Where You Live Shouldn’t Determine Whether You Survive Breast Cancer
Written by Jess Danforth, Founder and Executive Director of The Leo Project
October is Breast Cancer Awareness Month, and I understand the importance of awareness. It was in October, ten years ago, that I was diagnosed with breast cancer. But cancer does not follow a calendar. For women in Kenya and in many places across the world, breast cancer is not a month-long campaign or a pink ribbon worn for a few weeks each year. It is a daily reality, and a diagnosis that too often arrives too late in a health system still fighting to catch up.
Here in Boston, where I am currently pursuing my doctorate in public health, two major cancer hospitals are being developed by Dana-Farber and Mass General Brigham at a combined cost of nearly $4 billion. These investments reflect a recognition of what is coming. Cancer cases are increasing, and health systems must build the capacity to meet them.
In Boston, the question is how to advance cancer care. In Kenya, the question is how to ensure that women can access it at all.
Breast cancer is the most commonly diagnosed cancer in Kenya, accounting for 16.2 percent of all new cancer cases and 26.5 percent of cases among women (GLOBOCAN 2024). An estimated 69 percent of breast cancer cases in Kenya are diagnosed at Stage III or IV (NaCaRe-KE, 2024), when treatment is more complicated, more expensive, and less likely to succeed. In rural counties such as Laikipia, where The Leo Project operates, patients often face delays of a year or longer before beginning treatment. Geography, income, and access increasingly determine not only when someone receives a diagnosis, but whether treatment is possible at all.
Earlier this year, I traveled across Kenya and onto Rwanda with two Harvard MPH students, Renny Honda and Sonali Verma, to see what a stronger cancer referral system might require. One finding that emerged repeatedly is that Kenya does not simply lack medical expertise. What is lacking is the physical infrastructure and the systems needed to connect people to care. A primary care provider may suspect cancer but lack access to imaging or pathology. A woman may recognize a symptom but have nowhere to seek a diagnostic evaluation. A diagnosis may eventually be confirmed, only for treatment to remain hundreds of kilometers away and at a cost that would result in inter-generational debt.
Closing these gaps is the work The Leo Project is taking on in Laikipia County. As part of our planned hospital expansion, we are developing an oncology center that will bring cancer screening, diagnostics, and chemotherapy closer to communities where these services remain largely inaccessible. Build Health International is finalizing the architectural designs, and the building cost is estimated at $1.5 million, a fraction of the investment being made in Boston, but no less essential to the women whose lives will depend on it.
But a building alone is not enough, which is why we are also focusing on the less visible work of building trust, training providers, and improving referral pathways. Since opening our community health clinic in 2023, we have provided more than 35,000 patient visits, and that foundation is what this next phase of care will be built on.
In the communities surrounding our health clinic, cancer is frequently understood as a death sentence. Data presents another challenge. Kenya’s population-based cancer registries cover only about 11 percent of the population (MoH, Kenya. National Cancer Control Strategy). So, while we work toward construction of The Leo Project oncology center, our team is expanding education about breast health and warning signs across the twenty-two villages closest to our clinic, providing screenings, capturing data, reducing stigma, and working with local government and partners to strengthen the systems that connect patients to diagnosis and treatment.
Ten years after my initial diagnosis, I am able to look back. Too many women in Kenya have been denied that possibility, not because their cancers were necessarily untreatable, but because the systems required to detect and treat them were out of reach.
Our aim is to help change that, beginning in Laikipia.
If you would like to support The Leo Project's work to expand cancer screening, strengthen early detection, and bring oncology services to rural Kenya, please consider making a contribution to our capital campaign or contacting us to learn more about the project at info@theleoproject.org.