Largs Rotary £2000 Cheque

AfrOx is very grateful for the Rotary Club of Largs generous support...

At a packed lunchtime meeting of the Rotary Club of Largs at the Willowbank Hotel on 20^th September, Grahame Ross introduced his guest speaker, Professor Sir John Arbuthnott FRSE on his second visit to the Club.

John, a resident of Largs, spoke about his favourite charity, AfrOx (Africa Oxford Cancer Foundation), which is working in Ghana to help children with cancer.  He has been a Trustee of the charity since it was established in 2007 by Prof David Kerr of the University of Oxford; Alan Milburn, former UK Secretary of State for Health (1999-2003); Sir John Arbuthnott, former Chairman, NHS Greater Glasgow and Clyde and Margaret Roddan, Investment Manager and Consultant.

When he visited the Club in 2008 to talk about cancer in Sub-Saharan Africa he inspired the members who decided that they would support the efforts of the charity.

At the meeting on Tuesday he informed the Club that the £2,000 which they had donated was spent on essential equipment for the children’s cancer care clinic at Korle Bu hospital in Accra. One item is a special fridge for keeping chemotherapy drugs at a specific temperature, otherwise they are unusable.

John told the Club that the hospital had established links with the Rotary Club of Accra West, members of which will make the presentation of the equipment on behalf of the Largs Club when it arrives. The Largs club is in the process of forging links with the Accra Club to try and raise more funding for the hospital’s children’s cancer care unit.  John explained that cancer care and treatment is so rare in Ghana that there are only four specialists for a population of twenty-three million.

Sir John was then presented with a ceremonial cheque for £2,000 from the Largs Club by the President, David Walsh.

After the meeting concluded, Sir John was delighted to be invited to speak to another local Rotary Club and one in Glasgow as they are very keen to support AfrOx through the Rotary Club of Largs.

A Busy First Year for the Ghana-Edinburgh Childhood Cancer Care Partnership

Last year, AfrOx helped to set up a twinning partnership between the childhood cancer unit at the Korle Bu Teaching Hospital (KBTH) in Accra and the Royal Hospital for Sick Children (RHSC) in Edinburgh, to help improve care for children with cancer in Ghana. Dr Vanita Sharma, Head of Programmes, AfrOx describes how one year into the programme a lot has been achieved, thanks to the hard work of everyone involved…

To read more about the background and aims of the partnership, click here. 

After a busy twelve months, the twinning project between the Accra and Edinburgh paediatric cancer units has got off to a very encouraging start. Over 100 Ghanaian doctors and nurses have taken part in two workshops held at KBTH in November 2010 and April this year.  The first workshop was led by the Edinburgh team, including two doctors, a nurse and a play therapist, and focused on training staff from KBTH as well as some staff from Ghana’s only other paediatric oncology unit in Kumasi. The KBTH staff decided on the content of the workshop training, to ensure that teaching was directed towards their needs. (To read how the first workshop went, click here). The second workshop, in April, was led by Dr Lorna Renner, who heads the busy KBTH team, and brought together doctors and nurses from other hospitals in Ghana to raise awareness of children’s cancer and the importance of early detection and referral. 

One challenge that arose during the year was how best to maintain contact between the two teams in between workshops. We’ve therefore set up an internet link between the two units, using the website MedicineAfrica.com.  Georgina Newman, a medical student volunteer, ran sessions for the Edinburgh and Ghana teams on how to use the website and the first online tutorial took place in July.  There are now monthly online tutorials taking place, with nurses from RHSC Edinburgh providing training for the team of nurses from KBTH in Ghana.  To read about the MedicineAfrica project and the training in Edinburgh, click here, and to find out more about the training and first tutorial in Ghana, click here.

A childhood cancer database has also been set up at KBTH to enable accurate monitoring so that key areas for improvement of care can be identified and acted upon. AfrOx donated two computers to be used for inputting the data for the registry.  We also supported Dr Meaghann Weaver, a paediatrician from the US to travel to Ghana for three weeks to train the local data clerks on how to use the new registry. All new patient data is now being added which will allow a more accurate assessment of the problems faced in paediatric cancer care in Ghana.

One of the project’s main objectives was to raise awareness of childhood cancer across Ghana. Working with the Ghana Parents Association of Children with Cancer (GHAPACC), AfrOx designed two posters to raise awareness of the signs and symptoms of childhood cancer in Africa, which can be viewed here. We’ve donated over 2000 copies of each poster to GHAPACC which they have used in their local communities’ schools, churches and work places.  The posters were also used at events on international child cancer day in February and for training health-workers in early detection in the April workshop.  

Finally, the KBTH child cancer unit must be sustainable in the long term. To this end, AfrOx and World Child Cancer have all been working closely to help support efforts to secure local funding.  One key success has been that a local foundation, CanCare Foundation has agreed to raise funding in Ghana to support the project and has been providing funding towards subsidising the costs of treatment for families that cannot afford it.  World Child Cancer has also provided fundraising skills training to GHAPACC who run regular events to raise money to support the unit.

We’d like to thank all those who have been working hard over the last year to get the project off to such a successful start. In the second year, we hope to build on the solid foundations already established to achieve sustainable improvements in childhood cancer treatment at KBTH and across Ghana. Please check this blog regularly for progress updates.

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

MedicineAfrica Training in Ghana

In her previous blog entry, Georgina Newman described the project she’s been working on setting up a link between two paediatric oncology units using the innovative website MedicineAfrica. Here she tells us how the training in Ghana went…

After training the team at the Edinburgh Royal Hospital for Sick Children, I then travelled to Accra, Ghana, to introduce members of the paediatric department at Korle-Bu Teaching Hospital to the concept of MedicineAfrica. After an initial presentation, seventeen selected members of the department, including doctors, nurses and a pharmacist were given practical training in small groups on how to use the website.

During the training sessions we created medical cases, practised tutorials and even learnt how to upload X-rays to the cases. There were, of course, some glitches, which mostly centred around a sometimes rather slow internet connection. However, overall, the team were enthusiastic and felt the new technology would provide a useful teaching tool and be particularly helpful for discussing complicated cases. In fact, two of the doctors wanted to persuade their colleagues to join so that the website could also be used as an intra-departmental teaching tool.

Training completed it was time for our first tutorial! Fiona Bruce from Edinburgh tutored six nurses and one pharmacist from Korle Bu on the ‘Role of the Nurse in Oncology’. Participants were divided into two groups; each group had at least one computer literate member and shared a laptop. Initially participants were a little apprehensive but the tutorial soon generated a large amount of lively discussion and interest. Tutor and participants discussed the differences between the oncology wards in Accra and Edinburgh. The Ghana team members appeared to enjoy the tutorial and the opportunity to link up with the Edinburgh team. 

So what next? For the next few months, until the November workshop, the Edinburgh team at the Royal Hospital for Sick Children will be giving monthly tutorials to the Ghanaian nurses, who will access the website using the two laptops provided to the unit by AfrOx and World Child Cancer. It is hoped that the tutorials will help build the relationship between the two paediatric oncology teams and that they will promote knowledge exchange and skill retention, as they have done in Somaliland. The effectiveness of the tutorials will then be discussed at the November workshop. If found to be useful, the tutorials will be extended to all members of the Ghanaian oncology team. Please check back for an update on the project later in the year..

Time for the UN to Take Action

David Kerr is Professor of Cancer Medicine at the University of Oxford and President of the European Society of Medical Oncology (ESMO). He represented ESMO at a recent United Nations (UN) meeting in New York, held to discuss the upcoming UN Summit on Non-Communicable Diseases (NCD). He tells us about the NCD Alliance and what it’s trying to achieve...

You may know that, in an unprecedented move, for the second time only in its history, the UN is going to hold a high-level summit to discuss health. The topic that will be discussed is chronic non-communicable diseases.

The only time in the UN's history that it has met specifically to discuss health was around the AIDS epidemic. From that came UNAIDs and the extraordinary advances made globally against the AIDS epidemic. Those of us involved in chronic disease management (cancer, diabetes, cardiovascular disease, and respiratory diseases) have come together to form an NCD Alliance to lobby the UN Summit at the very highest level, so that action is taken when heads of state meet in the assembly at the end of September.

Working with the WHO, we would like to promote a greater degree of international cooperation, with those countries that have strong healthcare systems supporting countries with weaker healthcare systems, so that we exchange ideas and knowledge, create and even up partnerships, and move forward that way.

We would like to see the NCD Alliance continue because how often do you come to a room in which you find leading oncologists, leading diabetologists, leading cardiologists and respiratory physicians working together, singing from the same hymn sheet? Actually, we are usually lobbying against each other and competing for the same resources. At last, we have come together in what is a true partnership and alliance that seems very powerful.

A further area of action is about prevention. We want some very clear commitments from the summit and from global leaders. We need to improve our efforts in tobacco control, particularly in middle- and low-income countries. We would like to see dietary improvements with reductions in saturated fats, salt, and glucose, as well as better food labelling. We would like to see governments make efforts to reduce the harmful effects of alcohol.

With respect to treatment, we need to strengthen healthcare systems. Rather than trying to deliver cancer care or cardiac care or to manage diabetes separately, we need to take an approach in which we work laterally, so that we make an impact on all the chronic diseases that we are discussing. We also need to improve accessibility to drugs, to affordable cancer care, to vaccines - to the whole gamut.

Following the summit meeting, we imagine there will be warm words. But we need action to come from this. Again, we would like to stay involved as the NCD Alliance to monitor how governments put these warm words into effective action.

In Europe, 85% of all deaths are the result of the chronic diseases that we have brought together in this alliance. It is an extraordinary problem, but one which is increasingly faced by the developing world and places a huge burden on developing economies. Two thirds of all deaths in the world today are the result of chronic diseases. We must face up to it.

Global leaders, who will be attending the UN meeting, please listen. Let's go beyond rhetoric. Let's go beyond the semanticism of clever words. Let's come up with action because the world demands it, our patients need it, and there is an opportunity for us to work together in partnership and do something which is extraordinary.

AfrOx’s Cancer Nurse Training Programme in Ghana

Through the AfrOx Cancer Nurse Training Programme, AfrOx aims to provide training for nurses in Malawi, Ghana and Uganda.  Stewart Kerr, Project Manager, AfrOx, tells us more about the first nurse training workshop in Ghana ….

Nurses have an essential role in the provision of cancer care in Africa and they work tirelessly to look after their patients.  Cancer nurses in Africa are front line care givers: they administer drugs, communicate with the patients and their families, change dressings and help maintain the dignity of the patient throughout their treatment or until they pass away.  However, these cancer nurses are often overworked, poorly paid and have low social status; and they have few career development opportunities.  

A critical problem is that in countries like Ghana, Uganda and Malawi, there is no specialist training available for cancer nurses.  This year, working in collaboration with the University of Warwick, medical training schools, and ministries of health, AfrOx’s aim is to provide training for 100 nurses involved in cancer care in Ghana, Uganda and Malawi and to provide a free online training programme that will be of benefit to cancer nurses across Africa.

The first training workshop took place in Malawi in May (click here to learn more), and this month, we held the first workshop in Ghana at the Komfo Anokye Teaching Hospital (KATH) in Kumasi.  We took out a team of three volunteers Sally Campalani, Caitlin McCoy, and Fiona Young, who are full time oncology nurses based in the UK with a vast wealth of experience in oncology nursing and training of nurses new to oncology. 

The local faculty leaders included Dr Awauh (Medical Director of KATH), Dr Osei Obonsu (Medical Oncologist at KATH), Mrs Patience Ampong (Director of Nursing Services KATH), Mrs Sekyere and Mrs Antwi (both oncology nurses, KATH). 

Thirty, handpicked Ghanaian nurses who work with cancer patients in their day to day duties attended the workshop, dressed rather splendidly in there smart uniforms with fabulous nursing caps which reminded me of pictures I have seen of nurses from the UK in 1950s, which put me to shame dressed in my shorts and flip-flops.

Sally, Caitlin and Fiona worked together with the talented local faculty to run the training workshop.  The team covered a range of subjects, including how to communicate with oncology patients, the basic biology of cancer, an explanation of the treatments available in Ghana (Radiotherapy, Chemotherapy and Surgery), administration and side effects of the treatments, signs and symptoms of cancer and advocacy.  One question that arose during the workshop was that some nurses feared that after patients had gone through radiotherapy, they were radioactive and they were thus reluctant to touch them for 24 hours after their treatment.  The faculty explained how radiotherapy worked and helped to dispel this myth and encouraged these nurses that it would be safe to continue to care and tend to their patients after radiotherapy.

In the session on advocacy, when we were talking about how to raise awareness of cancer in the community, we found that a majority of the nurses at some point or another had talked with women in their community or at their church about the signs and symptoms of cancer - especially breast and cervical.  They also run a small palliative care outreach programme, where they go to the homes of terminally ill cancer patients and teach their families how to care for them and administer pain relief. I was impressed to learn that they carry out this service voluntarily, out of a feeling of duty towards their patients, usually without their transport costs or overtime being paid for.  Thus, for this reason it is confined to Central Kumasi.

The training workshop was very successful, with 100% of the nurses stating in their post evaluation questionnaire that they would change their day-to-day clinical practice in the treatment of cancer patients.  We were impressed by the hard-working cancer nurses and the inspiring leadership team at KATH who are both committed to providing good cancer care for their patients.  As a long-term objective of this programme, we are hoping to set up a formal partnership to provide longer-term mentoring and training; and to support efforts in Ghana to set up a post-graduate specialist cancer nurse training course.

Please check this blog regularly for progress updates.

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

Supporting Childhood Cancer Care through MedicineAfrica

Georgina Newman, intern at Afrox, tells us about the new project she’s been working on to set up an innovative link between two paediatric oncology units, one based in Edinburgh, the other in Ghana…

As part of its strategy to improve cancer care in Ghana, AfrOx together with World Child Cancer, are supporting a twinning project between the paediatric oncology unit of The Royal Hospital for Sick Children in Edinburgh and the paediatric oncology unit of Korle Bu Teaching Hospital, Accra. Currently, professionals from Edinburgh travel to Ghana twice a year to deliver workshops that cover a range of issues chosen by the Ghanaian professionals. Unfortunately, there is little opportunity for contact between the teams between the workshops, which is where the innovative website, MedicineAfrica, and my internship come in.

MedicineAfrica is a new website that allows healthcare professionals to give online tutorials to professionals or students in a totally different area. It was originally pioneered in Somaliland and the UK where British psychiatrists gave newly qualified doctors in Somaliland tutorials in mental health and psychiatric care. Because Somaliland has very few experienced doctors and no psychiatrists at all, MedicineAfrica is helping fill a gap in the continual professional development of Somaliland’s new generation of junior doctors. By doing this, MedicineAfrica hopes to increase their motivation and to slow the brain drain.

During my internship, I have been facilitating a link between the Edinburgh and Ghana teams using MedicineAfrica. This involved travelling to Edinburgh in June to teach the Edinburgh team how to use the website. It was the first time I had met the doctors and nurses from Edinburgh; they were lovely and really enthusiastic about the whole project, asking intelligent and perceptive questions about the twinning project. The morning was spent discussing the project and how to take it further and in the afternoon, I taught them how to use MedicineAfrica. During the two hours we spent together, we created medical case studies, tutorials, PowerPoint presentations and gave sample tutorials. Despite the Edinburgh team’s initial wariness of the website, internet breakages, and moments of utter confusion, the team left the session feeling much more confident using the website than they had done previously. 

In July, I then travelled to Ghana to meet the team at the Korle Bu Teaching Hospital to teach them how to use the website and attempt the first online tutorial between the Edinburgh and Ghana teams. Please read my next post to see how the training in Ghana went..

More from Malawi

In May, AfrOx ran a cancer nursing workshop in Malawi. Twenty-three nurses were trained, and four clinical officers and two doctors also participated in the workshop. Matron Loveness Nyirenda, the local coordinator, tells us about the importance of training nurses in Malawi...

Training Cancer Nurses in Malawi

In May, AfrOx ran a cancer nursing workshop in Malawi. Dr Ray Owen who works as an End of Life Counsellor was one of the trainers. He shares his experience with us...

I’m a clinical psychologist in the NHS, and for the last 18 years or so I’ve specialised in cancer and other serious physical conditions. Though a lot of my time is spent in face-to-face work with people with cancer and their families, I’m also very involved in teaching communication skills and psychological support skills to nurses, doctors and other staff who work in oncology.

When I was asked by Afrox to contribute to a training course for cancer nurses in Malawi and in Uganda, I was intrigued (and a little flattered!), but was initially doubtful how much the ideas and techniques that work in our own NHS would translate to a different culture, and to a drastically more resource-limited healthcare system.

Conversations with professionals already working out there, and now the days of experience with the wonderful Malawian nurses and doctors have convinced me my doubts were unfounded: these experienced and dedicated people are acutely aware of the importance of good communication and of providing psychological support.

I was fortunate enough to be teaching alongside Lynne Dodson, a fellow communication-skills trainer and highly experienced nurse. We quickly found that many of the approaches we’ve been working on in the UK seemed very useful to the local staff, as did our interactive teaching methods, and they were very able to explain to us when local conditions required handling differently! I was particularly impressed by the sessions where our Malawian colleagues presented their experiences of supporting the parents of seriously ill children, and of adults with advanced disease who were suffering stigmatisation within their local communities.

All of this of course is in the context of a poor country and a health system with few resources other than the dedication and compassion of staff making the best use of what the state (and foreign donors) contribute.

Every stage of diagnosis and treatment takes longer: just the lack of pathology services introduces a further 4 month delay in reaching a diagnosis – and any of us who have a had a family member undergo cancer tests knows just how stressful any wait can be.

Even the most basic cancer drugs can be unavailable, or only sometimes available, and way beyond the pocket of all but the very wealthiest; so distressing for the patient of a sick child.

The lack of any radiotherapy in Malawi means that very advanced and disfiguring tumours of a type we hardly see now in the UK are commonplace, with devastating consequences for social isolation and self-esteem.

And, when someone needs to be in hospital, they have to have a ‘Guardian’; someone to deliver day to day care – washing, feeding, administering simple medicine which the tiny number of nurses on duty can’t possibly provide. Not only is that stressful for the Guardian, the impact of being far away from home can be destructive financially and to the rest of the family.

So many things need to change for all these problems to improve, but bit by bit they are already moving. And equipping the doctors with more skills and confidence is a vital part of that process. Hopefully, this is just the start for cancer nursing education in Malawi, and we can support its development in many ways over the coming years. I’m so pleased that communication skills and psychological support are part of the programme right from the start; add that to the famous warm-heartedness of Malawians and we can feel optimistic that not only will cancer-care improve further, it’ll be the whole person being cared for.

Full More Than Fufu

In April, an AfrOx team led an oncology training workshop in Ghana along with a team from World Child Cancer. Meaghann Shaw Weaver shares a special moment with us....

April started out with a full agenda at the oncology training workshop in Ghana. These two days of focused sessions offered training in oncology interventions and supportive care. 

Much more than projects and pursuits, the real "fullness" of joy in Ghana comes from the strength of partnerships in working together for patient care. When removing the bandage from a biopsy site yesterday, a young patient's mum quietly told me "we must be brave together" and held my hand while I removed the tape. This is a mum who sits in a plastic chair next to her son's bed night after night, vigilant and hopeful in her bravery. This same mum insisted on sharing jollof rice with me today when she noticed I'd been at the hospital through lunch.

No matter that the day's serving of jollof rice was heaping and the fufu (pounded yam) expanded in my stomach, my heart still felt fuller than my stretched stomach at the day's close in Ghana. My heart feels full with admiration for the courage of patients, the perseverance of families, and the care offered by colleagues and mentors in Ghana. Ghana reveals the full potential of the human spirit when perseverance and partnership combine.

cancer prevention 4 africa

Raising awareness is a key part of AfrOx's work. But this doesn't just mean raising awareness about cancer in Africa - it also means raising awareness about how to PREVENT cancer.

In partnership with ESMO, we've launched a series of posters to be trialled in Ghana. The posters include how to check for symptons of certain cancers, as well as tips about cancer prevention.

The posters are free to download from the AfrOx website.

World Cancer Day

To mark World Cancer Day, the Ghana Health Service and Cancer Society of Ghana held a series of events in Accra to raise awareness of cancer. 

The program of the day included a march by 500 school children to the National Hockey Stadium which was followed by speeches to raise awareness of the signs and symptoms of cancer amongst the general public. 

Here are some snaps of the team, and the unveiling of AfrOx's Cancer Prevention posters...

To see the posters in all their glory, click here.

Palliative Care Conference

Palliative care is an essential component of cancer care. Pain and symptom control, coupled with counselling and spiritual care, enables patients to die with dignity, preventing a painful and distressing death.

Research has shown, however, that 79% of the global morphine supply is used by only 6 countries (USA, Canada, France, Germany, Australia and Britain). In Africa, there are also restrictions on the prescription of morphine because of fears about addiction. Without access to palliative care, most cancer patients in Africa die in considerable pain. 

At the end of January, AfrOx - in partnership with the American Society of Clinical Oncology and the Ghana Health Service - ran a palliative care workshop at the Korle Bu teaching hospital in Accra. There were 111 participants, ranging from medical students to social workers, representing nine of Ghana's ten regions.

The workshop gave an overview of what work is currently being done in Ghana on palliative care, and introduced models of palliative care being used in other African countries, including Uganda, Egypt and Tanzania. Discussions ranged from practical issues - such as pain medication - to ethics; while role-plays helped participants to explore how best to communicate with patients.

Before the conference, participants wanted to find out more information about what their role (as doctor, nurse, pharmacist, social worker), was in delivering palliative care to terminally ill patients.  They wanted a greater understanding of treatment methods and drugs involved in palliative care, and to know how to identify pain in patients, especially when dealing with a child. We hope that the conference has armed them with the tools they need to start developing effective methods of palliative care in Ghana.

To find out more about our palliative care programme, click here.

Cancer is a Runaway Train

In October, we launched the AfrOx film competition, giving amateur film-makers the brief of making a short film to raise awareness about cancer in Africa.

At present, cancer kills more than 7 million people per year and is responsible for more deaths worldwide than AIDS, malaria and tuberculosis combined.  It is estimated that if no action is taken, the situation will continue to deteriorate and by 2020 it is expected that there will be 16 million new cases per year.  70% of these new cases will occur in the developing world.

As Alan Milburn, former UK Secretary of State for Health and Chairman of AfrOx, described it,
"The rising incidence of cancer in Africa is like a runaway train coming down the track."

It was this "runaway train" that the competition winners, Hazel Taylor and Ben Donaldson used as the basis of their winning video...



The video was launced on World Cancer Day, in association with the European Society for Medical Oncology (ESMO), as part of the Cancer Prevention 4 Africa campaign.

To find out more about the campaign, click here.