1. Clinical Care on a National Level
This will entail the whole treatment process from pre-diagnosis stabiliztation to post treatment follow up care and everything in between. The levels and details of the participation of each individual centres in this process are outlined below. To date we have established partnerships with 11 centres across the country.
1.2 Partner centre structure
The TLMSEP model illustrates the four different levels of care for childhood cancer treatment. The highest, provide comprehensive sub-specialized treatment; the lowest level centres will be trained to suspect, stabilize and rapidly transfer children appropriately. Implementation of this model will ensure that children in need are fast-tracked to the most appropriate treatment centres avoiding current systematic referral delays. In many cases children will access cancer care closer to their homes and families.
It is important to understand that this is not a large infrastructural project. Nor will We Are TLM be required to expand its staff significantly to have a large presence at each of these centres. They stand as fully operational hospitals with existing government or NGO/FBO staff. Children are already presenting to these centres for treatment. What the We Are TLM network provides is basic Oncology education to key staff, free access to essential elements of cancer care (including chemotherapy, protocols, centralised diagnostic services and remote expertise through mobile technology) and assistance, when rapid referral is required, to all participating centres across the country. All We Are TLM services are provided free of charge. MNH management, at our Hub, has agreed to partner with We Are TLM in helping support the expansion of Paediatric Oncology network (Spoke centres).
Quaternary Care (Hub)
Based at MNH, this is the control centre or Hub of the entire network and will provide:
Central Pathology Services for children as required to confirm pre-treatment diagnosis.
Specialist procurement of chemotherapy, chemotherapy-protection, diagnostic and supportive care equipment
and consumables for patients.
Daily (as required) and weekly (regular) specialist case conference support to each individual centre.
Centralised development of all treatment protocols.
Provision of a National Paediatric Oncology EMRS for all centres.
Inpatient services for all children who require complex sub-specialist Oncology care.
Training for doctors (MSc in Paediatric Oncology in partnership with MUHAS) nurses (ten week intensive Clinical
Oncology Nurse Training certificate in partnership with MNH), Pharmacists, Laboratory technicians, Dieticians,
and Psychosocial support staff.
Access to the innovative SAFE Chemo HACPP.
National awareness campaigns regarding EWS and symptoms of childhood cancer.
Fundraising, project and donor management, M&E and administrative and technical support.
Nationwide transport coordination and support for rapid referral of sick children across the network.
Access to all medical guidelines, pocket guides, nutritional recipes, Play Therapy manuals and storybooks created by We Are TLM to support staff, children and families.
These care centres will provide Paediatric Oncology for all childhood cancer diagnoses unless Quaternary (Hub) level care is required. They will rely on the We Are TLM & MNH partnership for system strengthening, procurement and some pathology services (until their labs have been sufficiently strengthened through this programme or otherwise). They will act as a primary point of contact for all regional Secondary and Primary Level Care Facilities. These are University Hospitals based at the six main zones around Tanzania. The zones are: Lake Zone, Northern Zone, Central Zone, Southern Highland Zone, Coastal Zone and Zanzibar.
All regional centres with sufficient capacity and interest will be linked into this network to treat pre-agreed ‘easy to treat’ cancers and also work with other higher-level centres for follow up cases. They will also provide support to Primary Level Facilities.
These centres will be responsible for suspecting, stabilising and safely and rapidly transferring any child suspected of a childhood malignancy to the appropriate regional or national centre where definitive treatment will be available. These centres will also help with awareness campaigns in the community on EWS of childhood cancer.
In addition to the activities outlined above, special mention is needed for one of our key innovation
projects - click above heading to learn more.