Adapting despite current challenges
DR TRISH SCANLAN SPEAKS WITH MARY FOGARTY REGARDING ‘ THEIR LIVES MATTER’, A CHARITY FOUNDATION BASED IN TANZANIA WHICH IS STRIVING AS A RESULT OF THE CURRENT COVID-19 CRISIS
DR Trish Scanlan, a native of Windgates, an oncologist and founder of a Tanzanian children’s cancer treatment programme, said that the programme in Tanzania is suffering great pressure as a result of Covid-19.
The ‘ Their Lives Matter’ charity is the foundation which funds the National Children’s Cancer Service from Muhimbili National Hospital.
‘We were all set up for a great year,’ said Trish, speaking last week from her parent’s home in Windgates. She will be in Ireland for a number of weeks to do some work on the funding end of the programme.
‘It’s been a bit of a struggle. We were lucky in that we were a month or six weeks behind Europe and Ireland. I had watched it unfold in Italy and hit Ireland. I said I’ll do exactly what’s being advised there, even though it’s early, to try to protect our little space, our little world.’
She said that the staff and the parents were the main concern, as it was thought that children wouldn’t be as affected as adults. But at the same time, so little was known. ‘We were worried about everyone,’ said Trish. She said that ICU resources in Tanzania would be quickly overwhelmed.
Prior to the outbreak, things were very positive for the service. ‘We were planning two additional sites, bringing the total in the country to 11,’ she said.
Those plans were reigned in, with the priority being keeping everyone alive and keeping the service going.
‘ The amount of money we were spending doubled overnight,’ said Trish. ‘ There was price gouging for routine stuff. Things which were 30c became €5. Things like chemotherapy medication, masks and PPE, the prices were just ridiculous.’
They had to divide wards, re-allocate toilet facilities, and provide more toilets and sinks. ‘ We got staff off public transport and gave everyone masks and gowns,’ said Trish.
‘I realised that when a politician suggests something, it’s not always in the best health interests, they may weigh up economics.’
She said that the recommendation was not to put masks on parents or patients unless they were symptomatic.
There was a breakout on the ward with 18 people positive. ‘ That was quite stressful,’ said Trish. ‘ There were strict guidelines on who could get tested and no contact tracing. You knew there were people who could be positive even though they were a-symptomatic.’ The strategy she employed was to assume everyone was positive.
More than half of the people who tested positive were parents. None of the staff has gotten sick to date, a fact Trish puts down to hand hygiene and PPE.
The patients in question range in age from newborns up to the age of 18 or 19.
‘ The staff are amazing,’ she said. ‘ They really stepped up. I would ask someone if they were frightened, they would say yes, they were, but they wouldn’t be sitting back at the nurses’ station. I’m so proud of everyone.’
Each staff member was given hand sanitiser, masks, and a bag for their own PPE. They would be sterilised each day and returned to that particular staff member rather than allocated to someone else.
‘People around the city made us cloth masks and gowns so the ward was very colourful!’ The cloth gowns were bleached, washed and ironed at the end of each day, to help avoid overwhelming costs.
Despite all challenges, the services have been maintained. All sites are open and doing as much as possible.
Fewer children have been coming in due to fear of travel. People could come in, but were afraid, so now as fear decreases they have gone from their usual capacity of two or three patients a day to 10 a day.
‘ We’re still in very strange times, I don’t know that it’s finished,’ said Trish. ‘ We’re going to maintain precautions. We have two different teams who don’t see each other and we’ll maintain all of our precautions until the end of the year.’
Last year, the programme looked after 720 new patients over the year. Each year it’s 50 or so more, increasing over the last 10 or 12 years.
‘We think there are around 4,000 children each year who need treatment. We really have to get to other parts of the country and reach more children.’
She said that families require a referral letter and have to go through the system of primary care, local hospital and then to the programme.
‘ That can be removed if we can get to them,’ said Trish. ‘Many don’t know how to contact us but we have a network of allies across the country.
‘If we hear about a child in a village hospital we will treat them.’ So local hospitals can contact them and get the appropriate treatment arranged.
‘I call to every site in the country currently treating children,’ said Trish. ‘We give them the chemo, we provide all the chemotherapy for children in the country.
‘Any child that wants it can receive it once they are in our network. But definitely three quarters of children are still not getting the treatment they need.’
‘In 2005, we had about 120 kids with an over 90 per cent mortality rate, to 720 last year and approaching 60 per cent survival.’
With the funding pressures being what they are in the current crisis, Trish said that people have been incredibly generous. Regular donors have helped and some appeals have helped.
‘Having watched a little bit from afar what’s going on here, all the different media, TV, radio and print, have sort of set aside a bit of space to help charities,’ she said.
Their Lives Matter usually has a ball in Galway and another in Killruddery in October. The Galway one is definitely cancelled with Kilruddery in doubt. They have done some fundraising online, through media, and approaching donors.
‘One supplier who is decent has been helping and managed to get better prices,’ said Trish. Other expenses incurred, aside from higher prices include more cleaners, more doctors and more nurses.
They are feeding everyone every day to ensure they are healthy and well and nobody is hungry.
The children have been very flexible and adaptable, even in the face of their minders’ faces being covered by masks.
Some of the children have
THE IRISH PEOPLE ARE AMAZING, EVEN IN THE FACE OF THEIR OWN DIFFICULTIES AND TRAGEDIES AND UNCERTAINTY
obvious deformities, such as masses on the face, a lost eye or an amputation. They just accept each other, so the masks aren’t much of an issue,’ she said. ‘ The hardest thing is restricting their running around,’ said Trish.
There were previously large playrooms where all the children could mix. Now there are small groups of maybe six children who can play together.
Adjusting to the idea of Covid-19 was a process for Trish. ‘We all heard the news in China. I admit I thought what’s the big fuss at first. Then someone cleverer than I said - do that maths on the stats. If everyone gets it, what does that mean? The penny dropped that this was something to be really frightened of.’
While HIV and TB exist in larger numbers in Tanzania, they are not as infectious. ‘Neither would sweep the country the way this could. The fear was palpable at the beginning.
‘Because we started using the masks and hand sanitiser very early, we had time to get used to how to put on the mask, how to wash our hands properly and so on.
‘By the time the virus hit, everyone was doing it right. Not a single staff member got sick.’
She said that people here are probably looking after much more symptomatic patients.
She is convinced that the wearing of masks should be compulsory. ‘As we open up, yes there’s less virus around but people are less strict with themselves. We are more at risk coming out of lock-down as people become more complacent.’
As the system was running smoothly in Tanzania, Trish made her way to Ireland, where she is starting work at 8 in the morning and finishing at 8 at night. She is concentrating on fundraising and awareness for the coming weeks.
She was able to self-isolate in a friend’s chalet for a fortnight, before moving in to her family home, where she is delighted to be able to see her parents.
She said that all the work being done in Tanzania is in a large part down to the generosity of the Irish people. Around two thirds of the Their Lives Matter funding comes from Ireland.
‘We wouldn’t be able to survive without it, they are keeping the National Children’s Cancer Service alive. The Irish people are amazing, even in the face of their own difficulties and tragedies and uncertainty.’
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