Senegal’s solitary radiotherapy machine broke down on December 28 last year, leaving the country’s only radiation therapist and small team of technicians idly waiting as patients were turned away or offered alternative treatments.

The machine uses radioactive cobalt-60 to produce gamma rays that halt tumors in organs near the skin. Installed in 1989, it is from a generation of devices that are completely phased out in most developed countries.

The machine has broken down many times before. Doctors who are familiar with the technology say such a machine should normally not exceed 20 years’ use.

The Senegalese government promises that three state-of-the-art linear accelerators, which are standard elsewhere, will be installed by August.

This is somewhat surprising given that Senegal’s hospital system is a reference for the West African sub-region.

Patients cross borders to receive diagnoses, treatments and surgeries. The hospital in Dakar boasts a research unit and some of the only modern DNA sequencing machines on the continent.

The strength of the country’s health system, which doctors are proud to say is more than 100 years old, is due in large part to a long-standing high level of medical education in Senegal.

Medical students from Algeria and Morocco come to Dakar for research and studies. Yet the system is fragile and overwhelmed.

Almost 14 million people live in Senegal, but only a handful of doctors focus on cancer.

Doctors in the developed world recommend one radiation machine or linear accelerator for every 200,000 people. Senegal has one, and this year it is broken. So the lines in the cancer ward are long.