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.

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.