lynsey addario, photographer

Healthcare, Maternal Mortality and Sexual Violence: Breast Cancer in Uganda

  • Mable Mutamba, 37, a breast cancer patient, poses for a potrait at her sister's home in between chemotherapy sessions for a tumor that has burst through the skin, in Kampala, Uganda, July 21, 2013. Mable, like so many other women in Uganda, waited until her cancer was in the advnaced stages, and the tumor had burst through her skin and eaten away a large part of her breast, before seeking medical care at the Cancer Institute. She found a lump in her breast roughly two years before, and tried traditional medicine consisting of boiled herbs, which proved unsuccessful. While Uganda was able to get a handle on the AIDs epidemic through ARV drugs and assistance from the international community, the country still struggles with how to treat and diagnose an overwhelming number of Cancer patients across the country. Thousands are currently being treated by only a handful of trained Oncologists in the entire country of Uganda; basic chemotherapy and Cancer medicines are often in short supply or unavailable, the radiation machine is outdated, in-patient beds are limited, and most Cancer patients can not afford transportation fare to reach diagnosis and treatment in Kampala from villages across the country.
  • Breast Cancer patient Jolly Komurembe, 38, lies dying as her sister, Peace Magoba, cares for her, and Jolly's daughter, Martha Tumuhekyi, 15, says goodbye for the last time before going back to boarding school in the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 21, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Robert TK wipes the sweat off the face of breast Cancer patient Jolly Komurembe, 38, as he cares for her in the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 17, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Breast Cancer patient Jolly Komurembe, 38, is assisted by her sister in law, Louinca Kusasura, 36, cares for her in the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 17, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Breast Cancer patient Jolly Komurembe, 38, lies dying as her sister, Peace Magoba, cares for her in the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 21, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Breast Cancer patient Jolly Komurembe, 38, lies with oxygen as her sister in law, Louinca Kusasura, 36, cares for her in the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 17, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Breast Cancer patient Jolly Komurembe, 38, lies dying as her heart fails in the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 21, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • The sisters of breast cancer patient, Jolly Komurembe, 38, react to news from the doctor that Jolly's heart is failing, and death is imminent in the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 21, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Robert Biryomuruwe reacts to his wife's worsening condition minutes before Jolly Komurembe, 38, passes away from breast cancer in the Solid Tumor Ward of the Cancer Institute, in Kampala, Uganda, July 22, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Relatives and medical staff carry the body of breast cancer patient, Jolly Komurembe, 38, from the ward at the Cancer Institute to the mortuary attached to the Mulago Hospital, in Kampala, Uganda, July 22, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • A nurse wipes down the former bed of breast cancer patient Jolly Komurembe, 38, minutes after she passed away in the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 17, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Adrine Ashaba and Peace Magoba look at the dead body of their sister, Jolly Komurembe, 38, hours after she died of advanced breast cancer and before being transported to her village for burial in Western Uganda, in Kampala, Uganda, July 21, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Edith Kemigisha, 9, screams and weeps as she looks at the dead body of her mother, Jolly Komurembe, 38, hours after she died of advanced breast cancer and before being transported to her village for burial in Western Uganda, in Kampala, Uganda, July 21, 2013. Jolly, who has four children with her husband Robert, found a tumor around two years before while living in the western Uganda district of Rukunghiri. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, Jolly's cancer was advanced when she finally had a mastectomy in January 2013. These images depict the final week of her life.
  • Breast Cancer patient Jessy Acen, 30, sleeps outside at the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 17, 2013. Jessy, who has two children living with relatives in the northern district of Gulu, found a tumor in her breast in 2008, and eventually went to a medical center in Gulu for diagnosis. Her case was disregarded by doctors in Gulu, and after persisting, Jessy was finally sent to the Mulago Hospital in Kampala for treatment. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, or who are misdiagnosed by medical staff around the country, Jessy's cancer was advanced when she finally had a mastectomy. Jessy sleeps at the hospital for several weeks while receiving chemotherapy because she could not afford the $10. bus fare back to Gulu in between treatment.
  • Breast Cancer patient Jessy Acen, 30, receives chemotherapy at the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 22, 2013. Jessy, who has two children living with relatives in the northern district of Gulu, found a tumor in her breast in 2008, and eventually went to a medical center in Gulu for diagnosis. Her case was disregarded by doctors in Gulu, and after persisting, Jessy was finally sent to the Mulago Hospital in Kampala for treatment. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, or who are misdiagnosed by medical staff around the country, Jessy's cancer was advanced when she finally had a mastectomy. Jessy sleeps at the hospital for several weeks while receiving chemotherapy because she could not afford the $10. bus fare back to Gulu.
  • Breast Cancer patient Jessy Acen, 30, changes her own bandages before sleeping on the floor at the entrance of the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 17, 2013. Jessy, who has two children living with relatives in the northern district of Gulu, found a tumor in her breast in 2008, and eventually went to a medical center in Gulu for diagnosis. Her case was disregarded by doctors in Gulu, and after persisting, Jessy was finally sent to the Mulago Hospital in Kampala for treatment. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, or who are misdiagnosed by medical staff around the country, Jessy's cancer was advanced when she finally had a mastectomy. Jessy sleeps at the hospital for several weeks while receiving chemotherapy because she could not afford the $10. bus fare back to Gulu.
  • Breast Cancer patient Jessy Acen, 30, is examined by Dr. Victoria Mwebe, 26, before Jessy receives chemotherapy at the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 22, 2013. Jessy, who has two children living with relatives in the northern district of Gulu, found a tumor in her breast in 2008, and eventually went to a medical center in Gulu for diagnosis. Her case was disregarded by doctors in Gulu, and after persisting, Jessy was finally sent to the Mulago Hospital in Kampala for treatment. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, or who are misdiagnosed by medical staff around the country, Jessy's cancer was advanced when she finally had a mastectomy. Jessy sleeps at the hospital for several weeks while receiving chemotherapy because she could not afford the $10. bus fare back to Gulu.
  • Breast Cancer patient Jessy Acen, 30, waits to have her bandages changed by a nurse before sleeping on the floor at the entrance of the Solid Tumor Ward of the Cancer Institute attached to the Mulago Hospital, in Kampala, Uganda, July 20, 2013. Jessy, who has two children living with relatives in the northern district of Gulu, found a tumor in her breast in 2008, and eventually went to a medical center in Gulu for diagnosis. Her case was disregarded by doctors in Gulu, and after persisting, Jessy was finally sent to the Mulago Hospital in Kampala for treatment. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, or who are misdiagnosed by medical staff around the country, Jessy's cancer was advanced when she finally had a mastectomy. Jessy sleeps at the hospital for several weeks while receiving chemotherapy because she could not afford the $10. bus fare back to Gulu.
  • Breast Cancer patient Jessy Acen, 30, is assisted by a nurse as she walks with her belongings to the exit of the Cancer Institute the morning after receiving chemotherapy in Kampala, Uganda, July 20, 2013. Jessy, who has two children living with relatives in the northern district of Gulu, found a tumor in her breast in 2008, and eventually went to a medical center in Gulu for diagnosis. Her case was disregarded by doctors in Gulu, and after persisting, Jessy was finally sent to the Mulago Hospital in Kampala for treatment. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, or who are misdiagnosed by medical staff around the country, Jessy's cancer was advanced when she finally had a mastectomy. Jessy sleeps at the hospital for several weeks while receiving chemotherapy because she could not afford the $10. bus fare back to Gulu.
  • Breast Cancer patient Jessy Acen, from Gulu, rides the bus back to her family in Pece Vanguard, on the outskirts of Gulu in between Chemotherapy sessions in Kampala, Uganda, July 23, 2013. Jessy Acen first discovered a lump in her breast in 2009. She traveled from her home in Gulu to Mulago Hospital in the Ugandan capital of Kampala to have her diagnosis of breast cancer confirmed. She began chemotherapy soon after but, unable to afford the cost of transport the 300 km from Gulu to Kampala, she was forced to stop treatment. By the time she'd returned to Mulago in 2011 her cancer had spread to her lymph nodes, liver and lungs.
  • Breast Cancer patient Jessy Acen, from Gulu, is is bathed by her sister in Pece Vanguard, on the outskirts of Gulu, Uganda, July 23, 2013. Jessy, who has two children living with relatives in the northern district of Gulu, found a tumor in her breast in 2008, and eventually went to a medical center in Gulu for diagnosis. Her case was disregarded by doctors in Gulu, and after persisting, Jessy was finally sent to the Mulago Hospital in Kampala for treatment. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, or who are misdiagnosed by medical staff around the country, Jessy's cancer was advanced when she finally had a mastectomy. Jessy sleeps at the hospital for several weeks while receiving chemotherapy because she could not afford the $10. bus fare back to Gulu.
  • Breast Cancer patient Jessy Acen, from Gulu, is welcomed home by her two sons, Jered Kakanyero, 4, and Oyak Emmanuel, 11, and her brother, Owiny jackson, 26, in Pece Vanguard, on the outskirts of Gulu, Uganda, July 23, 2013. Jessy, who has two children living with relatives in the northern district of Gulu, found a tumor in her breast in 2008, and eventually went to a medical center in Gulu for diagnosis. Her case was disregarded by doctors in Gulu, and after persisting, Jessy was finally sent to the Mulago Hospital in Kampala for treatment. Like so many women in Uganda who don't seek medical care for diagnosis and treatment in the early stages of Cancer, or who are misdiagnosed by medical staff around the country, Jessy's cancer was advanced when she finally had a mastectomy. Jessy sleeps at the hospital for several weeks while receiving chemotherapy because she could not afford the $10. bus fare back to Gulu.
  • Breast Cancer patient Jessy Acen, from Gulu, plays tenderly with one of her sons, Jered Kakanyero, 4, as he caresses her swollen arm and hand in Pece Vanguard, on the outskirts of Gulu, Uganda, July 23, 2013. Jessy Acen first discovered a lump in her breast in 2009. She traveled from her home in Gulu to Mulago Hospital in the Ugandan capital of Kampala to have her diagnosis of breast cancer confirmed. She began chemotherapy soon after but, unable to afford the cost of transport the 300 km from Gulu to Kampala, she was forced to stop treatment. By the time she'd returned to Mulago in 2011 her cancer had spread to her lymph nodes, liver and lungs.
  • Ugandan woman Mary Namata awaits a team of American Oncologists to attend to her during a weekly screening for Breast Cancer at The Mulago Hospital in Kampala, Uganda, July 17, 2013. A team of American doctors from the University of Washington visited and worked alongside Ugandan medical staff at the Cancer Institute and the Mulago Hospital--the primary two locations in all of Uganda for detection and treatment of Cance
  • Surgeon Dr. William Wood looks over the tumors in Mary Namata's breast during a weekly screening for breast cancer at the Mulago Hospital in Kampala, Uganda, July 17, 2013. Namato has had the lump in her breast for roughly four years, but like many other women in Uganda, she first tried traditional medicine of boiled herbs to cure her tumor before approaching the Mulago Hospital or the Cancer Institute. A team of American doctors from the University of Washington visited and worked alongside Ugandan medical staff at the Cancer Institute and the Mulago Hospital--the primary two locations in all of Uganda for detection and treatment of Cancer.
  • Radiologist Connie Lehman performs a biopsy on the tumor in Mary Namata's breast during a weekly screening for Breast Cancer at The Mulago Hospital in Kampala, Uganda, July 17, 2013. A team of American doctors from the University of Washington visited and worked alongside Ugandan medical staff at the Cancer Institute and the Mulago Hospital--the primary two locations in all of Uganda for detection and treatment of Cance
  • Mary Namata jokes with her grandchildren outside her home, outside of Kampala, Uganda, July 20, 2013. Mary, like so many other women in Uganda, waited months before visiting a doctor after feeling a tumor in her breast. When she recently attended the breast clinic at the Mulago hospital, doctors surmised that her cancer would only be treatable for a time before it advanced too far to be treated with treatment available in Uganda. While Uganda was able to get a handle on the AIDs epidemic through ARV drugs and assistance from the international community, the country still struggles with how to treat and diagnose an overwhelming number of Cancer patients across the country. Thousands are currently being treated by only a handful of trained Oncologists in the entire country of Uganda; basic chemotherapy and Cancer medicines are often in short supply or unavailable, the radiation machine is outdated, in-patient beds are limited, and most Cancer patients can not afford transportation fare to reach diagnosis and treatment in Kampala from villages across the country.
  • Ruth Nabisubi, 52, right, waits in line for radiation treatment for cervical cancer at the Mulago Hospital, in Kampala, Uganda, July 19, 2013. While Uganda was able to get a handle on the AIDs epidemic through ARV drugs and assistance from the international community, the country still struggles with how to treat and diagnose an overwhelming number of Cancer patients across the country. Thousands are currently being treated by only a handful of trained Oncologists in the entire country of Uganda; basic chemotherapy and Cancer medicines are often in short supply or unavailable, the radiation machine is outdated, in-patient beds are limited, and most Cancer patients can not afford transportation fare to reach diagnosis and treatment in Kampala from villages across the country.
  • A Ugandan women receives radiation treatment for cervical cancer at the Mulago Hospital, in Kampala, Uganda, July 19, 2013. While Uganda was able to get a handle on the AIDs epidemic through ARV drugs and assistance from the international community, the country still struggles with how to treat and diagnose an overwhelming number of Cancer patients across the country. Thousands are currently being treated by only a handful of trained Oncologists in the entire country of Uganda; basic chemotherapy and Cancer medicines are often in short supply or unavailable, the radiation machine is outdated, in-patient beds are limited, and most Cancer patients can not afford transportation fare to reach diagnosis and treatment in Kampala from villages across the country.
  • A Ugandan man mixes drugs for chemotherapy in the outpatient ward of the Cancer Institute in Kampala, Uganda, July 17, 2013. While Uganda was able to get a handle on the AIDs epidemic through ARV drugs and assistance from the international community, the country still struggles with how to treat and diagnose an overwhelming number of Cancer patients across the country. Thousands are currently being treated by only a handful of trained Oncologists in the entire country of Uganda; basic chemotherapy and Cancer medicines are often in short supply or unavailable, the radiation machine is outdated, in-patient beds are limited, and most Cancer patients can not afford transportation fare to reach diagnosis and treatment in Kampala from villages across the country.
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