Our Story so far .....  

Before this journey began, nine out of ten children who reached treatment facilities in Tanzania, died. In addition those that reached these facilities represented less than 10% of children with cancer in Tanzania. As a result – in overall terms a cancer diagnosis was fatal for almost every child in the country.

 

The opening of the first Children’s Cancer Ward in Tanzania, at the Ocean Road Cancer Institute (ORCI) under Dr Jane Kaijage in 2004, marked the start of national efforts to bring about significant change in this neglected field. The Children’s Cancer Ward immediately took part in a multi-centre study for the Treatment of Burkitt Lymphoma (BL), at the time the most common children’s cancer in Tanzania. This was coordinated by the International Network

for Cancer Treatment and Research (INCTR). Within three years, cure rates for BL had improved from less than 10% to greater than 70% for children treated.

 

In April 2006, Paediatric Oncologist Dr Trish Scanlan conducted a needs assessment of this children’s oncology ward and reviewed outcomes of new patients from 2005. Results showed that while the outcome for BL children was steadily improving thanks to Dr Jane and the study, most other children attending the ward were dying.

 

In 2007, supported by the INCTR, Dr Trish returned to join the dedicated team changing the narrative of children’s cancer in Tanzania. While compassion and respect for the children were in high supply on the ward, the same could not be said for the supply of drugs, consumables, adequate staffing numbers, services and sub-specialist professional

education for everyone involved in their care. From this lack of resources and sustainability came the idea for Tumaini La Maisha, Hope for Life, (TLM).

Also in 2007, the Ministry of Health, Community Development, Gender, Eldery and Children (MoHCDGEC) formed the Cancer Control Steering Committee (CCSC). This 13 member group was tasked with developing the National Cancer Control Strategy, and creating an action plan to provide cancer treatment free for all citizens. Free cancer treatment at the

ORCI was then covered by national policy to be offered to all patients including children. In reality this meant free radiotherapy for all and free chemotherapy when it was available. Chemotherapy was reliably available for one condition – BL - thanks again to the INCTR led study. For other conditions regular stock outs were common.

In 2008, Children in Crossfire (CiC), a Charity from Northern Ireland, registered in Tanzania committed their support to the development of Paediatric Oncology provision. This decision was transformative. CiC provided all chemotherapy and other hi-tech medications required, diagnostic consumables, and improved staffing numbers by funding nursing overtime.Combined with the government’s initiative to provide free access to ward based care and treatment, this partnership immediately started to have an impact on the children’s survival across a range of conditions.

 

 

In November 2011, TLM was launched in Dar es Salaam.

 

With the support of CiC a new Non-Governmental Organisation (NGO), Tumaini La Maisha, was created. TLM is

dedicated to building on the work of CiC, caring for children with cancer and their families and provides both clinical and nonclinical supportive services. The honorable Mr Ali Hassan Mwenyi (Former President of

Tanzania) kindly agreed to be our patron.

In April 2012, the Children’s Cancer Ward moved from the ORCI to the Children’s Department at Muhimbili National Hospital (MNH). This was made possible by an agreement between ORCI and MNH facilitated by MoHCDGEC.

Space for new wards was made available by MNH and refurbished thanks to a donation from The Love Hope

Strength Foundation. Instantly, the children’s care improved. As part of Tanzania’s largest University Hospital,

access was now available to services previously lacking such as expert paediatric sub-specialist colleagues,

CT/MRI scans, surgical and emergency services and a 24 hour laboratory.

 

Before February 2013, most children and their guardians lived on the ward for many months at a time. Not only was traveling vast distances home between cycles of treatment impossible, it was often dangerous. In the same year, we were delighted to finally offer a home away from home and a safe and nurturing environment for children discharged from the ward to Ujasiri House, our family-style hostel. Comprising of 22 bed spaces, a kitchen, living room, classrooms, office space and skills room as well as an outdoor playground and a garden. The land was provided by 

MNH and the build was financed by generous private donors and the Abbott Fund. The hostel and all its’ facilities are managed by TLM. 

 

In August 2013, thanks to successful fundraising through the Rotary Dar Marathon for the two years previous, a new custom designed Paediatric Oncology facility was opened at MNH by Dr (Dame) Jane Goodall DBE. The combined Upendo/Tumaini Children’s Cancer Ward, with a capacity of more than 65 beds, is the only specialized Paediatric

Oncology facility in Tanzania, providing cancer care and treatment free of charge. The majority of children admitted are from poor families and have travelled long distances from all over this vast country.

 

During the planning and construction, TLM provided regular technical assistance to the design team and formed part of the Project Management team. TLM currently helps MNH maintain the wards to a standard befitting a Children’s Cancer ward.

 

As the clinical services and facilities advance, improving expertise became a priority. TLM partnered with Muhimbili University of Health and Allied Sciences (MUHAS) to create and maintain a locally based MSc programme in Paediatric Haematology/Oncology based onsite, and shorter courses to Tanzanian sub-specialty doctors. Local and international teams of experts visit Upendo/Tumaini Children’s Cancer Ward allowing almost all training to stay in Dar es Salaam, thus contributing to the care of all the children both present and future as they guide the students through the programme.

 

The initial MSc was launched in October 2013 and was financed by generous donations from Resolute Mining and the Karimjee Foundation. The next important milestone for children’s cancer in Tanzania and TLM was hosting the

international society for Paediatric Oncology’s Africa meeting in 2014 (SIOP Africa). The conference was entirely managed by a group of local volunteers coordinated by TLM. A great success, the meeting was attended by delegates from all over the continent of Africa and, indeed, the world. This firmly placed both Upendo/Tumaini Children’s Cancer Ward and TLM on the map for Paediatric Oncology services in Africa.

From the very beginning of these efforts, professionals from across Ireland and elsewhere began offering their expertise free of charge to assist in a variety of ways. In particular the positive impact of the efforts of the staff of Our Lady’s Children’s Hospital in Crumlin, Dublin, Ireland (OLCHC), cannot be overemphasised. In 2015 a Memorandum of Understanding (MoU) between MNH and OLCHC was successfully agreed upon, formalising this very close relationship which had developed over the previous eight years. This was facilitated by the Esther alliance, a European group working to promote quality health services in lower resourced environments.

 

OLCHC have been providing crucial clinical and technical support to Upendo/Tumaini Children’s Cancer Ward in Dar es Salaam. This has included regular expert site visits, weekly assistance for over 10 years processing histopathology specimens, interpreting radiology investigations and donation of decommissioned equipment. This is only a

sample of the support given.

 

To assist TLM in achieving our ambitious mission, two new sister charity entities were created, one in Ireland and one in the UK, both registered in 2015. Although governed by separate laws and guided by separate management boards, these two NGOs were designed with the aim of supporting all activities conducted by TLM. It was felt that a recognizable English name should be chosen with the same acronym (TLM), ‘Their lives Matter’ was the obvious choice. These three organisations work together to provide children’s cancer care in Tanzania.

 

In 2016 TLM established a National Expansion Plan of Paediatric Oncology care (centrally coordinated) to other regions of the country. It is crucial that a sick child be within no more than a one day distance of an appropriate treatment site so as to provide the best possible chance of survival. Late presentation, misdiagnosis and inability to pay for travel are all factors that impact the chance of a sick child becoming well again. In the period 2016 to 2018, seven collaborations have been formalised with centres across Tanzania who now enjoy free access to chemotherapy, diagnostic pathology services,

transport and procurement. Weekly expert conference calls where every active case is discussed are also provided by TLM experts. We aim to expand to more than 30 sites in the coming years.

In 2019, TLM proudly built and handed over to MNH, the first Paediatric Intensive Care Unit (PICU) ever established in Tanzania. This service is open to all critical children attending the hospital. (TLM also supported the development of a Neonatal Intensive Care Unit {NICU} facility at MNH). The development of these units were financed by the Big Heart Foundation and FoCP group in Sharjah.

 

The first intensive Paediatric Oncology Clinical training course for nurses was launched the same year which has transformed the care the children receive on the ward. We also began to use our automated chemotherapy

prescribing tools which were developed in-house and have reduced prescription errors by over 90%.

 

We are very proud to report that throughout all these years All TLM services both clinical and non-clinical are given

completely free of charge to every child and every guardian.

 

Their Lives Matter.

Together, We Are TLM.

Together, we can.

We Are TLM

TLM is a Tanzanian based NGO dedicated in providing free and curative care for all children with cancer in Tanzania

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