Burkitt’s Lymphoma — but only if the disease is diagnosed early, and treatment is aggressive.
Elizabeth Mehren is a professor of journalism at Boston University and a co-founder of the Boston University Program on Crisis Response and Reporting. Previously a national correspondent for the Los Angeles Times, she is the author of two books and the co-author of another.