Sunday, July 27, 2014

Toy Distribution for Eid

Here are some photos from yesterday's toy distribution on the ward.  You'll recognize the first little girl as she was given a toy during the an earlier toy distribution in April.  Her name is Jim and she's doing well with her treatment for leukaemia.  She's getting bigger!

All the children received new pillowcases, which are made by a Brittany, a young girl in Australia who had cancer and now make the pillowcases to encourage other kids with cancer!


Play therapy is now happening 2-3 days per week at BSMMU!
The playroom is finally finished!  Last week Gwen decorated the room with beautiful wall stickers, some of which were donated by TinyMe.  Play therapy is now available with volunteers 2-3 times per week!  The kids and parents now understand the routine: remove shoes and wash hands before entering the playroom.

At first we had a lot of tears whenever a child had the leave the playroom as he or she would want to keep the toys, but now everyone seems to better understand the routine. Every couple of months we do distribute gifts of toys to all the children on the ward.  These are toys which are donated and but aren't suitable for the playroom: stuffed toys or those that aren't durable enough for repeated use.

Hot air balloons to brighten the walls.

Putting stickers on the glass doors, so that no one walks into them!

Underwater scene on the ward.

Jungle scene above bed 12.

Thursday, July 10, 2014

Vist to Sylhet

This week, as part of the World Child Cancer visit, I also visited Sylhet as this will be another satellite centre.  Afiqul, Karen and I taught a workshop on pediatric cancer and palliative care while we were there.  The visit was very well received and we have invited 2 pediatric junior doctors and 2 nurses from the pediatric ward to come to BSMMU for a 1 month training period when they can work on the children's cancer ward and receive extra training.  At this time there are no pediatric cancer specialisits in Sylhet, there are only pediatricians who are doing some cancer treatment.  This is not ideal as they don't have sufficient specialized knowledge and training.  We hope that this one month training will be the start of more detailed and indepth training to improve the quality of care which is being provided in Sylhet.

Unfortunately we didn't get to visit the ward as our visit was cut short due to flight delays.

Here are some photos from Sylhet.  This was my first time travelling outside of Dhaka in Bangladesh!
Getting off the plane, 2 hours late!

Driving to the hospital, through tea plantations. 
Speaking at the Workshop on Childhood Cancer

Some of the workshop attendees; local paediatricians.

Afiqul making a passionate speech about ensuring that all children with cancer get access to the highest quality treatment available.

Walking back across the runway to board the plane home, also 1 hr late.

Visit to National Institute of Cancer Research and Hospital

Along with the visit to Dhaka Medical College, we visited National Institute of Cancer Research and Hospital (NICRH) to also help launch them as a satellite centre.  Despite the name, this hospital is unfortunately very limited in their ability to treat children's cancer due to the fact that they have only 4 inpatient beds.

They treat mostly patients with solid tumours (as opposed to leukaemia and lymphoma) as these patients don't require hospitalization as often and can receive most of their treatment as outpatients.  Secondly, this hospital has a strong team of cancer surgeons, which is vital for the appropriate treatment of solid tumours.

In general, the treatment of most solid tumours in children involves chemotherapy to shrink the tumour followed by surgery to remove as much of the tumour as possible, followed by more chemotherapy to kill any remaining cancer cells which may not have been removed by the surgery.  Sometimes radiation is also used after surgery.

It's very important for physicians and surgeons to work together for the best chance for cure in these cases.

Unfortunately this doesn't always happen. t recently saw a child with neuroblastoma, a tumour of the nervous system, which is generally located in the abdomen. In this case the child's tumour had spread to the area behind the eye, which is a common place for neuroblastoma to spread. Because there was swelling and protrusion of the eye, the child went to an ophthalmologist, who mistakenly supposed the swelling to be an eye tumour and so removed it. Sadly without chemotherapy and removal of the primary tumour in the abdomen, the child will have no chance of cure. Ultimately, children with this advanced stage of neuroblastoma in Bangladesh, as it is very difficult to treat once the disease is this advanced.

Talking at the Doctors' Morning Meeting at NICRH, Tim is emphasizing the important of coorperation and avoiding 'territorialism'.

Touring the ward with Dr. Olia. Unfortunately the children's beds are on a ward with about 30 adult patients.

More of the ward.

Kids' beds had bright green sheets in honour of our visit.