Project Center: Yangon Children’s Hospital in Yangon, Myanmar
Twinning Partners: Boston Children’s Hospital/Dana-Farber Cancer Institute, US Guy’s St Thomas’ NHS Foundation Trust, London, UK
Project Leader: Dr. Aye Aye Khaing
Project Mentors: Robert Carr is a consultant hematologist at Guy’s St Thomas’ Hospital in London. Carlos Rodriguez-Galindo & Lindsay Frazier are consultant pediatric oncologists from Boston Children’s Hospital. Lisa Morrissey is a senior pediatric oncology nurse from Boston Children’s Hospital.
Start Date: May 2014
Project Background: Myanmar is a low income country with a population of 48 million people. The majority of people live in poverty. The country has been ruled by a military dictatorship for many years but has recently started significant political and economic reforms. There are an estimated 1,200 – 2,300 new cases of childhood cancer annually (based on 80-150 cases per million children). Accurate figures are not available because there is no national population-based registry.
Yangon and Mandalay Children’s Hospitals are the only treatment centers for pediatric oncology in Myanmar. They are government-funded with patients receiving treatment free of charge but families are required to fund drug costs. Both hospitals have dedicated pediatric oncology wards with Yangon having better facilities including radiotherapy, pathology and the preparation of blood products. In 2012 Yangon diagnosed 260 children. No figures are available for Mandalay.
Pediatric oncology care in Myanmar was established by Dr Aye Aye Khaing in 2002. Over the last decade Dr Khaing and her team have made significant progress. However, long term survival rates remain low and there are still considerable challenges including:
- Late diagnosis (70%) and non-diagnosis due to lack of awareness amongst parents and healthcare professionals;
- Too few trained doctors and nurses to provide specialist care for children with cancer;
- Lack of appropriate treatment protocols lead to high rate of disease relapse;
- High death rate from infections;
- High rate of abandonment (40%) of treatment due to unaffordability of drugs;
- Limited provision of palliative care and effective pain relief.