Background and context: Breast cancer is a common type of cancer among women worldwide, with about 2 million new cases diagnosed in the yearly. It is the second common cancer and leading cause of cancer mortality among women in Tanzania, after cervical cancer. More than 70% of breast cancer patients in developed countries are diagnosed at early stages, whereas in low and middle-income countries, only 20%–60% of patients are diagnosed early. Physician in developed countries consults on average 15-20 breast cancer patients daily, while in developing countries the number triples. This high load does not allow a treating physician to spend ample time with patients explaining hence leaving patients not informed about their diagnosis, side effects of treatments and even living with the physical, emotional and psychological challenges of their disease. Residents at the Ocean Road Cancer Institute (ORCI), initiated a patient support group targeting breast cancer patients for feasibility. Aim: Provide forum for patients with same diagnosis to share common challenges Provide peer emotional, psychosocial support and cancer education Organize activities that will help to spread awareness to the community Initiate projects to improve socioeconomic status of breast cancer survivors in Tanzania Strategy/Tactics: Involved the ORCI administration from the beginning Involved the academic and research unit of ORCI Residents prepared session curriculum and teaching materials Sessions took place once a month Sessions were two hours long divided into three components, where the first is introduction of participants, then survivors led discussions or lectures prepared by an expert in the topic and lastly closing remarks by a physician Breakfast was provided Program/Policy process: Open membership for all breast cancer patients Physician lead face to face peer discussions Institutional acknowledgment of the support group Provision of primary registry of patients for follow-up Provision of a link to other social organizations Outcomes: Increase knowledge of cancer in general and breast cancer in particular A total of seven sessions were held to date For each session, participation ranged from 30-50 breast cancer survivors, and on average attendance was 4 sessions out of 7 Topics covered over a period of seven months included Coping with a cancer diagnosis and treatment Living with cancer and its changes to daily life Exercise Nutrition Breast cancer general knowledge Collaboration with other stake holders including IST secondary school students who initiated breast prosthesis knitting club What was learned: A need to reach out and give psycho-social support to ORCI patients Through education we can improve treatment adherence Possible partners are available if we reach out Exist a need to address misconceptions in the community so as to avoid stigma to patients.
Background: Shortage and lack of trained cancer specialists is one of the major challenges in addressing the increasing cancer burden in low and middle income countries. Inadequate undergraduate cancer education in oncology remains a major obstacle for both task shifting to general practitioners and for training of specialists. We provide the first report of cancer education in Rwanda's undergraduate program to survey how fresh graduates are prepared to provide care for cancer patients. Aim: - Identify the current status of cancer education in one of Rwanda's two medical schools; - Provide a basis for educational reforms that target improvements of cancer knowledge and management. Methods: Anonymous online survey was sent January to June 2017 to medical students in their senior clinical years (year 5 and 6). Questions related to the demographics, medical curriculum and general oncology exposure were included in the survey. Results: Of 192 eligible students, 42% (n=80) completed the survey and were analyzed. The majority were 25 to 29 years of age and 41% were female. Internal medicine was cited to provide the most exposure to cancer patients (50%) and cancer bedside teaching (55%). Close to a half (46%) have been taught oncology formally in addition to bedside teaching. A tenth (11%) of the participants felt comfortable in attending a cancer patient, and a fifth (21%) of the students felt comfortable while addressing multimodality treatment approach. The majority (99%) of the participants preferred having a formal oncology rotation. Of particular interest, 61% of the students are interested in pursuing an oncology career path. Conclusion: There is a need to modify the current oncology undergraduate curriculum to prepare future physicians for delivering cancer care in Rwanda. Raising the profile of oncology in undergraduate medical education will complement the on-going efforts to increase the country's capacity in task shifting an in training of cancer specialists.
Abstract Background East Africa is one of the fastest growing regions in the world and faces a rising burden of cancer; however, few people are equipped to effectively conduct research in this area. Materials and Methods A 31-item questionnaire was distributed to current trainees and recent graduates of the Master in Medicine in Clinical Oncology Program at Muhimbili University of Health and Allied Sciences in Tanzania. Areas that were assessed included (a) demographic information, (b) prior research training, (c) prior and current research activities, (d) attitudes toward the importance of research, and (e) supports and barriers to inclusion of research in an oncology career path. Results A total of 30 individuals responded to the survey, of whom 53% (n = 16) were male and 70% (n = 21) identified as current trainees. Among the majority of respondents, attitudes toward research were strongly favorable. Although only 37% (n = 11) reported receiving any formal training in research methodology, 87% (n = 26) reported intentions to incorporate research into their careers. The absence of protected time for research and lack of access to research funding opportunities were identified by a majority of respondents as critical barriers. Conclusion A majority of current or recent oncology trainees in Tanzania desire to incorporate research into their careers, but most also lack adequate training in research methodology and longitudinal mentorship. Our future collaboration will focus on creation of appropriate research training curriculums and fostering an environment that catalyzes interprofessional development and transforms and extends context-specific cancer research in East Africa. Implications for Practice Current and recent oncology trainees in East Africa expressed a high enthusiasm for research, driven by a sense of urgency related to the burden from cancer that the region faces. This highlights the need for cancer research training and mentorship in this setting. This work hypothesizes that African principal investigators can operate effectively if proper attention is given to selection and provision of high-quality foundational didactic training to learn the theory and implementation of research as well as to the development of an environment conducive to mentoring.
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