In my first year of fellowship (training to become a paediatric oncologist), I saw a two year old girl with retinoblastoma. She had been denied access to care because of where she came from – Zimbabwe. If she had been diagnosed in America or England her chance of survival would have been 100%, and because she came from the wrong side of a border, she was going to die. I came home and wept. I wept and wept until my eyes were red, raw slits and my throat felt ragged. Somehow in the next few days we got her into the system and she’s now a survivor.
I’ve stopped with the weeping. Now I act. It’s not about me and how I feel when a child dies or relapses or defaults treatment. My feelings are not important to the parents of that child. They care if we save their child, if their child survives the relapse, if their child grows up and has a child of their own.
Some days are hard. There are days when I have to give the most heart-breaking news what feels like every hour on the hour all morning. Days when it seems hopeless, like this problem is bigger than our incredible teams. Days when children come from rural areas with tumours bugger than their heads, and there is no hope we can give them. Those kids could have survived if they’d been born somewhere with more resources, better education, increased awareness. On those days I come home and hug my kids and give them extra love because it feels like all I can do.
Other days we ring the bell. The end of treatment, officially in remission. Some days we give terrible prognoses and years later we are proved wrong and survivors come and hug us and their parents say, “I told you MY child would be a survivor”. Those are the days I LOVE being wrong.
This work is my passion, what drives me to get up in the morning. SIOP’s vision is “No child should die of cancer”. Well we have a long way to go, and even further in under-resourced settings. In some parts of the world, no child SURVIVES cancer. We have to change that. We have to facilitate equity, help the local healthcare workers to increase capacity and save the lives of more children with cancer. This global inequity is a crime and it’s built on centuries of exploitation and colonisation. There is only one right response to this situation for me, and that is to become part of the solution. I don’t whine and I don’t cry anymore. I act.