Diagnosing and treating children with cancer requires persistence and determination. In spite of holidays, birthdays, and other key events, pediatric cancer treatment typically continues uninterrupted to provide the child with the best opportunity to survive. Over the last few months, we have been facing a new challenge: the coronavirus (COVID-19) pandemic. In sub-Saharan Africa, the pandemic has introduced unprecedented complications – medical supply shortages, patient travel restrictions, and resource reallocation to meet urgent coronavirus patient needs, to name a few.
There is nothing more inspiring than a child’s tremendous resilience.
To be treated for cancer, children must have their symptoms appropriately recognized. Families must navigate the medical systems to receive complex diagnoses. Only then can intensive treatments through extensive health system resources begin. Daily challenges for medical professionals exist as well. Patients present in very advanced stages of disease. Lack of life-saving blood products and crucial medications further complicates care. The additional burden introduced by COVID-19 adds profoundly to already challenging circumstances.
Together with other members of the Global Hematology-Oncology Pediatric Excellence (Global HOPE) team, I focus on building long-term capacity to treat and dramatically improve the prognosis for children with cancer and blood disorders in sub-Saharan Africa. Our vision is to ensure these children receive the most effective, state-of-the-art therapies available, and ultimately experience treatment outcomes comparable to those in high income countries such as the United States and Australia.
Recently, I joined fellow Global HOPE Medical Directors from Malawi and Uganda to offer a brief commentary on compounded challenges and opportunities created by the pandemic that could be leveraged to improve services for children. Although it would be natural to dwell on the negative impact COVID-19 has had on Global HOPE programs and every aspect of daily life, I would rather focus on the fact that when faced with a daunting challenge, individuals rose to the occasion.
In Botswana – the size of Texas or France, and where I am medical director of the Global HOPE program – almost every child undergoing treatment for cancer was able to stay on schedule despite the country’s seven-week lockdown. Botswana has only one program for children with cancer and blood disorders. With public transport suspended, and any movement outside one’s home requiring a permit, ensuring patients’ treatment was uninterrupted was an enormous feat. Our social worker and patient navigator worked day and night to ensure patients had proper permits. Medical staff nationwide arranged hospital-based ambulances or other transportation to get patients to us for treatment. The lengths individuals went so children could get needed care was inspiring.
One example stands out—a young boy with a brain tumor who lives approximately 600 miles from the hospital, developed vomiting and increased seizure frequency. Through extensive coordination, he was brought to the Global HOPE team in Gaborone where we could arrange for a brain scan and a crucial operation coordinated through multiple health facilities. Thankfully, he is now doing quite well as his treatment continues. The effort it took to get him the care he needed cannot be captured in just a few sentences.
Now that we are settling into new routines as a result of a pandemic, we look to the future. Already, local Lions have approached us as they seek to support us in new and innovative ways. While we may not be able to have in-person pediatric cancer awareness programs, we can do social media campaigns. We may not be able to have fun events for patients right now, but we can provide uplifting care packages. We continue this fruitful partnership with Lions clubs in Botswana, now in its third year.
I am often asked why I would choose a profession like pediatric hematology-oncology, most people assuming it must be terribly depressing. What people may not realize is that there is nothing more inspiring than a child’s tremendous resilience. Children always find ways to laugh and smile, despite the arduous journey they face. During these unprecedented times of a global pandemic, we must not simply sustain. Let us all follow the children’s example and focus on how we can continue to improve our efforts to diagnose and treat children with cancer and blood disorders in Africa amidst our new normal.
To learn more about how LCIF and Texas Children’s Global HOPE are partnering to fight childhood cancer in sub-Saharan Africa, visit lionsclubs.org/GlobalHOPE.
Dr. Jeremy Slone is a pediatric hematologist-oncologist with Texas Children’s Hospital and Baylor College of Medicine. He has been working in Botswana since 2012 where he is Medical Director of the Global HOPE program at the Botswana-Baylor Children’s Clinical Centre of Excellence.