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.