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...