Beryl Thyer Memorial Africa Trust: supporting African children that suffer from Burkitt lymphoma cancer

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Archive for December, 2011

A G Oettlé Memorial Medal awarded to Prof Hesseling

Dr Alfred George Oettlé was born in S Africa in 1919. He graduated in Medicine from the University of Witwatersrand in 1942. In a brilliant undergraduate career he achieved first-class honours and 5 awards. He spent 15 months in the UK at the Radcliffe Infirmary, Oxford, and later was awarded a Fellowship which he used in cancer research.

On return to S Africa in 1951 he was appointed Cancer Research Fellow at the South African Institute of Medical Research; he became respected wherever cancer research was in progress.

Dr Oettlé served the Cancer Association of S Africa with distinction up to his death in 1967 at the age of 47. His extensive research strengthened the idea that the environment might be important in the cause of cancer; indeed he became convinced that at least 80% of cancers fell into this category, and that, therefore, they might be preventable.

Distressed by the early death of this brilliant research worker, his colleagues gathered together a sum of money, which was donated to the Cancer Association, with the request that a memorial to him be established. The Association subsequently endowed a medal, to be known as the Oettlé Memorial Medal.

The medal may be awarded to South Africans who through their original research have made valuable contributions regarding cancer; or who have rendered service of outstanding value to the Association.

Prof Hesseling being presented with the A G Oettlé Memorial Medal

Prof Hesseling being presented with the A G Oettlé Memorial Medal

Newsletter

Many of you will remember the “Beryl Thyer Bulletin”. Peter McCormick’s sons Richard and David – now trustees – have created this website where you can find up to date news of our children’s cancer treatment programmes at the 3 Baptist Hospitals in Cameroon.

My recent visit to Cameroon (November 22nd to December 6th) with Prof Peter Hesseling was effective and I believe a real encouragement to our Cameroonian colleagues. Rather than produce a newsletter I have retyped some of my recent emails but with a few pictures to liven them up!

 

The new out-patient block at BBH

The new out-patient block at BBH

Thursday, 24 Nov 2011

Safe arrival at Douala on Tuesday evening and smooth passage through customs. Prof Hesseling arrived at the Catholic Procure at about midnight in the midst of a tropical downpour.

I am now at Mutengene Baptist Hospital. Much talking today – to lab.staff, to Eric and the palliative care team, to Richard in pharmacy stores, to Francisca Epie and the midwives who maintain the breastmilk bank, and even to carpenters (I organised some new shelving for notes in our registry office). I find it easy to link the excellent results of our Burkitt’s lymphoma (BL) treatment programme with the Cameroon Baptist Convention Health Board mission statement -which I often quote, hopefully to the encouragement of all.

Tomorrow we plan to visit a nearby Presbyterian hospital, then a small bush hospital and finally a village practitioner, “Dr” Peter Kimbi – they have all sent patients to us in the past sometimes partially treated. This is part of our now extensive advocacy/outreach programme.

Prof and I travel to Banso on Saturday.

 

"Dr" Peter Kimbi (village practitioner and fon), Prof Hesseling and patient

“Dr” Peter Kimbi (village practitioner and fon), Prof Hesseling and patient

Wednesday, 30 Nov 2011, at Banso

I have just lost a long email at point of SEND so I will make this a short one.

Today has been an exciting day. Prof Hesseling, nurses Glenn and Vera and I travelled to a small village called Ntada where 3 children treated for Burkitt’s lymphoma awaited us. All 3 children were well. The parents will form the nucleus of a new parents group: they will teach villagers to recognise BL (which is common) and support other “new” parents.

Afterwards Glenn and I addressed staff at a nearby Catholic Health Centre – and I was asked to see two more children with non-cancer related problems. Prof was given a live chicken (suitably trussed) and I was given a large cylindrical pawpaw (the sweetest variety).

 

Parents (Group) at Ntaba village who plan to rear pigs

Friday, 2 Dec 2011, Mbingo

Prof Hesseling has been working hard to review all the children’s files and enter data into a spreadsheet. Only by doing this do we know that the one year survival of our little cancer patients is over 60% – the best recorded in small hospitals in a resource poor setting in Africa. I have been entering the same data into POND (Paediatric Oncology Networked Database), a confidential website from St Jude Children’s Research Hospital, Memphis, Tennessee, USA. I use a template which I designed (or customised). Those of you who know my computer skills will realise that this is a minor miracle!

Research Assistant Nurses: Comfort Kimbi (left) from Mbingo, Glenn Mbah (centre) from Banso & Patience Nfor (right) from Mutengene

Research Assistant Nurses: Comfort Kimbi (left) from Mbingo, Glenn Mbah (centre) from Banso & Patience Nfor (right) from Mutengene

Sunday, 4 Dec 2011

Yesterday Prof and I attended a meeting of the N.W. Cameroon parents organisation (of children with cancer) – which we helped to launch in May of this year. One pa had travelled all the way from Mutengene in the S.W. I saw this man in May when he showed to us a prescription for drugs which would have cost him about £400. His 12 year old daughter had an aggressive muscle cancer (rhabdomyosarcoma) treated in the capital, Yaounde. He said “I have nothing left”. He had used all his money (and that sent by a sister in the UK) to pay for treatment. Prof looked at the list of drugs and decided what was essential. He then asked if I would be willing to supply these (free of charge) from our Burkitt lymphoma stocks. Of course I would!

Sadly this girl later died, but her grateful pa travelled all the way north to Mbingo to thank us. I still cannot get used to a system in which if you have no money you do not receive medical care. Isn’t our NHS wonderful!

Parents (& children) meeting in the canteen, Banso, May 2011

Parents (& children) meeting in the canteen, Banso, May 2011

Wednesday, 7 Dec 2011, Kettering!

On Monday evening Prof and I were back at Cameroon Baptist HQ in Bamenda. We had dinner with Walter Grob, Finance Comptroller of the CBC, and his wife Florence. It was a working dinner. Florence is a close friend of the wife of the Prime Minister, Mr Philemon Yang. We have humbly asked via Florence if the Prime Minister’s wife would be patron of our Parent Organisation. She would provide advocacy for our children’s cancer treatment programmes at the highest level.

We must go to Yaoundé the capital to meet the PM and his wife on our next visit in May 2012. Remind me to take a suit and a smart tie next time!

Lake Oku (supposedly sterile!) not far from the PM's village

Lake Oku (supposedly sterile!) not far from the PM’s village

Paul Wharin, Dec. 2011

Is it witchcraft?

We have treated over 700 children with Burkitt’s lymphoma at the 3 Baptist hospitals of N.W. and S.W. Cameroon. The one year survival of these children is over 60%: relapse rate after one year is less than 5%.

These are the best treatment results recorded in resource-poor African hospitals and a great credit to the small Baptist hospitals which receive very little if any government financial support.

Our nurses spend considerable time counselling “new” parents when children are first admitted. The nurses have conducted a survey in which parents were asked if they have consulted a village practitioner (bush doctor) and if so what diagnosis was given. 30% of village practitioners consulted gave the diagnosis of “witchcraft”: none used the word “cancer”, this being an unknown concept in their culture. So as part of their lengthy initial counselling the nurses try to convey the concept of “cancer”, explaining that the disease is not due to witchcraft, curses, poisoning or anything that the child or parents have done.

The nurses are experts at this but sometimes the message does not penetrate far. I have found that when a child (whom we cannot cure) is discharged with palliative care the parents will return straight to the village practitioner who will say, “Of course, this is witchcraft and not a problem that those hospital doctors are competent to deal with”. We cannot blame the parents who, just like parents in the UK, will do anything they can to find help for their child.

In November we re visited village practitioner and fon (chief) “Dr” Peter Kimbi who had previously referred a patient from his village. This boy (in the photo) is now well 2 years after chemotherapy. Peter Kimbi told us of a meeting of village practitioners in the S.W. and invited our nurse, Patience Nfor to address them. We are changing things, slowly!

"Dr" Peter Kimbi (village practitioner and fon), Prof Hesseling and patient

“Dr” Peter Kimbi (village practitioner and fon), Prof Hesseling and patient

Note: in the picture Peter Kimbi is wearing a black hat with a brilliant red feather on the right hand side. The feather is from the “green” turaco (called “lourie” in S.Africa). Only fons (chiefs) may wear feathers from this bird. There are big fons and lesser fons – I think Peter Kimbi belongs to the lower ranking.

Paul Wharin Dec. 2011

A message from Dr Francine

Greetings to all our supporters everywhere!

Yesterday evening I was reading a topic in SIOP News Issue no 41, entitled “Paediatric oncology in Developing Countries: How can the SIOP and ASPHO membership collaborate?” Some of the points mentioned included career opportunities, funding, establishing programmes, feasibility of treatment, and demonstrating ‘twinning’ approaches. As I was reading this I reflected that our own programme has demonstrated success in some of these areas.
Since 2003, what has been achieved as far as paediatric oncology is concerned here in Cameroon? Going back to the Cancer Pond Registry we see that 700 children with Burkitt’s Lymphoma (BL) were treated in our 3 centres, and 28 children with Wilms’ tumour (WT)  under the leadership of Prof Hesseling. A service of palliative care is also available and it is offered whenever there is a need for it.
At the beginning of this year, our services were extended to provide care to children with retinoblastoma and Kaposi sarcoma.  A Support Group has been put in place. Of the children with BL and WT, many would have died in pain and misery without the treatment we can now offer.
We are still facing some challenges, especially the children with Wilms’ tumour. It has not been easy to manage these patients. After the children have received chemotherapy, many of the guardians decline the necessary surgery despite vigorous counselling.
We would like to take this opportunity to thank each of you for joining us in our battle against childhood cancer. We are grateful to Prof Hessling for writing our protocols and for all his trips here in Cameroon as he continues to teach us. We appreciate his availability by email to answer various questions and offer further contributions.
To Dr Paul, Dr Peter and the other trustees of BTMAT, we thank you all for the financial support to run these programmes. Your ideas and suggestions help us to improve the care of our children.
To Baxter Oncology and Swiss Cancer League , and World Child Cancer, we are all grateful that you have stood by our side in this war against childhood cancer.
On behalf of the team in Cameroon, we want to reassure you that we will continue to treat these children. We will continue to offer our best to these families with your support. We will continue to use the resources at our disposal judiciously.
We wish you all a Merry Christmas and a wonderful New Year!
Dr Kouya Francine
Supervisor of Paediatric Oncology for Cameroon Baptist Convention Health Board
Mbingo Baptist Hospital
N W Region, Cameroon

One Sunday in Mbingo

Yesterday Prof Hesseling and I attended a meeting of The N.W. Cameroon Parent Organisation (i.e., parents of children with cancer) here at Mbingo – which we helped to establish in May of this year.

One pa had travelled all the way from Mutengene in the S.W. I saw this man in May when he showed  us a prescription for drugs which would have cost about £400 His 12-year old daughter had an aggressive muscle cancer (rhabdomyosarcoma) treated in the capital Yaounde. He said “I have nothing left doctor”. He had used all his money (and that sent by a sister in the UK) to pay for treatment. Prof looked at the list of drugs and reduced it to the bare essential ones. He then asked if I was willing to supply these (free of charge) from our Burkitt lymphoma stocks. Of course I was. Sadly this girl later died, but her grateful pa had travelled all the way north to thank us; all day in public bus. I still cannot get used to a system in which if you have no money you do not receive medical care. Isn’t our NHS wonderful; for all its problems?

Paul

Brief messages from Dr Paul in Cameroon

One

Today has been an exciting day. Prof Hesseling, nurses Glenn and Vera and I travelled to a small village called Ntada where parents of 3 children treated for Burkitt’s lymphoma awaited us.

All 3 children were well. The parents will form the nucleus of a new parent group which will teach villagers to recognise the cancer and support other “new” parents. Afterwards Glenn and I addressed staff at a nearby Catholic Health Centre, where I was also asked to see 2 more children with non cancer related problems. Prof Hesseling was given a live chicken (suitably trussed) and I was given a large cylindrical pawpaw (the sweetest variety).

Paul

Two

I thought that I would write about a few “minor” problems. Problems are there to be overcome. I am writing from our Registry room at Mbingo. I arrived here on Thursday. The noise of a large generator nearby, is battering my eardrums but I should be grateful for power to write this mail. My room in the hostel here, has a flashing strip light and a sink with no water (so I thought). I have learnt how to turn a valve to give a cold supply! The hostel is full so I am sharing with a young American internist (this is not a problem). I have just had dinner with a Dutch surgeon working for Smile Train (repairing cleft lips), an American cardiologist and his wife, and a Catholic priest and his mother. Mbingo Hospital gets a lot of visiting specialists unlike Banso Hospital.

Paul

Three

These are only minor problems really. but I do not want you to think that my 2 weeks in Cameroon are all holiday excitement and adventure. Prof Hesseling has been working hard to review all the children’s files and enter data into a spreadsheet. It is only by doing this that we know that the one year survival of our little cancer patients is 63%, the best recorded in small hospitals in a resource poor setting in Africa. The frustrating thing for Prof is that our African colleagues sometimes write poor records (the nurses are better than the doctors at recording!) but he is very patient. I have been entering the same data into POND (paediatric oncology network database) – a confidential website from St Jude Children’s Hospital, Tennessee, USA. I use a template which I designed (or customised). Those of you who know my computer skills will realise that this is a minor miracle – or an answer to much prayer. Prayer changes things and people!

Paul

Sock Monkeys from St Andrew’s

St Andrew’s C of E Church, Kettering, is one which was represented at the Synod I spoke at in September (see ‘help from on high’). The clergy and congregation there have responded, and have certainly put heart and soul into helping our Trust.

This evening was the first of two days of St Andrew’s Community Christmas Fair.

Chairs in the church had been moved away, and stalls set up. Twenty-five local and national charities will benefit from items for sale on the stalls. One stall was dedicated to BTMAT. Local adults and children associated with the church, had made Sock Monkeys; (yes, I didn’t know what they were either!). Each monkey is made from a pair of socks, looks charming, and quaint, and fun, and costs £12 (or 2 for £20). They were selling like the proverbial hot cakes. Sandy, who was manning the stall, assured us that a minimum of £300 would be raised tonight. Saturday is the other day, and we could expect even more.

This, it seemed to me, was Christianity and humanitarianism in action, and it was wonderful to see an enthusiastic crowd in the church, smiling, chatting, and buying things. The children of St Andrew’s School Choir sang carols; you really felt that the whole evening was something intrinsically good; and heart-warming. Alan enjoyed it too. We bought two Sock Monkeys.

Hazel, Sandy, Alan and Morey at the BTMAT stall

Hazel, Sandy, Alan and Morey at the BTMAT stall