Medical Education and development of Expert Service
Staff shortages for paediatric oncology remain an urgent priority. Even with the required cancer facilities in place, patients will not receive the necessary treatment without doctors, nurses and other health professionals trained in the specifics of paediatric oncology and haematology. Therefore, the need for rigorous educational programmes in paediatric oncology and haematology to train the next generation of Tanzanian paediatric oncologic specialists is imperative.
MSc in Paediatric Oncology/Haematology
There are currently no qualified Paediatric Oncologists in Tanzania. It is an essential part of the strategic plan for Paediatric Oncology to ensure that there are local skilled human resources available over the next 15-20 years to meet the demands of the expanding capacity of Paediatric Oncology services in Tanzania. MUHAS, Muhimbili National Hospital (MNH) and other Tanzanian Medical University centres, including Bugando Medical Centre (BMC), KCMC and Mbeya Hospital have a cadre of specialists with postgraduate training in Paediatrics and Child Health (PCH) who have an interest in paediatric haematology/oncology, and who are currently managing patients with haematology/oncology disorders but do not have training in this specialized field.
The locally based MSc in Paediatric Haematology/Oncology was designed, funded and commenced enrolment in September 2013. Enrolled students are in their second and final year. A second enrolment will begin again in September 2015. This masters programme currently relies heavily on international experts with more than 20 lecturers from all over the US, Europe and Africa, supervising and training students. Over time locally trained experts will take on this educational role. This Programme is hoped to train sufficient paediatric haematologist/oncologists for Tanzania and the region of East Africa. .
Currently, there is no recognised training for nurses in Paediatric Haematology/Oncology. TLM in collaboration with MUHAS and the Tanzanian government will development a Certificate Programme for Nursing in Paediatric Oncology and Haematology. The Certificate Programme will be direct entry for practicing nurses. The programme will consist of 10 modules that each student must complete in order to gain the certificate. Modules can be completely on an individual basis to allow nurses to continue working while studying in the certificate programme.
Lab Scientists Training Programme
TLM in collaboration with the Dublin Institute of Technology, Ireland will develop a training programme for lab scientists with a focus on haematology and pathology. Once trained, the lab scientists will conduct all in-country biopsy analyses for oncology/haematology specimens, including Immunohistochemistry, in Tanzania.
MD in Paediatric Pathology
University College Dublin have offered (through TLM) to create an MD programme for Tanzanian and Irish pathologist interested in training in Paediatric oncology pathology. This course will be based at UCD but all research topics will be related to the clinical oncology service at MNH and the students will be expected to run all samples through the newly designed paediatric pathology unit. The programme will train an in-country pathologist with a dual Irish MD and Tanzanian MD degree.
Pathology training at MUHAS
The number of trained pathologists in Tanzania are hugely inadequate for the current need. We expect this need to rise significantly as access to quality services improve. MUHAS offers a quality pathology training programme. We would like to support the training of at least 2 further pathologists over the next 5 years to begin to meet this need.
Palliative care training
Both doctors and nurses will be formally trained to provide end of life care to children with cancer and join the existing palliative care team at MNH. Over time others will be identified to provide a similar service to the children’s oncology services in sister institutions.
Clinical Engineering support
In order to maintain all the equipment both for the planned PICU and the existing paediatric oncology ward it is planned to provide ongoing professional education to an existing clinical engineer at MNH through the twinning programme between MNH and OLCHC. The funds for the initial training will come from the funds for the PICU build. A small clinical engineering work shop will be created next to the PICU.
Tumour board Meetings
In order to improve communication between all sub-specialists involved in the care of children with cancer a weekly tumour board is vital. This has been established at upendo ward but will be strengthened and developed over time. Once sister sites have been established these sites will be encouraged to develop separate TBM and in addition will be invited to join (via virtual technology) the MNH meetings and present any especially challenging cases.