Transcript Kuinita Margraff, Samoa Update

Pacific
Island Child
Cancer
Regional
Conference
AN UPDATE FROM SAMOA
OVERVIEW
– INTRODUCTION
– PAEDIATRIC STAFF
– SAMOA CANCER SOCIETY
– CANCER PATIENTS – update
INTRODUCTION
– Samoa - is a Polynesian Pacific county northeast of Fiji.
–
–
- consists of 4 inhabited and 5 uninhabited islands
- capital is Apia and is located on Upolu (most populous island &
developed)
–
- population is approximately 200,000.
–
- 1962 independence (1st pacific island to achieve independence)
– The chief hospital of Samoa is the Tupua Tamasese Meaole Hospital at Motootua
– - provides primary, secondary and tertiary healthcare facilities in addition to
offering a range of specialist medical services, surgery and outpatient clinic.
– - bed capacity of 200
Who are in the paeds unit?
STAFF
–
Acting HOU – Dr. Kirtimalini Anand
–
Snr registrar – Ulugia Dr. Tito Kamu
–
Snr registrar – Dr. Litara Esera
–
Snr registrar – Dr. Fiona Hunt (Fiji)
–
Jnr registrar – Dr. Kuinita Margraff
–
Jnr registrar – Dr. Maluapapa Siaosi
Nursing staff
– Clinical Nurse Consultant
– Nurse Manager
– 13 registered nurses (5 trained for oncology)
– 2 full time enrolled nurses + 1 part timer
– 1 auxiliary nurse
SAMOA CANCER SOCIETY
 An independent, not-for-profit organization deeply committed to reducing the number of people impacted by
cancer, as well as ensuring the best possible outcomes for those affected by it.
 Established in 1998, and is governed by a voluntary board
 Partners
1.
Child cancer foundation NZ
2.
Starship Children's Hospital
3.
Cancer society of NZ
4.
USO Bike Riders NZ
5.
American Samoa Community Cancer Coalition
Cancer patients
in Samoa
Patient name
Diagnosis
Protocol
DOB
Age
Completed
treatment
Progress
Female
Wilm’s tumour
Left kidney
Stage III FH
Pl Wilm’s #1
29/10/05
11
May 2014
Likely cured from Wilms. Off treatment 3 years.
Surgery in Samoa- nephrectomy and splenectomy
SSH- radiotherapy and commencement
chemotherapy.
Completed chemotherapy in Samoa May 2012.
Remains well.
Follow-up every 3 months review with Paediatric
Male
Wilm’s tumour
Right kidney
Stage II FH
PI Wilm’s #1
28/05/12
4
Jan 2014
Well. Off treatment 2 years
Male
Burkitts
Lymphoma
Malawi 2000
18/01/05
11
April 2012
Cured of Burkitts for 4 years
Male
Histiocytosis
Family disorder
LCH 4
06/10/11
5
Ongoing
Responding well to treatment. 9 cycles left to
complete.
Follow-up every three weeks in Paediatric ward.
Next chemotherapy due December 12
Male
ALL
PI – ALL 1
07/11/11
5
Under
investigation
Currently in New Zealand
Male
? ALL
19/08/08
8
Under
investigation
Currently in America (US national)
UPDATE
– Currently we are only seeing approximately 5 cases/year
– There is a lack of national awareness on childhood cancers
– Traditional and cultural mind-set that cancer is an ‘adult only disease’
– Late presentation to the hospital due to ancient beliefs. Traditional healers over
modern medicine.
– 2016: 1. Ekeroma Sauloa Tulaimalo (Histiocytosis – non Langerhans cell)
2. Jayden Roebeck (currently in NZ)
3. Zarahya Moors (currently in USA)
Update
– We currently do not have anyone on palliative care
– Following chemotherapy criteria, only two cases from 2015-2016 period were
referred to NZ for treatment.
– In the past, two paediatric doctors & five nursing staff were trained to
administer chemotherapy drugs
– Ongoing partnership with the Samoa cancer society. They provide support for
the families of those affected as well as financial assistance for patients coming
in for chemotherapy.
– “Project Paeds” founded by Dr. Salote Vaai. Project also assists in meeting
financial needs of low income families, who are struggling to come into the
main hospital for treatment.
Update
– Complicated cases are referred overseas for investigation
– We can manage febrile neutropenia (Ceftazidime, Gentamicin, Ceftriaxone, Vancomycin)
– Our ICU team are equipped to assist with central lines (for chemotherapy patients)
– Limitations:
 Availability/cost of drugs
 Staff shortage
 Lab – all tests sent to NZ (takes 2-3weeks for the results)
 Family situations (e.g. financial, cultural/traditional beliefs, isolation)
 Awareness – we need more especially for our children age group
Update
– July 2016 Dr. Jane Skeen and Oncology team visited Samoa to review children
who were undergoing chemotherapy
– Samoa is very fortunate that we have a good relationship with the Starship
team in assisting us in diagnosing our cases and ongoing consultation on
difficult patients.
– Samoa currently has a overseas treatment scheme that allows patients to go
over to NZ for investigations as well as treatment.
FA’AFETAI 