Chemotherapy? In Africa!?

One of the first questions I get after telling someone that I am a pediatric hematologist-oncologist in Botswana is, “Can you give the kids chemotherapy?” The answer is yes, but it is a complicated process. First, the hospital purchases and supplies all medications, including chemotherapy, like hospitals do back in the United States.

Some can be stored at room temperature (as in this box below):
Box of chemotherapy medicine in BotswanaSome chemotherapy must be kept very cold (2-8°C) and/or out of direct sunlight. I clearly mark the boxes with chemotherapy drugs, as I share a refrigerator that stores all types of medications for children in the hospital. The blue and white boxes on the bottom shelf are factor VIII for patients with hemophilia A. We go through about 20 boxes per week.
Refrigerator of chemotherapy medicine in BotswanaWhen a child is diagnosed with a particular type of cancer, we determine a treatment regimen for that patient. I calculate the dose of chemotherapuetic medication based on the patient’s weight and height then go to my “chemotherapy pharmacy” to make the chemotherapy. I wear goggles, a special mask, gown and two pairs of latex gloves when I make the chemotherapy. Signs are posted so nurses and doctors know to stay away from this area.
Chemotherapy bench in BotswanaThe process here at Princess Marina Hospital (PMH) is quite different than at a children’s hospital in the U.S. where multiple physicians would confirm doses, the order would be sent to a state-of-the-art chemotherapy pharmacy where doses would be recalculated then the chemotherapy made in special chambers, followed by dispensing of the drugs to a specially trained chemotherapy infusion nurse who would again confirm dosages. The process is much simpler at PMH, but lacks the multiple steps of oversight. Because the buck stops with me, I calculate, re-calculate, then calculate again. The process for preparing each drug is different. Some require dilution, some come as powders that need to be dissolved, some just need to be drawn into a syringe.
Chemotherapy bench in BotswanaThis was a particularly busy day!
Chemotherapy pharmacy in BotswanaIn future posts, I will describe how we give the chemotherapy to patients after it is prepared. Lastly, I should probably thank my undergraduate academic advisor for strongly encouraging me to get that chemistry minor. I never anticipated I would be putting it to use in this manner!

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About Dr. Jeremy Slone, Pediatric Oncologist

I am a member of the International Program at the Texas Children’s Cancer Center.

I'm primarly based at the Princess Marina Hospital in Gaborone, Botswana, where I provide clinical care to hematology and oncology patients and continue to research the disparities in outcomes seen in children residing in developing countries.

Posted in Cancer and Hematology, International Cancer and Hematology

4 Responses to Chemotherapy? In Africa!?

  1. Khushi Malhotra says:

    Enjoying reading your posts Jeremy, and I congratulate you on the great work you are doing!

  2. carol Slone says:

    Son, I enjoyed this very much. ! I am so proud of you and how God is helping you in your profession! Really enjoyed your info..on your work.. Love you so much…

  3. Sherri Anderson says:

    Really interesting Jeremy! Look forward to hearing more about your work there! Brooklynn and I pray for you, Amanda and Claudia each night when we say our prayers.
    Love ya cuz!
    Sherri

  4. Dr. Jeremy Slone, Pediatric Oncologist Dr. Jeremy Slone, Pediatric Oncologist says:

    Thank you all for your kind comments!

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