I have had the chance, over the past month, to spend a couple of mornings rounding and chatting with Dr. Jeremy Slone, the Texas Children’s pediatric oncologist from Texas Children’s Cancer Center’s International Program based at Princess Marina. Batswana children, given a wealthier health care system, have much greater availability in terms of scans and access to chemotherapeutics than what I witnessed in Blantyre, Malawi. For procedures such as port placement (although many just rely on peripheral iv’s) and procedures deemed necessary and unaccessible in Botswana, Dr. Slone is able to petition the Ministry of Health for permission to cover the expense procedures and travel to neighboring Republic of South Africa.
The oncology ward is small, only 4 beds. While it is “separate” there is no door or true barrier separating these immunocompromised kids from any of the other 50 odd children in the ward. They do keep the infectious diarrhea patients at the other end! There is no clinic space so all sick visits or follow up visits are conducted on a wooden bench in the middle of the pediatric ward. Dr. Slone makes all his own chemo! What a rare, but very interesting opportunity to take part in daily chemo making. Despite Dr. Slone’s best efforts to hang warning signs, people leave their pens, notepads and whatever else in the chemo station like it’s no big deal!
While I would have loved to spend more time with Dr. Slone, my time was limited given my HIV clinic responsibilities. Here is the link to a blog post, “No Children Should Have to Suffer Like This” he posted about a few of the patients I was able to round on one day I spent with him earlier in the month. I love gaining any and all first hand exposure to pediatric oncology in limited resource settings. I look forward to comparing what I saw with Dr. Slone to the norm in Rwanda. I still struggle to see where my love for peds heme/onc fits in my greater interest in the field of global health. Hopefully fellowship will allow me to figure it out!