Kesho Conference 2014

1. Opportunities and Challenges in
starting an Oncology Program at
Aga Khan Hospital, Dar Es Salaam
Tanzania
Amyn Alidina,
Medical Oncologist, Aga Khan Hospital, Dares Salaam
David Makumi
East African Regional Manager, AKUH Cancer Programs.

2. Regional Cancer
Infrastructure.
Just who has what?
Where?
How can everybody else
access it

3. One Program, 2 Countries, 4 campuses
Mombasa
Kisumu
Nairobi
Dar es Salaam

4. Prostate
29%
MALE SITES: AKH DAR JAN –SEPT
Colorectal
19%
Urinary
bladder
7%
Esophagus
6%
Pancreas
5%
liver
3%
Multiple
myeloma
5%
Kaposis
sarcoma
lymphoma
6%
6%
others
14%
2014
FEMALE SITES: AKH DAR JAN –SEPT 2014
Breast
37%
Colon &
rectul
11%
Cervical
9%
Pancreas
5%
Stomach
3%
leukemia
5%
Ovarian
3%
Endometriu
lymphoma
8%
m
4%
Others
15%

5. 30
25
20
15
10
5
0
10 to 20 20 to 30 30 to 40 40 to 50 50 to 60 60 to 70 70 to 80
AKUH Dar -Cancer Patients age Distribution

7. Standardizing oncology practice
across 4 institutions in 2 countries.
How do we do it?

8. Prevention screening Diagnostics treatment
Survivorship&
Follow-up
Psychosocial support & Palliative
Care
Cancer Control elements &
Regional Cancer programs
Cancer
information &
Awareness
Education & Research, Surveillance, Legislation & Policy

9. Mentorship & Education
• Knowledge transfer:
• Pharmacists
• Nurses
• Cancer Registry staff
• Medical Officers
Mentored on Site Attachment with specific
learning objectives.

11. Institutional and country specific
adaptation of:
•Oncology Documentation tools
•Oncology Policies & standards
•Guidelines

12. Nursing Education video
conference
• Once a week
• 3 sites / 2 countries
• Oncology topics of mutual
interest.
• Cost effective model of
capacity building for
oncology nurses.
• Initial investment in VC
equipment

13. Shared tumor boards
Weekly
• General Tumor
board
• Breast Cancer
Tumor board

14. COMPUTERIZED PHYSICIAN ORDER
ENTRY FOR ONCOLOGY DRUGS
Consultant
Review/ Request
Doctor Prescribe
Medication
Pharmacy
Dispense
Medication
Nurse
Administer
Medication

15. Challenges
• Cost of
medications.
• Regulatory issues
for new products
• Training
• Medical tourism

16. Opportunities
• Research
• Education
• Common regional specific guidelines
• Product evaluation
• Cancer registry

17. Conclusion
• Implementation of a new program is challenging
at the best of times, implementation on a region-wide
basis brings new challenges.
• Strong leadership participation is required to
articulate a clear vision and ownership of the
processes.
• All institutions have their own cultures and ways
of doing business; this can be challenging when
trying to standardize best practices.
• Do not re-invent the wheel: learn from others.

18. Asante Sana