The survival from cancer in low and middle income remains unacceptably low. Nearly 75% of the global deaths from cancer occur in low and middle income countries where access to treatment is suboptimal. Cambodia has only recently begun treating pediatric patients with cancer and while improvements have been made their remains a significant need. I have been involved pediatric cancer care in Cambodia since 2013 through a collaboration with Health Volunteers Overseas and the American Society of Hematology (HVO-ASH). My focus has been on the education of the local staff, developing therapy and supportive care guidelines, and expanding access to treatment options. I first began working with HVO-ASH at Angkor Hospital for Childen in Siem Reap, Cambodia. When we started the collaboration there were 40 new cancer patients that presented yearly and now with expanded options they are seeing around 150 patients. With the expansion of the program, HVO-ASH partnered with Calmette Hospital in Phnom Penh, Cambodia to help expand options in other areas of the country. I have been Project Director of the Calmette collaboration since 2019 but have been unable to visit since due to the COVID19 pandemic. I plan to return the both Calmette and Angkor Hospital for Children to provide ongoing education support of physicians, nurses and pharmacists and help develop a registry database to collect data on pediatric cancer patients in Cambodia. I will also be working with each site to develop a collaboration plan between the 2 sites to improve access to patients.
The benefactors of this project will be both the healthcare personnel at Angkor Hospital for Children and Calmette Hospital, and the children diagnosed with cancer in Cambodia. Historically, children with cancer in Cambodia have not been given the opportunity to receive chemotherapy for their disease. Only recently has treatment been an option, however, the medical staff has little to no training. Proper training is necessary to ensure the correct treatment plans are being administered in a safe way. We have been conducting virtual educational session but hands on training is necessary.
The children of Cambodia also need expanded treatment options. There has been great growth in the treatment of certain cancers however approximately half of the patients still have no treatment options. My hope for the visit is to continue to develop treatment protocols for specific diseases not currently treated and to develop a registry database to better understand the disease patterns and response to therapy.
My hope for the visit is to continue to develop treatment protocols for specific diseases not currently treated and to train medical staff in how to safely administer them. I also hope to develop a registry database to better understand the disease patterns and response to therapy. Following my return from the visit, I will continue my participation with both sites by attending monthly zoom calls to follow up on the interventions and continue the education process.
I had a wonderful trip to Cambodia to visit Calmette Hospital in Phnom Penh and Angkor Hospital for Children in Siem Reap. My time at Calmette was spent giving hematology and oncology lectures to the residents, attending physicians, and laboratory personnel. Certificates were presented to attendees who completed the training course. I also conducted an autologous transplant readiness assessment to determine the needs prior to the first transplant in Cambodia. We are now developing an e-learning curriculum which we hope to institute in the next month. We will also work together to develop policies and procedures around transplant.
I also continued my work in Siem Reap at Angkor Hospital for Children where I have volunteered since 2013. Earlier this year we developed a protocol for the treatment of AML and have now treated the first 4 patients at the hospital and am happy to report that all are doing well. My time was spent conducting rounds with Dr. Sam and Dr. Bun and reviewing the research database which includes 10 years of patients treated at the hospital.