Passing The Torch: Pediatric Cancer In Botswana

In 2007, Dr. Parth Mehta, a pediatric hematologist-oncologist, left the United States for Gaborone, Botswana, to treat children with cancer at Princess Marina Hospital (PMH) through the Baylor International Pediatric AIDS Initiative (BIPAI). Prior to his arrival, there were no pediatric hematologists-oncologists in this country of almost 2 million people.

Dr. Mehta labored for 4 years to improve the accessibility and quality of pediatric hematology and oncology care in Botswana. He shared many thoughts on this blog. Last year, Dr. Mehta returned to the U.S. to lead the International Program at Texas Children’s Cancer Center. He passed the torch to Dr. Anurag Agarwal for the past year. Dr. Agarwal is moving on to Ethiopia, a country with even less resources for pediatric cancer than Botswana.

So now it is my turn! My wife, daughter and I left the familiar confines of the U.S. to move to sub-Saharan Africa. I've had a passion for treating children with cancer since 2006 when I completed a 2-month medical elective as a 4th-year medical student at Kudjip Nazarene Hospital in the Western Highlands of Papua New Guinea. It was there that I realized that children with cancer had little to no hope of survival in resource-limited countries. Knowing that 80% of children in the U.S. and other developed countries survive, it didn't seem fair to me. During my pediatric hematology-oncology fellowship, I was fortunate to work with physicians treating children with cancer in Lusaka, Zambia. Now, Botswana is my focus.

Though the locale may change, the challenges are the same. To list only a few, these include: delayed recognition of cancer leading to late presentation, access to resources to adequately diagnosis patients and determine the spread of their cancer, essential medications (chemotherapy, antibiotics, antifungals), access to radiation therapy, inadequate supply of blood products, paucity of social supports for families with very limited means who often travel a great distance.

It is with full knowledge of the road ahead that I gladly accept this torch from Dr. Mehta and Dr. Agarwal. They have left big shoes to fill so I may be stumbling a bit out of the gate but should soon hit my stride. Barring unforeseen events, my family and I are committed to staying here for at least 3 years. I will attempt to chronicle my experiences in this forum. Many stories will be sad, some will be happy, but hopefully all will be thought-provoking and will open eyes to the plight of children with cancer in Botswana and other resource-limited countries.