The earliest portrait in the RCSI collections was commissioned in 1810. Past presidents were rendered in portrait form regularly throughout the nineteenth and early-twentieth centuries, though the tradition of routinely commissioning a new portrait at the end of each presidential tenure was only formalised in the mid-1950s.
3D Slicebox - DO NOT USE a gallery 18 Months: In Malawi, only 10% of women diagnosed with breast cancer survive beyond 18 months. This is the time most of these women will have to be with their families, to see their children grow, to take care of their elders. In Malawi, almost the entire population lives in rural areas and there are hardly any services or organisations dedicated to breast cancer prevention and information. height 7016 width 9933 5 Hours: There are only two hospitals in the whole country where women have access to a breast health specialist. One is Kamuzu Central Hospital, in the capital city Lilongwe, and the other one is Queen Elizabeth Central Hospital, in Blantyre. In the capital, the breast cancer clinic at the hospital opens for three hours weekly. The Blantyre clinic receives patients for just two hours every week. height 7016 width 9933 0: Malawi faces a dearth of breast cancer specialist surgeons. Currently, Queen Elizabeth Central Hospital in Blantyre has only two general surgeons with an interest in the area, who have acquired knowledge about this condition without a formal qualification. Moreover, Malawi does not have radiotherapy services, and patients must seek it abroad - an option that is only accessible to a fortunate few. height 7016 width 9933 74%: According to a report from 2022, approximately 74% of Malawians believe that witchcraft is practised in the country and have expressed support for efforts to make it a criminal offence. The survey reveals that the elderly, particularly elderly women, are at the highest risk of being accused of witchcraft.
There are numerous cases where breast cancer is not recognised as a medical condition. height 7016 width 9933 13.7%: Breast cancer has become a disease of high morbidity and mortality globally and in the sub-Saharan African region in particular. According to the Global Cancer Observatory, 186,598 breast cancer cases and 85,787 related deaths were recorded in Africa in 2020. Breast cancer is expected to more than double in many African countries by 2050: rates are rising disproportionately in Africa. height 7016 width 9933 13%: In Malawi, girls from poor families face considerable barriers to access education. Many lack the resources to stay at school resulting in high rates of early marriage, teen pregnancy and school dropout. Only 13% of girls complete upper secondary school, and among the poorest children, this falls to just 2%. Education is a powerful instrument for health, gender equality and socio-economic growth. height 7016 width 9933 2.3 Million: Breast cancer incidence in sub-Saharan Africa is on the rise, as this region holds the highest age-standardised breast cancer mortality rate globally. Yet high-quality breast cancer data in sub-Saharan Africa is limited due to the lack of data collection systems. This is also the case in Malawi.
In 2020, the World Health Organization recorded 2.3 million women with breast cancer worldwide. height 7016 width 9933 40: More than 40 frontline health workers (clinical officers, medical assistants and nurses) located in Blantyre district, in the Southern region of Malawi, have recently completed an intensive three-day breast health training programme – the first-ever in the country.
This course has given healthcare providers who work in rural communities knowledge of how to recognise and assess suspicious lesions. height 7016 width 9933 3 Days: The Akazi project has offered frontline healthcare providers working in rural communities an intensive three-day breast health course, equipping them with essential knowledge and skills to assess women with breast concerns and to facilitate early detection of breast cancer. This training is a historic one because it is the first one ever on this subject in Malawi. height 7016 width 9933 20 Million: Malawi, with a population of 20 million, continues to be one of the world's poorest countries. It has the second-highest percentage of people living in extreme poverty in sub-Saharan Africa. Only 18% of its population resides in urban areas, while the majority live in rural areas. For rural dwellers accessing healthcare is challenging and can result in catastrophic expenses. height 7016 width 9933 1 Million Children: Cancer in women, including breast cancer, leaves a devastating impact on the next generation. A study by the International Agency for Research on Cancer suggests that with an estimated 4.4 million women dying of cancer in 2020, nearly 1 million children were orphaned, 25% of which were due to breast cancer. Children who lose their mothers to cancer experience health and educational disadvantages. height 7016 width 9933 150: Akazi brought together district authorities, breast cancer survivors, journalists, health workers and community leaders to create locally relevant messages aimed at raising awareness about breast health in rural communities. 150 frontline health workers (nurses, midwives, health surveillance assistants, environmental staff, medical assistants) have been trained in communicating these messages. height 7016 width 9933 24%: Africa bears 24% of the global disease burden associated with non-communicable diseases. Early detection of breast cancer is impeded by lack of awareness about the disease, limited access to diagnostic and treatment services, and other related issues. It's evident that more resources are needed to prevent avoidable deaths.
Akazi has collaborated with local authorities to raise awareness. height 7016 width 9933 67%: According to a survey taken in 2019, more than 67% of Malawians, including young people, prioritise the 'wisdom of the elders' over fresh ideas from young people. Older people are figures of authority, with responsibility for guiding the next generation and passing down traditions and values. They also play an important role in demystifying myths and combating stigmatisation and discrimination. height 7016 width 9933 80%: Around 80% of Malawi's population is believed to rely on traditional healers for treatment. Traditional healing remains a primary source of healthcare for many in Africa, as it has been throughout the continent's history. Several reasons are suggested for the popularity of traditional healers: they share their patients' culture and beliefs; their approach takes into account patients' social lives. height 7016 width 9933 30 Men: That is roughly the number of men diagnosed with breast cancer each year in Ireland. Globally, around 0.5–1% of breast cancer cases occur in men. In countries like Malawi, it is crucial to engage men in the efforts to raise awareness and disseminate information about breast cancer, not just for their own health but also because traditionally women rely on their husbands' consent for medical care. height 7016 width 9933 92%: Some women diagnosed with breast cancer delay seeking help because of fear of social exclusion. The fear, shame and guilt felt by women with breast cancer are not side issues – they can have a real impact on their access to care and chances of survival.
A recently published study showed that 92% of female cancer patients experienced body image disturbances.
height 7016 width 9933 10 Million: In Malawi, women make up approximately half of the country’s almost 20 ml population. Nevertheless, breast cancer, a predominantly female issue, receives insufficient attention. In recent years, the government and international organisations like MSF have directed more focus towards cervical cancer, primarily due to the high mortality rates associated with it and its link with HIV. height 7016 width 9933 1%: Spreading awareness inspires positive change and people like Francesca (part of the Akazi team), who passionately engage with their communities, are a prime example of this. Singing, dancing and encouraging speeches are Francesca´s communication tools. Only 1% of global health funding is allocated to interventions for NCDs in low and middle income countries, where they account for 67% of deaths. height 7016 width 9933 7 Health Centres: The Akazi training intervention has been implemented in 7 health centres. In a country like Malawi, where many people live in remote areas far from hospitals, health centres play a crucial role as the primary contact point for all kinds of medical concerns. Cultural beliefs and a lack of awareness about individual health status often deter people, especially women, from seeking services. height 7016 width 9933 82%: The majority of the population in Malawi lives in rural areas: 82%. When travelling around the country it is common to see images like this one, whichever road one takes. These improvised markets are one of the heights of women's social life, bustling with vendors trying to sell their produce and shoppers looking for a deal. As such, they offer a great scenario to reach out to local communities. height 7016 width 9933 300 Patients: Ruth, a medical assistant, attends to an average of 300 patients every day at Chileka Health Centre, near Blantyre airport. The majority of her patients are women. Ruth was one of the 40 health workers who participated in the three-day course on breast health provided by Akazi. The training has already helped her to provide better services for patients in her community. height 7016 width 9933 29 Seconds: Despite the startling statistic of a woman being diagnosed with breast cancer every 29 seconds around the world, it appears that the need for ongoing education and awareness initiatives is greater than ever before. This is the reason Akazi worked with nurses, midwives, health surveillance assistants, environmental staff, and medical assistants to disseminate information on breast health. height 7016 width 9933 2023: One day Doreen (second from the left) went for a free breast scan at the Breast Cancer Care Foundation (BCCF), a small organisation in Malawi offering breast cancer screening and information services in rural areas. She was then referred for a biopsy, which confirmed she had breast cancer. In 2023, Doreen passed away after recurring infections she developed post-breast cancer surgery. height 7016 width 9933
