An Oasis for Cancer Care

Becky Lee is a 4th year medical student at the David Geffen School of Medicine at UCLA. She has recently completed her MPH degree in Global Health at the T.H. Chan School of Public Health at Harvard.

Becky Lee is a 4th year medical student at the David Geffen School of Medicine at UCLA. She has recently completed her MPH degree in Global Health at the T.H. Chan School of Public Health at Harvard.

Rising above a community of butcher shops and fruit vendors in old Cairo, flanked by the historic Aqueduct of the Nile, the Children’s Cancer Hospital Egypt 57357 (CCHE) is quite the sight to see. With two enormous mesh structures billowing like sails in the wind, and its blue-green windows that defy the dusty layer of sand to glimmer in the sun, the hospital is designed to resemble a ship–sailing towards a healthy, cancer-free world for its children. CCHE has an international reputation as the largest pediatric cancer hospital in the world, with a capacity of 320 hospital beds and immediate plans to add 300 more within the next five years. Inspired by St. Jude Research Hospital, CCHE runs on an innovative finance model in which charitable giving supports 100% of the hospital’s services, allowing it to treat its patients at no charge. Patients from any background are accepted on a first-come, first-serve basis, as long as they are 1) between the ages of 0 and 18, 2) free of any previous treatment, and 3) referred to CCHE as a potential cancer case. The institution sees an approximate 2000-2500 new patients a year, an astounding amount that reflects the high demand of services within the nation as well as the broader Middle East region.

The Radiation Oncology service has been operating since the hospital’s opening in 2007. Dr. Mohamed Zaghloul, the head of the Radiation Oncology department, estimates that the unit treats about 100-120 patients a month on its two linear accelerators. As part of a practicum project for my Master of Public Health degree at Harvard, I traveled to CCHE to explore the strategic plan for its expansion. This ambitious plan includes the process of expanding its radiotherapy services to include a proton therapy center. After intense business planning, the hospital has signed its final agreement and is starting installation. The goal? To treat its first patient with proton therapy in July of 2019.

hospital

The hospital’s current expansion includes a shift from innumerable small donations to larger corporate donors, as well as units within the hospital that will be used for profit. Interestingly, the new proton facility will double as both a new treatment modality and a revenue-generating unit to contribute to the hospital’s budget. While it will continue to prioritize the pediatric population at no cost to the patient, it will also start treating adults in the region on a for-profit basis. These plans are in their preliminary stages, and it will be interesting to see how the hospital will balance the long pediatric waitlist with the inevitably high demand of adult patients. This has been an exciting period for the hospital, and during my time there, there was already much buzz floating among its staff in anticipation of this new machine. I was fortunate enough to attend a lecture series completely dedicated to proton therapy and the hospital’s vision (luckily in English). I was impressed by the transparency of the plans for the new center. Everybody in the hospital was invited to attend the lectures, including one given by Dr. Zaghloul detailing the basic science of radiation therapy, and another from a representative of the vendor installing the new machine.

The culture within CCHE was fascinating. I was especially struck by the complete focus on CCHE’s vision. Everyone, even my assigned driver, who became my good friend throughout my trip, knows the mission of the hospital by heart. The CEO is a dynamic, larger-than-life leader, intensely focused on his vision and immensely involved in all hospital activities. While running the analysis on our qualitative data, my partner and I both cited the mission-driven culture as one of CCHE’s biggest strengths. As the hospital continues its expansion and further advances the services it provides its patients, I look forward to it fulfilling its reputation as a beacon of hope for pediatric cancer patients in the region.

CCHE Project Manager Dr. Dinana, at one of the new construction sites for the hospital expansion

CCHE Project Manager Dr. Dinana, at one of the new construction sites for the hospital expansion