Education and care coordinator

Minke Huibers

Minke Huibers is the education and care coordinator, responsible for hospitals in Nairobi and Moshi, including the Kenyatta National Hospital in Nairobi, Kenya, and the Kilimanjaro Christian Medical Centre in Moshi, Tanzania.

Dr. Minke Huibers: “Equal opportunities for all children with cancer”

“The twelve-year-old Malawian Ellina (not her real name) had leukemia and was very sick for six months, but she recovered and was radiant again,” says trainee oncologist Dr. Minke Huibers (40), who had formed a bond with the girl. Ellina was one of the first Malawian children with cancer who, thanks to Dr. Huibers’ efforts, was allowed to be treated in the Intensive Care Unit when she experienced respiratory distress due to pneumonia. The doctor was connecting the oxygen when she heard Ellina gasping and taking her last breath.

It is estimated that eighty percent of Kenyan and Tanzanian children with cancer do not receive the medical care they need, giving them a lower chance of surviving the disease. In the Netherlands, three out of four children with cancer are cured, while in Kenya, Tanzania, and Malawi, fewer than one in ten are cured.

Equal Opportunities

“I believe it is important to work towards a world with equal opportunities for all children with cancer,” says Dr. M.H.W. (Minke) Huibers. Huibers worked for the Outreach program of the Princess Maxima Center in Malawi and Tanzania and is now, in addition to her work as a trainee oncologist at the Princess Maxima Center, responsible for the collaboration with partner hospitals in Kenya and Tanzania. The goal is to improve oncological care for children with cancer. “We focus on training medical staff, timely recognition of cancer, free access to oncological care, and improving diagnostics and treatment,” says Minke Huibers.

Life-Saving Care

Dr. Huibers explains that three-quarters of Malawian children with cancer are severely malnourished, which must be considered in their treatment. She therefore recommends involving a dietitian in the treatment of these malnourished children with cancer and supporting their families. Huibers emphasizes that awareness among medical staff and following prescribed protocols is essential for the success of cancer treatment in children. “In addition, it is important to support our colleagues in developing scientifically based treatments for children with cancer in their country. Developing and applying care together at the children in our partner hospitals is life-saving.”

Pediatric oncologist

Annelies Mavinkurve

Pediatric oncologist Annelies Mavinkurve regularly works in Malawi

Malawian children with cancer are also often malnourished.

“We sometimes feel powerless in the care and treatment of Malawian children with cancer,” says pediatric oncologist Annelies Mavinkurve-Groothuis, who is responsible for the collaboration between the Princess Maxima Center and the Queen Elizabeth Central Hospital in Malawi. “I remember a boy with an arm as thick as an adult’s thigh. We took X-rays and saw that the entire arm was taken over by the tumor, and that there were also metastases in his lungs. Since there was no chance of recovery for the boy in this situation, he was not treated but sent home with pain relief. ’’

Exchange

Twice a year, the Outreach team, consisting of two pediatric oncologists, a nurse specialist, a pediatric oncology nurse, a medical pedagogical caregiver, and a child psychologist, travels from the Princess Maxima Center to Malawi to exchange knowledge and skills as part of the twinning program to provide better care for children with cancer. In addition, online knowledge exchange also takes place.

Brain Tumor

Pediatric oncologist Mavinkurve is pleased that she can share the good Dutch care with medical staff in Malawi through her work. She notes that Malawian children with cancer are not treated or are treated too late because there is still too little knowledge about the disease among local doctors. “For example, I have never met a Malawian child with a brain tumor, although they must be there.” Due to the lack of knowledge, many children with cancer do not end up in the hospital. Raising awareness among the population and training medical staff will help more children be diagnosed in time and receive better treatment. Expanding the treatment team will also increase the survival chances of children with cancer.

Satisfaction

Satisfaction “I would like to continue working in Malawi because I find it fulfilling to mean something to Malawian children with cancer,” says Annelies Mavinkurve. She mentions that many Malawian children with cancer are malnourished, which must be considered in their treatment, such as in the dosage of the medication. “It gives me satisfaction to share some of my knowledge with them. We hope to contribute to improving care with our team by sharing knowledge about both treatments and the support of children with cancer and their parents. By visiting Malawi twice a year with a few extra hands on the bed, we also show them: ‘You are not alone.’”

pediatric oncologist, director Academy & Outreach Princess Máxima Center, professor VU Medical Center

Gertjan Kaspers

Professor Gertjan Kaspers became pediatric oncologist in 2000, and has been Professor in Pediatric Oncology since 2006, at Amsterdam UMC. Since 2013 onwards, he is Director of the Academy & Outreach of Princess Máxima Center, the Dutch center of excellence for children with cancer. He supervises research on leukemias, DIPG, quality of life and late effects and on pediatric oncology in developing countries. He is promotor of 27 PhD students and trained 27 PhD student successfully. He is involved in several “outreach” projects, aiming at improved outcome for children with cancer in LMIC. He initiated and chairs an I-BFM-SG Task Force on Outreach and the Foundation World Child Cancer NL. Gertjan Kaspers is visiting Professor at UZ Gent (Belgium), MTRH in Eldoret (Kenya) and UGM in Yogyakarta (Indonesia).

Doctor

Judith Spijkerman

Much to gain for Indonesian cancer patients.

Wismu Has Fond Memories of the Care He Received.

“There is still much to be gained for Indonesian cancer patients,” says Dr. Judith Spijkerman (43). She is a fellow in pediatric oncology at the Princess Maxima Center and, as coordinator of outreach Indonesia, responsible for two Indonesian hospitals: Dr. Hasan Sadikin General Hospital in Bandung and Dr. Sardjito General Hospital in Yogyakarta.

“To ensure that children can survive, it is essential that childhood cancer is quickly and correctly diagnosed and adequately treated. Currently, it takes an average of 1.5 months for children to see a pediatric oncologist after their first visit to a doctor, and then another 2 months for a diagnosis to be made. In the Netherlands, this process takes an average of one to a few weeks. To improve this, it is important to share information about childhood cancer with the population and healthcare workers.”

A referral system is being developed for children with cancer so that doctors know how to safely and quickly refer patients to the right hospitals. This ‘national approach to childhood cancer’ plan is being developed in collaboration between Indonesian pediatric oncologists, the Indonesian Ministry of Health, St. Jude, and the Maxima.

Judith Spijkerman also notes that communication between doctors and patients is different than in the Netherlands: In Indonesia, the doctor provides information to the patient, but the patient rarely asks questions and is not an equal partner in care, which affects the outcome of the treatment. Hierarchy and limited knowledge of diseases by the patient and their family may play a role. Hierarchy also plays a role among healthcare providers: the oldest doctor, even if he no longer provides patient care, never retires and remains the authority. Younger doctors are afraid to ask questions of senior doctors, although this could improve the quality of care.

Judith Spijkerman is pictured with Wisnu (11), who is cured of leukemia. The doctors and nurses explained to Wisnu that he had cancer and how he would be treated. “I enjoyed swimming with Dr. Pudjo and have good memories of the care I received,” says Wisnu, who is happy to be cured of cancer.

Laura van Tinteren

Marrie Bruin