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.

Childhood Cancer - November Workshop

One of AfrOx's ongoing aims is to enable twinning programmes between hospitals in the UK and Africa. In November, a team from the Department of Paediatric Haematology and Oncology, Royal Hospital for Sick Children, Edinburgh had their first formal visit to the Childrens’ Cancer Unit at the Korle Bu Teaching Hospital, Accra, Ghana...

The twinning programme
Dr Lorna Renner, a senior paediatric oncologist in Accra, used to work with the team in Edinburgh and has since set up a busy unit to treat childhood cancer in Accra. The idea behind the twinning programme is that the team from Edinburgh provides teaching and training support using all means possible (visits for workshops, email, and if possible videoconferences); while AfrOx provides financial support and coordinates workshops and poster campaigns to raise awareness of childhood cancer throughout the country. It is vital that the content of the teaching and training is decided by the resource-poor country themselves, and not by the resource-rich nation.

The November workshop
The first formal workshop took place between 12-13 November 2010. The programme included talks on brain tumours, Wilms tumour and bone tumours; as well as supportive care, administration of chemotherapy, play specialist techniques and palliative care. The workshop was attended by  around 50 doctors, nurses and pharmacists from Korle Bu teaching hospital as well as from the hospital in Kumasi.

On the first day, topics included multidisciplinary team working, introduction to twinning programmes, bone tumours, brain tumours and play therapy techniques including guided imagery. Angela Edgar presented very important information on the setting up of a registry - without this it is impossible to assess improvements in diagnosis and survival rates and reduction in abandonment.

On the second day there were sessions on administration of chemotherapy and supportive care, an interactive play therapy session using patients and some siblings, and talks on Wilms tumour and palliative care. The latter was very much appreciated by all who attended.

Although hard work, the overall feeling of the RHSC team was that the workshop had been a success. The team from Edinburgh are all extremely keen to return to Ghana later in 2011 and to consolidate on what was achieved this time.


The visiting team was made up of Dr Emma Johnson, (Associate Specialist), Dr Angela Edgar, (consultant), Staff Nurse Fiona Bruce, Play Specialist Helen Veitch, and Vanita Sharma from AfrOx.

To find out more about our work, click here.

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.