Contributing towards Childhood Cancer Management in Ghana: Role of the Dr. Robert Mitchell Memorial Foundation (RoMMeF)
As we observe this year’s International Childhood Cancer Day under the theme “Better Survival” is achievable #throughyourhands’’, let us remind ourselves of the tenets of the Convention on the Rights of the Child, which affirms that every child regardless of the socio-cultural background has the right to good health and care, among others.
It is a day set aside by the international community to put the searchlight on the devastating effect of childhood cancer on children and society at large. Childhood cancer continues to be a common medical cause of death among children, with more than 300,000 aged between 0 and 19 years, diagnosed with the disease worldwide annually.
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Globally, more than 19 million people were diagnosed with cancer, with about 10 million deaths recorded in 2020. Cancer causes more deaths worldwide than the combined total deaths from HIV/AIDS, TB, and Malaria, with 70% of the disease occurring in developing countries. Even as reliable data on cancers in Ghana are scarce and limited to institutional reports, available data indicates that cancer has emerged as a compelling cause of morbidity and mortality in Ghana.
Set Up and Role of RoMMeF
The Dr. Robert Mitchell Memorial Foundation (RoMMeF), which was established in 2008, is a non-governmental, non-profit, non-partisan, non-sectarian organization that seeks to help as many children as possible, with special emphasis on children with cancer, gain access to affordable and quality healthcare.
RoMMeF turned its attention to the fight against Childhood Cancer because even though paediatric oncology is a major public health issue both in Ghana and globally, the focus on childhood cancer in the country is quite low compared to other health interventions for malaria, HIV AIDS, and cancer in adults. Consequently, childhood cancer kills more children; a situation that is aggravated by late detection, the high cost of treatment and access to quality healthcare
The prospect of a child facing a debilitating illness with its attendant emotional suffering, is traumatic for both the child and the family. The situation becomes even more difficult to manage when there is no support to deal with the pain, anxiety and the financial burden associated with the treatment of the disease. Children from deprived communities who become afflicted with the disease are even more at risk of losing their lives due to the non-availability of health facilities.
Various activities are undertaken to commemorate the International Childhood Cancer Day, but in Ghana RoMMeF publicizes the awareness of childhood cancers through its activities that are covered by the major electronic and print media houses. This is because the phenomenon and its devastating effect on children and their families in the country hardly attract attention from the public.
Cancer has become a taboo in our society and most people do not want to associate children with this dreadful disease. The reality, however, is that childhood cancers refer to neoplastic disorders affecting individuals aged less than fifteen years, who are part of the age group that constitute approximately 40% of the population of Ghana.
Probable Causes of Childhood Cancers
Very little is known about the probable causes of most childhood cancers. Most of these cancers occur at an early age suggesting causative factors which operate before birth.
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The environmental factors as probable causes include –
- Radiation is established as a cause;
- Electromagnetic waves (as in microwave ovens and MRI scanners have an unclear association with leukemias; this should, however, not be underestimated; whilst
- Pesticide use has also been associated with bone marrow cancer i.e. acute myeloid leukemia.
Infections as other probable causes include –
- Viruses, for example Ebstein - Barr virus, Hepatitis B virus HIV have been associated with varying cancers; as well as
- Repeated malaria infections implicated in the development of Burkitt’s lymphoma.
Furthermore, genetic factors also include –
- Less than 5% of childhood cancers attributable directly to genetic factors leading to increased risk of cancers such as in Down syndrome.
Early Warning Signs of Childhood Cancer
For the past eleven years, RoMMeF has been championing the fight against childhood cancer through its many initiatives, including awareness programs, raising funds to pay for the treatment cost and advocating for national support for children with cancer. To enhance its awareness programs for the public, the Foundation, with the help of the Ghana Broadcasting Corporation, has produced audio translation of the following early warning signs of childhood cancer in six Ghanaian languages (namely, Twi, Ewe, Ga, Dagbani, Nzema, and Hausa) as follows -
- Continued, unexplained weight loss;
- Headaches, often early morning vomiting;
- Increased swelling or persistent pain in the bone, joints, back or legs;
- Lumps or mass, especially in the abdomen, neck, chest, pelvis, or armpits;
- Development of excessive bruising, bleeding, or rash;
- Constant infections;
- A whitish colour behind the pupil of the eye;
- Nausea which persists or vomiting without nausea;
- Constant tiredness or noticeable paleness;
- Eye or vision changes which occur suddenly and persist; and
- Recurrent or persistent fever of unknown origin.
Impact of Ghanaian Lifestyles
The lifestyle and diet of the average Ghanaian family has changed over the years, and the pervasive destruction of our natural environment, such as the “Galamsey” menace, has become a source of concern which has compounded the challenges of the country’s not so robust health management system. In this scenario, coupled with our socio-cultural set up, that puts children at the bottom of the ladder of society, the health of children and their general well-being are the most affected.
Establishment of Cancer Registries
The establishment of Cancer Registries at major hospitals in the country by RoMMeF in collaboration with the Ministry of Health and the hospitals involved which will facilitate evidence-based diagnoses and research of cancer in general, is very timely. The first registry, which was commissioned at the Cape Coast Teaching Hospital in February 2019, will be followed with cancer registries in Ho, Tamale and Koforidua and the strengthening of the capacities of the registries at Korle-bu and Komfo Anokye Teaching Hospitals.
The dynamics of the management of childhood cancer and other related diseases of children, call for the application of robust interactions. We have learnt from our years of experience that to bring about a long-term change in the lives of children with cancer and the other related diseases there is the need for strategic partnership and support of the Government, Parliament, corporate bodies, media, and caring individuals.
Achievable Future against Call for Financial Support & Partnerships
Encouraged by medical experts, that more than 80% of all childhood cancer can be treated with early detection, the Foundation is poised to whip up its awareness programs throughout the country and continue with its other initiatives to realize its mission of reducing the incidence of cancer in children and increasing their survival rate. RoMMeF is strongly pursuing its vision that every child in Ghana will have access to quality healthcare and most importantly no child with cancer should die due to lack of financial support.
This goal that may seem lofty, but achievable, and can only be realized with the full support of policy makers and other stakeholders in both the public and private sectors as well as the general populace. Partnership and unity of purpose can change the trajectory of any demanding situation for the better.
This is an urgent call to save our children who form the future of our country and we look forward to everybody’s support in whatever form and size.
By Hon. Emma Mitchell
Former Member, Council of State
Minister of Trade & Industry
& Founder / Trustee, RoMMeF