In a crowded children’s ward in a hospital in Kumasi, Ghana’s second city, a father and mother sit on either side of a bed, looking sadly at their son.
Three-year-old Richard, whose family did not want his second name to be published, has a bloated stomach and big eyes. Each breath is a wheeze. A white bead necklace with a cross hangs loosely around his neck. His father tries to spoon some food into his mouth, without success.
Out of earshot, nurse Janet Sarpong talks about the case. Richard was brought to the hospital in January, and diagnosed with Wilms’ tumour, a form of cancer. He had surgery and an initial round of chemotherapy before being discharged, and his chances of full recovery appeared good.
But the family had spent all their savings on the hospital treatment. His father tried to scrape some more money together for the remaining chemotherapy cycles but could not. Richard appeared to be getting healthier, so they kept him at home. By the time they brought him back to the Komfo Anokye Teaching Hospital in September, the cancer had spread.
“It’s now just a case of palliative care,” said Mrs Sarpong. She opened a battered ledger with a spine reinforced with pink sticking plaster – the register of cancer patients – and went through it year by year. “We see so many relapse cases where a child comes back in a worse state because of the financial situation,” she said. “Most of them die.”
But things are looking up. One of the paediatricians at Komfo Anokye hospital, Dr Vivian Paintsil, recently completed a year-long course in child oncology in Cape Town, so the hospital now has a specialist on site. And World Child Cancer, the UK-based charity chosen by the FT for the 2013 Seasonal Appeal, is about to start working with the hospital.
A “twinning” relationship with the Royal Hospital for Sick Children in Edinburgh has already produced good results at the main teaching hospital in Accra, the capital, and is to be extended to Komfo Anokye. Local staff will benefit from training and mentoring by Edinburgh doctors and nurses, and WCC funding will help subsidise the cost of treatment for patients and raise awareness of the disease, so patients arrive earlier.
WCC made the decision to extend the partnership to Kumasi after witnessing the dedication that Mrs Sarpong and her colleagues have shown despite the meagre resources at their disposal.
The hospital sees about 100 new cases of child cancer a year. The “child cancer ward”, with 16 beds and 16 cots, also serves as a ward for neurology, haematology and children with other diseases and illnesses, including meningitis and malaria. When the beds are full, patients must share.
Mothers typically stay at their children’s bedside 24-hours a day, sleeping on mattresses on the floor at night or slumped over the beds during the day.
Mrs Sarpong, an outgoing, kind woman, explains that the hospital serves northern Ghana – the poorer half of the country. Many of the patients are referred here from clinics and small hospitals hundreds of miles away.
Because of a lack of awareness about child cancer in Ghana – even among medical professionals – the referrals often come too late and only after the parents tried herbal and other traditional treatments.
A four-year-old girl recently admitted has a tennis ball-size growth protruding from her left eye – a retinoblastoma – covered by a dirty green bandage. She is waiting to have a biopsy and the specimen will be sent to the capital Accra for diagnostic study. “The cancer is spreading,” Mrs Sarpong said. “The prognosis is poor.”
Even when parents can afford the tests and cancer treatment – which costs at least $700 and often much more – obtaining the necessary medicine can be a challenge. Of the three main drugs used to treat Burkitt’s lymphoma – the most common form of child cancer in Ghana – only two are in stock at the hospital. A pharmacy in Accra has the monopoly on importing cancer drugs, so when it runs out of a particular medicine there are no options.
Lined up in the corridor next to the cancer ward are numerous children previously treated at the hospital who have come for further chemotherapy. Faustina Agygmang, five, was there with her father, Eric. She was diagnosed with Burkitt’s lymphoma in 2010. Doctors treated her and she appeared to be cured, but in February this year she fell ill again. A biopsy showed that she had neuroblastoma, another type of cancer.
Faustina had surgery and has since been through several cycles of chemotherapy. She appears to be getting better and has resumed her schooling.
The medical costs have financially ruined Mr Agygmang, who sells second hand computers and radios for a living. But he says he will do whatever it takes to ensure she stays on treatment. “The hospital has done a very good job,” Mr Agygmang says, before turning to Mrs Sarpong. “If you were not here, Faustina would not still be with us.”