Apart from providing training for health care professionals, we cooperate with our partner hospitals in the fields of scientific research and parental education programs. In this video we explain how this works at our partner hospital in Indonesia.

Background

Indonesia is a large country with estimated population of more than 260,000,000. About 30% of the population is children in the range of 0-14 years. Approximately 60 % of all Indonesians live on Java, one of the five biggest islands in this country. 

Dr. Sardjito Hospital is an academic hospital and the tertiary care referral hospital for the region, and also receives referrals from neighboring provinces. It is located in Yogyakarta province and covering the south part of middle Java region. All children with cancer of Yogyakarta province are referred to this hospital, and also many of the patients from the surrounding provinces, the whole of South-Middle Java.

Childhood cancers were not the top priority programs of Indonesian government. This had impact on the management of childhood cancers in Indonesia such as, very limited epidemiology data, no cancer control program, limited diagnostic tools for childhood cancers, and also limited facilities  for palliative and supportive care for children with cancer. In addition, an important cause for the failure of the treatment is prematurely stopping cancer treatment (this because the patient no longer visits the hospital, for all kinds of reasons). Another important problem concerns chemotherapy availability and supply.

 

Facts & figures
  • 5000 new cases of childhood cancer expected annually in Indonesia.

  • 250 new childhood cancer cases diagnosed each year in Yogyakarta.

  • 4 pediatric oncologists take care of all childhood cancer patients in Yogyakarta.

  • Dr. Sardjito Hospital is a tertiary referral hospital for Yogyakarta and surrounding areas estimated served 15 million population .

  • At the Dr. Sardjito Hospital pediatric oncologists prof. Sutaryo, dr. Pudjo Hagung Widjayanto, dr. Sri Mulatsih, dr. Eddy Supriyadi and pediatrician dr. Mei Neni Sitaresmi are involved in the twinning program.

  • From the Princess Máxima Center the following pediatric oncologists are involved: Gertjan Kaspers, Arjenne Kors,  Netteke Schouten- van Meeteren, Annemarie Peek and researcher  Saskia Mostert. Other team members are child life specialists Merwe de Witte and Sanne van der Mark, nurse practitioner Kim Kamphuis and nurses Jaccoline Oosterkamp and Jan Wink. 

  • Collaboration since 1992.

  • Since the introduction of the Universal Health Coverage almost all children have a health insurance. 

 

Challenges
  • High number of new patients.

  • Limited number and competence of health care professionals.

  • High rates of abandonment.

  • Low survival rate.

  • Limited facilities of diagnostic tools, treatment, and supportive care facilities.

  • Lack of awareness amongst health care professionals and communities around childhood cancer symptoms and potential curability.

  • Inadequate parents shelter home for patients during treatment.

  • Parents with low social economic background.

  • Difficulties in travelling to reach health care services.

Key activities
  • Development of cancer registry.

  • Development of diagnostic tools.

  • Workshop for developing treatment protocols.

  • Training of local healthcare professionals through mutual project visits.

  • Implementation of structured parental educational program.

  • Weekly teleconferences for discussing difficult cases.

  • PhD program for Indonesian and Dutch doctors. Indonesian doctors graduate at the VU and are supported by Dutch students during their research.

​Outcome
  • Collection of reliable data regarding childhood cancer in Indonesia.

  • Improvement of childhood cancer survival.

  • Reduction of treatment abandonment.

  • Improvement of knowledge and skills of health care professionals.

Impact
  • Increase in newly diagnosed patients.

  • Improvement of event free survival from 20% to 50% for specific types of cancer.

  • Reducing abandonment rate from 35% to 25%.

  • 7 completed PhD programs and 4 ongoing PhD programs.

  • Building cancer ward and shelter homes.

The Dutch Foundation ‘Estella Fonds’ has played an important role in improving care for children with cancer, in both Indonesia and Malawi, on which World Child Cancer NL can gratefully build on. With the help of the ‘Estella Fonds’, a building has established specifically built for children with cancer at the Dr. Sardjito Hospital in Yogyakarta.

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