A teenage girl, who was diagnosed with thyroid cancer following biopsy tests in Guyana nearly two years ago, was flown to Delhi, India for urgent treatment by the Mississauga-based Three Rivers Kids Foundation. However, the specialists in India discovered that the cancer was benign and surgery was not necessary.
This was not the first time that a patient had been misdiagnosed and Jeanette Singh, a registered nurse who founded the organization seven years ago, is not about to blame Guyana’s health care system.
“Some of the equipment physicians are using are outdated and they are doing the best with what they have,” said the Trillium Health Centre practitioner.
Recognizing there is a serious shortage of physicians with paediatric cancer care training and limited technological resources, SickKids Foundation – which raises funds for the Hospital for Sick Children – is working to develop a Caribbean network aimed at improving clinical outcomes and quality of life for children who are suffering from cancer and serious blood disorders.
The five-year plan – which will be supported by Can$7.3 million that SickKids is trying to raise over that period – will address gaps in research, care and education in order to advance the diagnosis and management of paediatric cancer and serious blood disorders across the Caribbean.
“The idea for this project came out of a conversation that one of our patient families had with Dr. Victor Blanchette (he works in the haematology and oncology department at Sick Kids Hospital),” said SickKids foundation president and chief executive officer, Ted Garrard. “The family was interested in knowing what the survival rate for children with cancer would be like in the Caribbean and they wanted to compare those numbers with Canada.
“To do that, they helped to fund a needs assessment so it could be determined what the gaps in care in the Caribbean are. As a result, we sent a medical team to six Caribbean countries to see what some of the problems and issues were.”
The six countries which are now partners in the project are Jamaica, Trinidad & Tobago, the Bahamas, Barbados, St. Lucia and St. Vincent & the Grenadines.
The medical team’s findings were quite revealing.
In addition to a lack of trained personnel to help properly diagnose children with cancer and blood disorders and front-line health care providers, including nurses and pharmacists, there is an absence of a patient registry system to document the number of children suffering from cancer, the type of cancer they have, how they are treated and what are the outcomes.
“Having identified these gaps, we went to the University Hospital of the West Indies in Jamaica and basically offered to help them with patient registry training and in other areas that could make a difference,” said Garrard, a former University of Western Ontario vice-president (external). “They were very receptive. In the next five years, we hope we will be able to build capacity in each of the six countries to better diagnose and treat children in their home communities by having better diagnoses and trained personnel and by being able to have SickKids consult as needed on difficult cases.
“Up until nine months ago, there was not a single trained paediatric oncologist in Jamaica (Dr. Michelle Reece-Mills recently completed her training in Canada this year and is at the University Hospital of the West Indies), one in Trinidad & Tobago and one in Barbados that treats both the adult and child population. Our hope as a result of this program is that we will be able to identify other medical practitioners in the Caribbean who might want to specialize in cancer treatment and come to SickKids for that or they might be medical students at the University of the West Indies who, because we now have an interest in paediatrics and blood disorders, might decide they would like to come and finish their training in that speciality at SickKids. We are hoping we will get more (practitioners) trained and practicing and that will have the impact of then helping more children.
“If you want to become an oncology specialist, you will probably take three years, once you finish medical school, (you will come) up here to do a specialization in paediatric oncology either funded by yourself, your government if you agree to go back to your home country or in some cases we will use philanthropic dollars to support medical students who would come here.
“In the case of other practitioners like nurses and some medical doctors who are not oncology specialists but want a better background on oncology treatment, this initiative is actually going to fund them to come here. Their home hospitals have to agree to give them release time so they can be paid, but SickKids will pay for their travel, accommodation and for other key out-of-pocket costs.”
SickKids will work with the six countries to train health professionals in oncology, nursing, laboratory analysis and pharmacy; provide consultation and diagnostic expertise and improve outcomes by developing and expanding access to diagnosis, treatment and supportive care.
Garrard said children residing in territories outside the six selected countries will have access to the specialists and facilities in the hubs.
“If there are children who can’t get a proper diagnosis or treatment in their home country, they would be taken to the nearest hub and given the best diagnosis and treatment with a view to determine the necessary course of action that should be taken,” he said.
The hubs were selected based on some world-leading experts in blood disorders, paediatric cancer and infectious disease who have roots in those countries.
“We are blessed at SickKids to have some great medical leaders who have come from the Caribbean,” said Garrard. “They are already at SickKids and have a good appreciation for the state of health care in the countries of their birth.”
In addition to Barbadian-born Dr. Blanchette, Jamaican-born Dr. Upton Allen and Dr. Melanie Kirby-Allen are leading the initiative.
Blanchette was the inaugural chair of the Canadian Council of Paediatric Haematology & Oncology directors while Kirby-Allen – who was born in St. Vincent & the Grenadines – pursued clinical studies at the University of the West Indies Mona campus and the Queen Elizabeth Hospital in Barbados where she also interned before coming to Canada in 1984. She is the co-director of the Hospital for Sick Children’s sickle cell & thalassemia clinic, a Saturday Morning tutor for children with sickle cell and member of the Sickle Cell Awareness Group of Ontario’s (SCAGO) advisory board.
Raised in Port Antonio, Allen – a graduate of Titchfield High School – ran track, captained the school’s cricket team and played soccer before going to the University of the West Indies, Mona campus to pursue medical studies.
After graduating with honours in medicine and therapeutics in 1981, he came to Canada two years later to pursue specialized paediatric training for four years at the Hospital for Sick Children that’s affiliated with the University of Toronto. He completed his Master’s in Clinical Epidemiology at McMaster University and spent five years in the department of Obstetrics and Gynecology at Ottawa General Hospital, University of Ottawa and the hospital’s Microbiology division prior to returning to the HSC in 1995, where he’s the Chief of the Infectious Disease Division.
A Fellow of the Royal College of Physicians in Canada and England and a Fellow of the American Academy of Paediatrics, Allen’s research interests are in the areas of infections in immuno-compromised patients and transplant-related infections.
SickKids is seeking financial support for the project from Canadian donors and naming opportunities are available for gifts from $25,000 to $2.5 million.
Paul Lee-Chin, a member of SickKids Foundation International Committee, is convinced an investment in the program will decrease the mortality rate in the Caribbean.
“As a Jamaican-Canadian, I believe that children who suffer from cancer in the Caribbean should have the same access to diagnostics and therapeutics as children in Canada,” said Lee-Chin, the son of Jamaican-born entrepreneur, Michael Lee-Chin. “That’s why I am proud to champion this partnership.”
By RON FANFAIR