Cancer rates vary wildly across the world, and we don’t know why.
Still a young woman, Emily now looks after her family’s rural homestead near Iten — a town famed for churning out long-distance runners and playing host to Mo Farah’s training camps. We reach it by driving through urban sprawl and out into the hills, passing a seemingly endless stream of impossibly fit athletes pounding the roadside paths.
Emily is busy cooking lunch when we arrive. Her kitchen is a small straw-capped mud hut built in the traditional style, similar to the other buildings that make up the homestead, with smoke pouring out of the door from an open fire and chickens scratching in the dirt nearby. It seems idyllic, but there’s a killer on the loose around here, and we’ve come to track it down.
That killer is squamous cell oesophageal carcinoma — one of the two main forms of oesophageal cancer, which starts from the cells lining the oesophagus. Cases started piling up more than 60 years ago in South Africa, when a doctor working in the Transkei territories noticed an unusually high number of people dying from the disease, which was almost unheard-of before the 1940s.
The situation in Africa seems to be no better today. Worldwide, an average of 5.9 people per 100,000 will develop oesophageal cancer each year. In East Africa, that figure rises to 9.7 people per 100,000. In Kenya specifically it’s 18 in 100,000, while in Malawi it’s even higher — 24 in 100,000 — making oesophageal cancer one of the three most common cancers in these countries.