Inside Yangon Children's Hospital

The average cost to treat a child with cancer in a low income country is only $1,000. What can you do to change a life today?

What would you do if your child had cancer? Would you travel 11 hours to get your sick child to the hospital? Would you spend your life’s savings on medical treatment? Would you camp out in the parking lot to be near the hospital? You would. Just like Myo’s mother.

Myo lives in rural Myanmar. She was 5 years old when she was diagnosed with cancer. To get to Yangon Children’s Hospital (YCH) to receive treatment, Myo and her mother have to make a dangerous journey that includes a one-hour walk barefoot through flooded fields, which are home to poisonous snakes. This is followed by transport on the back of a motorbike, the hire of a small boat to cross the river, and a bus ride.

After Myo was diagnosed with leukaemia in December 2015, her father abandoned the family, leaving them without any source of income. Myo was forced to stop her treatment at Yangon Children’s Hospital as her mother could not find sufficient money for them to travel to the hospital. Her mother then borrowed money from local lenders at an interest rate of 10% per month to fund the travel.

Myo’s story is not unusual: 80% of childhood cancer cases occur in developing countries. Many childhood cancers can be effectively treated if diagnosed early enough. Three thousand children are expected to develop cancer each year in Myanmar. Due to a lack of awareness about childhood cancer, an inability to accurately diagnose cases and the absence of funding for drugs, the number of newly diagnosed cases is far lower than expected for the country.

A staggering 60-90% of childhood cancer cases are estimated to go undiagnosed, leaving children to suffer and die from curable diagnoses. In addition, many families take their children home early before finishing treatment because of the financial burden of drugs and long stays in hospital. Yangon Children’s Hospital is one of only two hospitals in Myanmar that can provide treatment. Families and children travel, on average, 11 hours to reach the center.

Fortunately, Myo’s travels to and from the hospital are now supported in a partnership between Please Take Me There and World Child Cancer (WCC). As a result, she no longer misses any treatment and her mother is not at the mercy of high-interest loans to fund their travel.

Yangon Children’s Hospital is a current World Child Cancer site. In January, World Child Cancer board member Dana Bryson, her husband Dr. John van Doorninck, a pediatric oncologist practicing at the Rocky Mountain Hospital for Children, and member of World Child Cancer’s Project Committee and their two children visited the site. “The trip was absolutely incredible, and we are all forever changed by the experience,” said Bryson.

Children being treated at YCH live on an open ward, with 35 in-patient beds. In the open ward environment, controlling spread of infections is a high priority. Children with cancer have suppressed immune systems, so are very susceptible to infections. To combat the spread of diseases, World Child Cancer funded a hand washing station on the ward. This was essential, as there was only one bathroom area available for all patients and families.  

Another challenge of the open ward is limited privacy during sickness or dying. Which can have a great emotional and psychological toll on the patients and their families.

Families of patients at YCH generally cannot travel home each day, due to the cost and time of travel. Many families live in makeshift housing outside the hospital. Children at YCH are provided one meal a day. If they do not eat it, their families can have it. Dana, John and their kids, who are 6 and 8, spent a lot of time before the trip thinking about what they could bring to help the patients and their families. The children helped brainstorm and shop for supplies and gifts, and passed them out to the patients.

John was especially moved by what he saw at YCH. John’s hospital, the Rocky Mountain Hospital for Children in Denver, Colorado, has been a major supporter of World Child Cancer. As a Pediatric Hematologist-Oncologist, seeing the children on the ward hit very close to home.

“There were 35 children on the ward that day. Many had relapsed cancer and as such would likely not live. These children had diagnoses that are largely curable in high income countries. As a physician, that is so hard to see, so sobering. The truth is that the greatest prognosticator of whether a child will live or die from cancer is the country in which they were born. Every life is equally valid, equally vital. This is, at its core, a social justice issue. World Child Cancer is fighting to correct these inequities.  It is a privilege to witness and support its work.

said Van Doorninck.

The team at Yangon Children’s Hospital is led by Dr. Aye Aye Khaing, the head Pediatric Oncologist, who Dana described as “a real powerhouse, and a very strong leader.” She is doing a great deal with limited resources, but spirits are high at the hospital. The Heroes School, a program put in place by World Child Cancer, is doing a lot to help boost the mood of the patients.

The hospital school provides education for the children with cancer and blood diseases, as well as their siblings. Class takes place in a room off one of the wards that is decorated with drawings and creations made by the children. A bell rings at 1pm to begin class. The children sing a variety of  songs from a Burmese version of the hokey pokey to songs about washing hands properly (which ties in with the new hand washing station) and a favorite; ‘happiness is here, happiness is there, happiness is everywhere’.

Almost 300 children have been able to continue their education at the hospital school since the Heroes School opened in 2016. In addition to academic instruction,  World Child Cancer provides funding for play therapists, who provide much needed psycho-social support to the children and families. World Child Cancer has also supplemented salaries for nurses, so that there can be more than one nurse on staff at night for the ward. These psycho-social supports and other key activities by World Child Cancer have had tangible success:

  • The number of families abandoning treatment has reduced significantly.
  • The number of children newly diagnosed with cancer increased by 18% from 2015 – 2016. With early detection, there can be early treatment.
  • Together with our partner organization, Please Take Me There, transport costs for the most vulnerable families, like Myo’s, are supported.

World Child Cancer has been recognized as the key NGO stakeholder for pediatric oncology in the Burmese Government National Cancer Control Program. We will continue to fight for improved diagnosis, treatment, and outcomes for children with cancer in Myanmar and beyond.

No child should suffer and die from cancer, simply because of where they were born. Will you join us, and help save a life?

 

 

 

About the author

Marian Pulford

Marian