A journey of a thousand miles begins with a single step: lessons from University of Gondar Cancer Center, Ethiopia

drderessaDr. Biniyam Tefera Deressa

University of Gondar, Ethiopia

Email: biniyamtefera.md@gmail.com

Two years ago, in January 2015, Dr Daniel Rauch, a Swiss oncologist, and ! were in Gondar, Northwest Ethiopia to evaluate the first cancer patients. Until that day there was no dedicated cancer treatment in the University of Gondar Hospital. Our first patient, Abeba*, came into the office and started to tell us her story. She taught in a primary school in a small village 15km from Gondar. After an operation for breast cancer, her surgeon told her she needed to go to the capital, Addis Ababa for adjuvant chemotherapy and radiation therapy. Over there she encountered many unexpected issues. There were thousands of patients waiting for treatment. After one week of struggles, she finally received a card that would grant her an appointment for oncology evaluation. The waiting list was very long, and she was only able to obtain an appointment after 4 months. They also informed her that the chemotherapy would be administered every 3 weeks for 6 cycles. This was bad news for her since she would need to travel 750km every 3 weeks. This was unaffordable not only financially, but also psychologically.  When she heard that a cancer center had been established in Gondar she was very pleased and thankful to be able to get treatment closer to her village.

The story of Abeba is the story of most cancer patients in Ethiopia. Since the country up till now, has had only one center dedicated for cancer treatment, with four qualified clinical oncologists and two radiotherapy machines, all cancer patients were forced to go to Addis Ababa. This certainly exposed them to different financial, social, psychological and even medical harms.

Here it is important to thank four Ethiopian senior clinical oncologists (Dr Mathewos, Dr Wondemagegnehu, Dr Aynalem and Dr Bogale) who worked hard in order to increase cancer awareness in the country, whilst treating patients under difficult circumstances. It became increasingly obvious to them that Ethiopia needed more oncology centers and professionals.

It was in 2014 when Dr Daniel Rauch and I proposed to establish a cancer treatment center in Gondar. Our proposal was mainly based on using small applicable steps to carry out a big dream. We planned to use the available resources and create new solutions for an oncology service. With extraordinary support from the University of Gondar, in January 2015 the Gondar oncology center was ready to accept its first patient, Abeba.

The main steps in our journey to establish the cancer center were:

  • Renovating the already existing building but now exclusively repurposed for cancer patients;
  • Training of nurses and doctors in Addis Ababa in basic oncology practice;
  • Preparing protocols for chemotherapy, premedication and management of oncologic emergencies.
  • Organizing short training programs for other disciplines such as pathology (e.g. immunohistochemistry) and radiology (e.g. contrast-enhanced ultrasound) in Switzerland which were previously unavailable in Gondar.
  • Establishing tumor board meetings which recommend treatments based on available resources and establish the practice of multidisciplinary discussions.
January, 2015 after the center was ready to accept patients

January, 2015 after the center was ready to accept patients

 

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Tumor board meeting

Currently, the center is treating more than 600 patients per year. It is also recognized as the second cancer treatment center in the country by the Federal Ministry of Health of Ethiopia. In addition to these achievements the Gondar cancer center has a collaboration with University Hospital Inselspital, Bern and Spital STAG, Thun in Switzerland which includes an exchange program of professionals. As wel, the Gondar cancer center has been visited by experts from the MD Anderson Cancer Center and ASCO.

To further improve cancer care for our patients, the University of Gondar is currently constructing a modern building which is designed to provide full oncology services such as medical oncology, radiation oncology and hemato-oncology. Varian Medical Systems has been selected to supply advanced linear accelerators to the hospital. The current cancer center in Gondar is the footsteps of the future modern center. All the nurses and doctors are working passionately to provide great care for our patients. We are all very much looking forward to our upcoming modern oncology and research center.

 

Architectural plan of building of Gondar oncology center

Architectural plan of building of Gondar oncology center

*Abeba is a fictitious name in order to preserve patient’s privacy.