Jul
28
2015

Texas Children’s expands crucial care to cancer and hematology patients in developing countries

Dr. Parth Mehta’s favorite picture is one with five young children sitting around a small table putting together a puzzle. The kids, most of them bald, are smiling for the camera as their doctor snaps the photo. They’re cancer patients in a Texas Children’s clinic in Botswana and of the five, four have survived. While even one death is devastating, just a few years ago, none of them would have received the appropriate treatment. Most would have died without ever being diagnosed. Eight years ago, Mehta, now the director of Texas Children’s Global Oncology Programs, was the first pediatric oncologist in Botswana. When he arrived at the Princess Marina Hospital, only 22 cases of pediatric cancer had ever been diagnosed there. Today, more than 200 patients are under the care of Texas Children’s physicians in the same facility, and over the last eight years, more than 450 children with blood disorders and cancer have been treated.

“There is a population of 2 million people in Botswana and the challenge was quite overwhelming,” Mehta said, “Children died from diseases with a 95 percent cure rate in America because the drugs were not consistently available and no one really knew how to take care of these patients.”

Mehta started the first organized international effort in sub-Saharan Africa by Texas Children’s Cancer and Hematology Centers, the largest pediatric cancer institute in the U.S. Under the vision of Physician-in-Chief Dr. Mark W. Kline, Texas Children’s and Baylor College of Medicine had already established several centers to care for children with AIDS in Africa. Baylor International Pediatric AIDS Initiative helped secure the Texas Children’s name in these regions and Dr. David Poplack, director of Texas Children’s Cancer & Hematology Centers, was determined to make a long-term effort to help kids with cancer and blood disorders in these countries.

“Our role has been to put ‘medical boots’ on the ground,” said Poplack. “We send physicians and nurses and we use our staff to train our local counterparts in the treatment of these diseases. Our real aim is to provide the intellectual capital to train the appropriate individuals who will carry the work forward.”

That’s the key to the sustainability of these programs. About 80 percent of pediatric cancer cases are in developing countries where the survival rate is less than 40 percent. In countries like the U.S., it’s approximately 80 percent. While Texas Children’s treats patients from all over the U.S. and 26 different countries, for those in Africa, just bringing their child to a clinic in a nearby town is a difficult task. Dr. Gladstone Airewele who grew up in Nigeria knows about these problems. Airewele is the director of the Global Hematology Programs at Texas Children’s Cancer & Hematology Centers. For many of his patients, saving a life is as easy as a pin prick to collect blood for newborn screening to detect sickle cell disease.

“It’s very gratifying to see children come to the clinic, get great care and do much better than they ordinarily would if it weren’t for this program,” Airewele said.

Airewele said the long-term plan is to help with a broad range of hematologic diseases including bleeding disorders, bone marrow failure, and hemoglobin disorders.

“In a few years, I hope to see leaders of pediatric blood disorders all over Africa who are affiliated with Texas Children’s but are local physicians in those countries,” Airewele said. “People who have been trained and are training others, so these diagnoses are no longer a death sentence for these children.”

Texas Children’s international cancer & hematology initiative is concentrated in sub-Saharan Africa with programs in Uganda, Botswana, Malawi, and Angola. Poplack and his team plan to expand the program to other regions. For now, a group of physicians at Texas Children’s are on call as consultants to BIPAI physicians who need answers about hematological and cancer-related diagnoses. Mehta and Airewele make frequent visits to the designated cancer clinics to pursue potential growth in our programs. For Mehta, the five young patients in that old photograph are a reminder of why this work is so pertinent.

“Medicine is not about borders,” Mehta said. “Medicine is not about cities and states. Cancer doesn’t just affect children in some places, and as a doctor who cares, not just treats, but cares for children with cancer, it’s almost axiomatic that one must take care of children everywhere.”