Background

The Queen Elizabeth Central Hospital in Blantyre is a major government hospital providing diagnosis and treatment for children with cancer in the South of Malawi. The hospital diagnoses around 30% of the 1,000 expected annual cases in the country. The majority of patients has Burkitt lymphoma, a common and relatively easily curable cancer. The centre provides healthcare free of charge and receives government funding. Additional costs for travel and food during the stay in the hospital end up falling to families to fund themselves. As one of the poorest countries in the world, this causes huge barriers for families when facing the diagnosis of a child with cancer, and results in too many being forced to abandon treatment if families are not supported.

Facts & figures
  • 1,000 new cases of childhood cancer expected annually in Malawi.

  • 280 children diagnosed each year at the hospital in Blantyre.

  • The collaboration with the Netherlands started in 2009.

  • Project lead is Dr. George Chagaluka, pediatric oncologist at the Queen Elizabeth Central Hospital. Project leader of the twinning programme with the Princess Máxima Center for Pediatric Oncology is Dr. Trijn Israels, pediatric oncologist. Other team members are physician assistant Janna Weijers, pediatric oncologists Annelies Mavinkurve and Auke Beishuizen, psychologist Esther van den Bergh and pathologist Ronald de Krijger.

 

Challenges
  • Only 1 doctor trained in pediatric oncology in the country.

  • A shortage of trained nursing staff and lack of funding for government nurses.

  • Over-stretched facilities within other essential pediatric departments such as pathology, surgery, imaging and palliative care.

  • Delays in diagnosis often result in children starting treatment too late for a cure to be possible.

  • Follow-up of patients not possible due to a shortage in staff and lack of a reliable electronic database.

  • High rate of abandonment due to practical issues associated with a lengthy hospital stay.

  • Lack of awareness amongst healthcare professionals and in communities around childhood cancer symptoms and potential curability.

 

Key activities
  • Increase the accessibility of cancer diagnosis and treatment for more patients.

  • Support in the development of adapted treatment protocols and aim for improvements in survival rates of easily treatable malignancies.

  • Capacity building for staff caring for children with cancer through ongoing mentoring and support.

  • Enable infrastructure improvements to ensure quality treatment and care.

  • Decrease abandonment of treatment through family support and improved follow-up.

 

Outcomes
  • Provision of funding for nursing staff on the pediatric oncology ward.

  • Purchase of essential diagnostic equipment.

  • Support for families through provision of drugs and financial support of travel costs and food during their stay in the hospital.

  • Training for staff on the oncology ward through ongoing twinning mentorship and opportunities to attend regional and international meetings.

 

Impact
  • Increase in the number of newly diagnosed patients.

  • Improved survival rates for common and curable cancers, for some from 25% to about 50%.

  • Decrease in abandonment of treatment of some cancers from 30% to 5 - 10%.

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.

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