Malawi

Malawi was the first programme that World Child Cancer started supporting. We partnered with the paediatric oncology unit at the Queen Elizabeth Central Hospital in Blantyre, which had been led by Prof Elizabeth Molyneux for a number of years.

Programme Centre

Queen Elizabeth Central Hospital, Blantyre

Twinning Centres

VUMC Medical Centre, Amsterdam & Royal Victoria Infirmary, Newcastle (UK)

Programme Lead

Dr George Chagaluka

Programme Mentors

Prof Liz Molyneux, Dr Trijn Israels (VUMC) & Prof Simon Bailey (RVI)

Contact

Piera Freccero

Head of Programmes

Start Date

January 2009

Impact
Background
Problems
Key Activities

Queen Elizabeth Central Hospital in Blantyre is the main tertiary care centre providing diagnosis and treatment for children with cancer. The hospital diagnoses around 30% of the 1,000 expected annual cases in Malawi, mainly comprising Burkitt lymphoma and other relatively easily treatable solid tumours. The centre provides healthcare free of charge but receives government funding which is insufficient to the needs, so many costs end up falling to families to fund themselves. As one of the poorest countries in the world, this causes huge barriers for families when facing the diagnosis of a child with cancer, and results in many being forced to abandon treatment.

Only 1 doctor trained in paediatric oncology in the country
A shortage of trained nursing staff and lack of funding for government nurses
Over-stretched facilities within other essential paediatric departments such as pathology, surgery, imaging and palliative care
Delays in diagnosis often result in children starting treatment too late for a cure to be possible
Follow-up of patients not possible due to a shortage in staff and lack of a reliable electronic database
High rate of abandonment due to practical issues associated with a lengthy hospital stay
Lack of awareness amongst healthcare professionals and in communities around childhood cancer symptoms and potential curability

Increase the accessibility of cancer diagnosis and treatment for more patients
Support in the development of adapted treatment protocols and aim for improvements in survival rates of easily treatable malignancies
Capacity building for staff caring for children with cancer through ongoing mentoring and support
Enable infrastructure improvements to ensure quality treatment and care
Decrease abandonment of treatment through family support and improved follow-up

Training and succession of leadership with Dr Chagaluka taking charge of the unit
Increase in the number of newly diagnosed patients from 150 to 290 annually
Improved survival rates for Burkitt lymphoma; from 48% to 60%
Established treatment protocols for other malignancies including leukaemia
Support for online pathology through a digital microscope camera link-up with experts in Newcastle, enabling fast and accurate diagnosis
Provision of 2 new ultrasound machines for the diagnosis of abdominal tumours
More than 1,700 patients newly diagnosed and accessing improved services since the start of the programme