Introducing safer laparoscopy surgery for child cancer patients in Ghana

Introducing safer laparoscopy surgery for child cancer patients in Ghana

The Royal Hospital for Sick Children in Edinburgh is partnering with World Child Cancer to deliver training on keyhole surgery in Korle Bu and Komfe Anokye Teaching Hospitals in Ghana to improve care for child cancer patients.

The World Health Organisation recognises that non-communicable diseases (NCDs) are an emerging priority for global child health[1] and the disparities in care are stark: survival rates of childhood cancer in high-income countries are 80%, compared to just 10% in many low and middle-income countries.

As part of new efforts, the Government of Ghana has recently developed policies to tackle NCDs, including cancer which affects an estimated 1,300 children in Ghana each year[2].

Korle Bu Hospital in Accra, and Komfe Anokye Hospital in Kumasi, are the country’s main treatment centres for paediatric cancer, seeing approximately 300 children with cancer each year. The number of cases diagnosed in Ghana is increasing each year and together these hospitals act as referral centres to a growing network of units around the country. Access to healthcare services is limited for much of the population, so there remains a large number of children who are currently not diagnosed.

Many of the children who do arrive at the hospitals need to undergo basic surgery such as biopsy to help with diagnosis and care. However, surgeons at these hospitals, and across Ghana, lack confidence in the use of laparoscopy (keyhole) surgery, and instead are relying on open surgery – sometimes for something as simple as obtaining a sample of tissue for a biopsy.

Conventional open surgery techniques are painful and risk of complications during procedures are high, resulting in delayed healing, increased risk of infection, long stays on wards and high morbidity rates. The longer stays add to the costs of treatment as well as taking up vital bed space. Keyhole surgery is a cheaper, less invasive and less painful alternative with a faster recovery time, and has been a common procedure in high-income countries for decades.

Developing the capacity of surgeons to use laparoscopy techniques in Ghana will reduce morbidity and improve the quality of life of children with cancer. It will also reduce the cost of treating children who require the use of laparoscopy in their operation, particularly benefitting children from low-income families; in Ghana, treatment for childhood cancer is not covered by national health insurance.

With funding from thee Africa Grants Programme, a Johnson & Johnson funded and THET managed scheme, the Royal Hospital for Sick Children in Edinburgh and World Child Cancer will be supporting a three volunteer paediatric surgeons from Edinburgh and one nurse from Leeds Children’s Hospital to travel to Ghana in May to deliver training sessions on laparoscopy techniques to 28 paediatric surgeons, anaesthetists and nurses from Korle Bu and Komfe Anokye Teaching Hospitals. Training will be a practical hands-on experience in-situ, and monthly on-line mentoring sessions will back up training for as long as required.

It has been crucial to involve multidisciplinary teams in the training sessions, as Pokua Sarpong a General Anaesthetist at Korle Bu Hospital explained to THET on a recent monitoring and evaluation visit:

“Every surgical procedure has an impact on so many other disciplines, especially anaesthesia. It is vital that we understand the laparoscopy techniques the surgeons will be using so that we can provide that right support and anaesthesia for both the patient and the theatre teams.”

Additionally, two of the surgeons at Korle Bu Teaching Hospital will be given extra support during the training visits to become trainers for Ghana and share acquired skills across hospitals. They will be trained on leadership and training skills, ensuring that expertise is developed and passed on in-country.

We very much look forward to updating you on the progress of the project following the training in mid-May!

[1] http://www.who.int/nmh/en/

[2] https://www.worldchildcancer.org/what-we-do/where-we-work/ghana