Thursday, 28 October 2010

The Ghana-Edinburgh Childhood Cancer Care Partnership

AfrOx has been working on an exciting new project to set up a health partnership between the Korle Bu Teaching Hospital in Accra, Ghana and the Royal Hospital for Sick Children in Edinburgh, which aims to help improve the treatment of childhood cancer in Ghana.  Dr Vanita Sharma, Head of Programmes at AfrOx, tells us more…

Cancer is often perceived as a disease of affluent, Western societies, but this is not true. Whilst close to 80% of children survive cancer in richer countries, outcomes in Ghana are currently very poor with survival rates around 20%, despite the fact that effective and inexpensive drugs exist. There are many reasons for this: 

1) low diagnosis rates - probably only 20% of total childhood cancer cases are diagnosed, partly because there are currently only two hospitals in Ghana which diagnose and treat child cancer – the Korle Bu Teaching Hospital (KBTH) in Accra and the Komfo Anokye Teaching Hospital in Kumasi; 
2) late diagnosis – a lack of awareness means that many children present with cancer that is too advanced to start potentially curative treatment; 
3) lack of specialist child cancer care  - there are only two qualified paediatric oncologists in Ghana; 
4)  lack of accurate child cancer statistics, which makes it impossible to identify key areas for improvement;  
5) abandonment of treatment in up to 50% of children – many parents are unable to fund drug therapy and find it impossible to cope with the practical, social and economic pressures of a child undergoing cancer treatment;  
6) lack of palliative care which means that children dying from cancer often fail to receive adequate pain relief.  

One solution to the problem of child cancer in lower income countries is likely to lie in the development of twinning partnerships between hospitals, medics and parent support groups in resource poor settings and those in developed countries. Such twinning projects have already achieved great successes in other parts of the world, for example, links between US and South American hospitals. Through training, mentoring and regular contact, these partnerships provide a two-way transfer of skills and knowledge to develop locally appropriate solutions which are realistic and achievable. Financial support is also provided towards the costs of training programmes, drugs, equipment and awareness raising campaigns. Importantly, the long-term sustainability of child cancer units is secured by facilitating the development of strong relationships with local NGOs and parent support groups.  

AfrOx, working in collaboration with World Child Cancer, is jointly funding a 5 year twinning partnership between the Korle Bu Teaching Hospital (KBTH), Accra, Ghana and the Royal Hospital for Sick Children (RHSC), Edinburgh, UK.  The aim of the programme is to help improve the diagnosis, treatment and care of childhood cancer in Ghana. 

The programme was set up as a result of a request from Dr Lorna Renner, who qualified at the Royal Hospital for Sick Children (RHSC) in Edinburgh, and now heads up a dedicated paediatric oncology team at KBTH. Her team is committed to increasing survival rates for children with cancer across Ghana by developing expertise at the countries’ two specialist teaching hospitals, KBTH in Accra and Komfo Anokye in Kumasi, and creating satellite centres around Ghana where children can receive much of their treatment without having to travel long distances to Accra or Kumasi. This should enable more children to complete the full course of treatment. 

During an initial needs assessment visit to Ghana, we held discussions with staff at the KBTH unit, the Ghana Health Service and the Ministry of Health to decide on the goals of the partnership. Our initial objectives include:
1) improving pain management and the treatment of  infections in children with compromised immunity due to chemotherapy
2) provide training for health professionals from hospitals across Ghana through a series of workshops held twice a year at KBTH. Doctors and nurses from RHSC will travel to Accra to attend the training sessions and lead workshops
3) ensure that adequate chemotherapy and palliative care drugs are supplied so that all children receive the appropriate medication.
4) create a child cancer database to provide vital data to improve treatment.
5) improve the retention of skilled nursing staff at the KBTH unit by providing a monthly salary supplementation.  

6) improve adherence to treatment by recruiting a community outreach nurse who will be responsible for following up patients who have failed to return for treatment.   

7) implement awareness raising campaigns to promote recognition of the early signs and symptoms of childhood cancer and to remove the stigma associated with the disease.    

We’re very enthusiastic about the potential of this twinning partnership. Please do check back for updates on how the project is progressing…

If you would like to donate to support AfrOx’s work, please click here.

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