By Morgan Johnson
Launched in August 2016, The Aslan Project’s pediatric oncology program at Jimma University Medical Center (JUMC) in southwestern Ethiopia has progressed rapidly. From its opening through December 2017, the program treated 137 children with cancer, administered more than 1000 doses of chemotherapy, with zero accidents or administration errors, and provided education and training to more than 30 JUMC health professionals to equip them to diagnose, treat, and care for children with cancer. Education and training remains the cornerstone of Aslan’s work at JUMC; in 2017 alone, Aslan sent members of our all-volunteer global medical faculty from 13 institutions in six different countries to Jimma to evaluate patients, advise staff, and train doctors in our pediatric hematology/oncology (PHO) fellowship program.
Dr. Manoo Bhakta, Chief of Pediatric Oncology and Hematology at Children’s Hospital at Erlanger in Chattanooga, has twice served as a member of our faculty – in October 2016 and again in July 2017. The latter trip was a very special one, as Manoo was accompanied by his son, Dr. Nickhill Bhakta, an assistant faculty member at St. Jude Children’s Research Hospital, where both father and son completed their fellowships.
“I was amazed to see how much was achieved in just nine months,” said the senior Dr. Bhakta after his return to JUMC. “Ethiopia was the perfect place for Nickhill and I to bond as we practiced our profession treating children,” he continued. He further noted that an increased public awareness of the center’s pediatric oncology capability and the ensuing strain on its staff and resources presented new challenges and puzzles for the duo to solve. The combined efforts of the Drs. Bhakta introduced lasting improvements to the unit and opened up new avenues of support for JUMC’s patients, staff, and fellowship program.
With Aslan's Clinical Director Dr. Miguel Bonilla on leave at the time of their visit, the pair lent their considerable energy and expertise to address a wide variety of needs in the pediatric oncology unit. In the clinic, they supervised procedures performed by the fellows and worked with pathologists to diagnose patients with challenging cases. In one noteworthy example, a child with an initial pathology report of a sarcoma was re-diagnosed correctly with Burkitt’s Lymphoma, a dangerous and fast-growing cancer requiring immediate intervention. With an accurate diagnosis, the patient was able to start therapy right away. “We expected a rapid response and were rewarded to see this as well as parents with huge smiles next morning on patient rounds,” said Manoo.
In addition to individualized patient care, Manoo and Nickhill also helped plan and supervise holistic improvements within the unit itself. Since its opening, the unit has seen a significant increase in patient referrals and maintains an occupancy rate of 91%. With a consistently busy unit, infectious disease prevention is critically important to keep patients, families, and JUMC staff safe during treatment. Working with the JUMC Chief of Pediatrics, Dr. Melkamu Berhane, Nickhill identified immediate priorities and drafted a budget allocating grant money from the Bristol-Myers Squibb Foundation to enable implementation of critically needed infection prevention measures.
An indefatigable team, Manoo and Nickhill also shared their respective areas of expertise with the JUMC fellows. “Together, we had old school experience mixed with [the] enthusiasm and optimism of youth,” noted the senior Bhakta, who offered a variety of lectures on coagulation and thrombosis. With his strong interest in public health, Nickhill instructed the fellows in cutting-edge approaches to biostatistics and epidemiology and laid the groundwork for digital tumor boards between the fellows and Aslan’s Medical Advisory Board to provide case consultations online – a modality that has since provided an invaluable line of communication allowing our pediatric oncology team to obtain advice from our international specialists on unusual or difficult cases.
“We worked hard and did not realize how quickly time passed,” said Manoo of their experience in Jimma. “It was surprising to us both how much we were able to achieve in two weeks.” With their dedication, breadth of knowledge, and dynamic teamwork, their success came as no surprise to Aslan and our JUMC partners. We hope to welcome both Drs. Bhakta back to Jimma regularly in the years to come!