SCI Annual Progress Report 2014-15

SCI

SickKids-Caribbean Initiative Enhancing Capacity for Care in Paediatric Cancer and Blood Disorders

ANNUAL PROGRESS REPORT 2014 - 2015

Executive Summary Improving Outcomes Together Global efforts to improve child health have largely been directed towards reducing levels of infectious or communicable disease in children. While these efforts have laid the foundation for considerable progress, non-communicable diseases such as cancer and blood disorders are now emerging as a significant cause of global childhood mortality and morbidity. In high-resource settings, advancements in the diagnosis, treatment and management of these diseases have drastically improved clinical outcomes for paediatric patients. Still, countries with resource constraints, financial or otherwise, have not made parallel gains.

In the Caribbean, children with cancer and blood disorders are at a disadvantage because of a deficit in health and human resources – limited health workers with specialized training, limited technological resources, sparse data on treatment efficacy and disease epidemiology, as well as a lack of front-line health care providers. Poor clinical outcomes are also exacerbated by the fact that some of these countries face unique geopolitical challenges, as well as limited accessibility to specialized diagnostic services and chemotherapeutic agents.

The Division of Haematology/Oncology at The Hospital for Sick Children (SickKids) in Toronto, Canada is among the largest worldwide and, as Canada’s most research-intensive hospital, SickKids is well equipped to share clinical expertise, therapeutic gains and organizational skills with other centers.

Launched in 2013, the SickKids-Caribbean Initiative (SCI) aims to build sustainable, local capacity to diagnose, treat and manage pediatric cancers and blood disorders in the region.

Partnerships have been formalized with key stakeholders – the University of the West Indies (UWI), Ministries of Health, hospitals and institutions – in six Caribbean countries. Upon assessment of local needs and resources, six collaborative working groups were operationalized to target diagnostic services, clinical care, oncology data registration, nursing education and sickle cell disease.

Together, these working groups and their respective activities constitute a programmatic approach to the enhancement of infrastructure, training, strategy and advocacy.

SickKids Foundation is providing funding of $8,000,000 CDN through private donors and corporations. The estimated budget will be leveraged over the course of five years, to support program implementation for activities including telemedicine equipment enhancements, training and education, and the establishment of regularly occurring Case Consultation Review Rounds.

Over the past year, SCI achieved many significant milestones and we are confident that by working together we can SCI Progress Report 2014-2015 | page 2

achieve our collective goal: to enhance capacity for care and improve the outcomes and quality of life for children living with cancer and blood disorders in the Caribbean. It will be important to maintain this momentum in the coming years to achieve our end goal for the five-year initiative.

This progress report highlights annual achievements, while communicating goals for the project’s next year of collaborative activity, monitoring and evaluation.

Objectives The goal of SCI is to build capacity among paediatric primary care providers and allied health-care professionals through: • Improving the clinical management and treatment of paediatric cancer and blood disorders.

• Providing opportunities for training and education in the areas of nursing, pharmacy, diagnostic services, pathology and clinical care.

• Establishing best practices and improving health outcomes through the development of local hospital-based oncology databases.

• Establishing an integrated and sustainable communication structure for bidirectional education amongst local partners.

Partners and Stakeholders SickKids is working in partnership with the University of the West Indies (UWI), Ministries of Health and key hospitals from six participating Caribbean countries: Jamaica; Barbados; The Bahamas; Trinidad and Tobago; St. Vincent and the Grenadines; and St. Lucia.

Areas of Focus 1.

2.

3.

4.

5.

6.

Diagnostic Services Clinical Care Local Oncology Databases Nursing Sickle Cell Disease Research and Scholarly Activities

SCI Impact • Enable improved local access to services for children in the Caribbean with cancer and blood disorders.

• Build long-term and sustainable capacity for Caribbean partners; from diagnosis to follow-up care.

• Support SickKids’ vision of Healthier Children. A Better World™ through knowledge transfer and exchange with partners.

2014-2015 at a Glance

20

Specialized Diagnostic Tests Completed for Patients Newly Diagnosed with Leukemia

$8 Million

Fundraising Target Achieved

Newborn Screening Pilot Program Launched in St. Lucia

56

Canada

The Caribbean

Case Consultations Completed

90

Patients Registered in Local Oncology Databases All

7

6

Patient Care Education Rounds Held

Planned Telemedicine Facilities Completed SCI Progress Report 2014-2015 | page 3

The Bahamas Population: 377,374 Did you know? The Bahamas consists of 700 islands, of

which 30 are inhabited, which presents unique challenges for accessing healthcare services

Jamaica Population: 2.715 million Did you know? Bustamante Hospital for Children, which is located in the capital city of Kingston, is the only specialist children’s hospital in the English speaking Caribbean

SCI Progress Report 2014-2015 | page 4

SCI Partner Countries

St. Lucia Population: 182,273 Did you know? Saint Lucia is the only country in the

English-speaking Caribbean to deliver universal newborn screening for Sickle Cell Disease; their programme launched in April 1990

St. Vincent and the Grenadines

Barbados

Population: 109,373 Did you know? With a population of 109,373,

Did you know? Dr. Victor Blanchette, SCI McCaig Magee

Saint Vincent and the Grenadines is the smallest participating country, making the need for specialized services paramount

Population: 284,644 Family Medical Director, was born and raised here

Trinidad and Tobago Population: 1.341 million Did you know? Since launching in 2004, the University of

the West Indies (UWI) Telehealth Programme at Eric Williams Medical Sciences Complex has a formal relationship for clinical consultations with The Hospital for Sick Children

SCI Progress Report 2014-2015 | page 5

Country Highlights From country lead physicians at the Annual General Meeting (AGM) held in Toronto, Canada on April 13, 2015 We have seen a significant number of initiatives and accomplishments as a result of our participation in SCI. One such accomplishment was the introduction of a mechanism by which we direct all flow cytometry tests for new leukemia patients to SickKids for risk stratification. As well, a continued focus on nursing education will be an important contribution to realizing the impact of the project on paediatric patient care.

Dr. Corrine Sin Quee, University of the West Indies, School of Clinical Medicine & Research and Princess Margaret Hospital, The Bahamas SCI has encouraged a more streamlined and standardized system of care which has led to a significant improvement in the care of children with cancer and blood disorders. The project has helped to raise political and public awareness and there is now keen interest and attention by local government.

Telemedicine capacity, availability of flow cytometry testing and timely pathology results have been significant milestones to date. Physician training through participation in these activities has helped to improve expertise in this area and a continued focus on nursing education will contribute to project success.

Dr. Michelle Reece-Mills, University Hospital of the West Indies and Faculty of Medical Sciences, University of the West Indies, Mona Campus and Dr. Michelle-Ann Richards-Dawson, Bustamante Hospital for Children, Jamaica Clinical knowledge translation has been instrumental in increasing capacity for more focused, standardized management of children with cancer. The project has encouraged better coordination with the nurses and has also strengthened collaboration with colleagues across the Caribbean. The establishment of a telemedicine facility has given us access to expert consultation and the reduction in turnaround time for diagnostic tests has been a huge achievement, with tests that previously took up to 2 weeks now taking only 2 days, resulting in a significant patient impact.

Dr. Rosemary Boyle, Pediatrician, Milton Cato Memorial Hospital, St. Vincent and the Grenadines SCI Progress Report 2014-2015 | page 6

Obtaining buy-in from hospital administration and the University of the West Indies was a major achievement for the implementation of project activities in Barbados.

The telemedicine facility, which opened in 2013, has allowed us to participate in case consultation review rounds and have been very beneficial for accessing expert opinion for patient management. The recently launched diagnostic service has improved access to immunophenotyping testing at SickKids, leading to improved patient outcomes.

Dr. Cheryl Alexis, University of the West Indies, Cavehill Campus, Barbados Case consultations have enabled improved patient care, not only learning from SickKids specialists but also from challenging cases presented by Caribbean colleagues.

Leveraging the UWI Telehealth Programme, with SCI funded equipment upgrades, will drive local ownership and sustainability and maintain inter-Caribbean capacity well beyond the original telemedicine facility in Trinidad.

Next steps will need to focus on the evaluation of clinical care guidelines and on measurable patient outcomes.

Dr. Curt Bodkyn and Professor Zulaika Ali, Department of Clinical Medical Sciences, Faculty of Medical Sciences, UWI, St Augustine Campus, Trinidad and Tobago, Trinidad and

Tobago

We have already begun to reap the benefits of this initiative through a more structured approach to the management of our children with cancers and blood disorders and are expecting that these benefits will only increase with time. The installation of a full telemedicine conferencing system at our Public Hospital was one of the more significant financial investments in our health infrastructure for 2014 as it offers an affordable solution to an oft missed gap in clinical care in developing nations - ready access to subspecialty expert opinion. We have also been selected as a pilot site for the introduction of newborn screening for sickle cell disease using blood spot testing, which places us on a trajectory for a significant practice change in newborn screening promising more accurate and timely diagnosis of sickle cell disease the most prevalent genetic disorder in our population.

Dr. Lisa Charles, Consultant Emergency Medicine, Medical Director, Victoria Hospital and Dr. Jackie Bird, Consultant Paediatrician and Consultant Head of Community Paediatrics,

St. Lucia

Focus Areas DIAGNOSTIC SERVICES Early and accurate diagnosis is the foundation of all subsequent patient management, but can prove challenging in resource-constrained settings, due to challenges in access, availability and diagnostic capabilities. Using the immunophenotyping technique of diagnostic testing, in which blood, bone marrow or fluid sample is tested by flow cytometry, cells are marked with antibodies and analyzed for leukemia/lymphoma. Since cases of leukemia and lymphoma together make up 40% of all paediatric cancers, increasing access to immunophnoetyping will have the highest impact on children’s health outcomes, compared to other diagnostic services. By implementing this strategy, SCI will be able to enhance the collection of comprehensive and accurate registry data for patient cases.

2014/15 Progress • Two-pronged immunophenotyping services strategy launched in November 2014 • For The Bahamas, Barbados, Trinidad and Tobago, St. Lucia and St. Vincent and the Grenadines: Developed a Standard Operating Procedure for shipping samples to SickKids and returning reports to referring hospitals • For Jamaica: Supported University Hospital of the West Indies (UHWI) to provide immunophenotyping testing for all newly diagnostic paediatric leukemia patients presenting at Jamaican hospitals. As of March 2015, five tests have been completed. While Jamaica is the most advanced country in the region in terms of diagnostic services available, access to these services remains a challenge • In total, 20 tests have been completed

collective goals. Regularly scheduled telemedicine sessions and interactions provide a forum for clinical collaboration, knowledge exchange and real-time discourse on locallyappropriate treatment recommendations.

2014/15 Progress Telemedicine uses live interactive videoconferencing technology to facilitate consultations and connect health-care professionals from across the Caribbean and from SickKids.

New Telemedicine Facilities to-date: BTC Telemedicine Room Princess Margaret Hospital, The Bahamas

July 2013

Shaw Family Telemedicine Room November 2013 University of the West Indies, Cavehill, Barbados Sandals Foundation Telemedicine Room Victoria Hospital, St. Lucia

October 2014

Children of St. Vincent and the Grenadines Telemedicine Room, Milton Cato Memorial Hospital, St. Vincent and the Grenadines

October 2014

UWI Telehealth Programme (upgrade) Eric Williams Medical Sciences Complex, Trinidad and Tobago

November 2014

Wayne & Nigela Purboo and QuickPlay Media Telemedicine Room, Bustamante Hospital for Children, Jamaica

February 2015

Next Steps • Build capacity for immunophenotyping services at the National Public Health Laboratory to provide a second testing site in Jamaica • Establish Quality Assurance standards across SCI enhanced diagnostic testing sites • Develop strategy to ensure ongoing equitable access for immunophenotyping services for all SCI countries

CLINICAL CARE The SCI clinical care working group was established to ensure best practices across the region, in conjunction with other SCI working groups. In order to achieve this objective, SCI working groups utilize new and upgraded telemedicine facilities and technology to connect and interact to reach their

Sandals Foundation Telemedicine Room opening Victoria Hospital, St. Lucia October 2014

SCI Progress Report 2014-2015 | page 7

Best Practices in Clinical & Supportive Care Working towards SCI’s objective of improving the assessment, diagnosis and treatment of paediatric cancer and blood disorders, SCI specialist physicians are working together with Caribbean physicians to: (1) discuss treatment approaches in specific disease areas; (2) gain insight into the current practices to best understand what is working, resource constraints and opportunities for improvements; and (3) engage in interactive educational sessions. In April 2015, a workshop was held in Toronto at SickKids to discuss clinical guidance and approaches for the following areas:

Supportive Care Guidance Document Workshop The Hospital for Sick Children (SickKids), Toronto April 2015

1.

2.

3.

4.

5.

Brain Tumours Haematology Solid Tumour Leukemia/Lymphoma Supportive Care Guidelines in Transfusion Medicine, Febrile Neutropenia, Anti-Emetics, Tumour Lysis Syndrome, Hyperleukocytosis

Case Consultations and Review Rounds • Monthly Case Consultation Review Rounds were launched in September 2013 and focus on interprofessional education delivered through telemedicine technology.

• A total of 56 case consultations have been conducted between September 2013 and March 2015 • Cases have been submitted and presented on from all SCI countries as outlined in the table below:

Sickle Cell Unit, Tropical Medicine Research Institute, Kingston, Jamaica January 2015

Country Number of Cases The Bahamas 10 Barbados 8 St. Lucia 2 St. Vincent and the Grenadines 2 Trinidad and Tobago 16 Jamaica 18 Total Cases 56 The figure below depicts the types of cancers that have been presented at SCI rounds and highlights the most common consultation requests:

27%

32%

Leukemia/Lymphoma Solid Tumour Neuro-oncology

Dr. Victor Blanchette and Nursing Team, Princess Margaret Hospital, The Bahamas January 2015

SCI Progress Report 2014-2015 | page 8

20%

16%

5%

Non-malignant haematology Other

Patient Care Education Rounds Led by the SCI Nursing Working Group, periodic Patient Care Education Rounds are also held via telemedicine on topics relevant to holistic, patient and family centred care for paediatric cancers and blood disorders. Since June 2014, six sessions have taken place on topics including:

• Leverage oncology databases to capture utilization of best practices in patient management and standards of care

NURSING

• Pain Management in Children with Sickle Cell Disease • Childhood Leukemia: Care of the Family and Child (Parts 1&2) • Nutrition in Paediatric Cancer • Potential Interactions between Natural Health Products and Chemotherapy • Hydroxyurea in Sickle Cell Disease

Interprofessional healthcare teams have complementary roles in caring for children with cancer and blood disorders. Nurses have a critical role in these teams, often managing the delivery of patient care and in many cases leading implementation of best practices and protocols. By focusing on interprofessional collaboration and family-centered care, clinicians work together to advance paediatric nursing practice and build local nursing capacity through continuing education.

Next Steps

2014/15 Progress

• Implement supportive care and clinical care guidance documents to improve the clinical management and treatment of paediatric cancers across all SCI sites • Continue capacity building through education via monthly telemedicine Case Consultation Review Rounds • Support ongoing inter-professional Continuing Medical Education (CME)

• Nursing Strategy Retreat was held in February 2014 to engage nursing champions from across the region to identify education priorities • Strategic nursing session was held alongside attendance at the Caribbean Nursing Organization (CNO) conference in 2014 to develop an action plan • for the development and implementation of a specialized nursing education curriculum • Continued engagement of the members has been achieved through bi-monthly meetings with representation across all seven sites at the hospital, academic and government level • Draft curriculum for the SCI Paediatric Haematology/ Oncology Nursing Program at The University of the West Indies School of Nursing (UWISoN) in Trinidad and Tobago proposed

LOCAL ONCOLOGY DATABASES Based on an identified regional need to consistently and reliably monitor treatments and outcomes of paediatric oncology patients, SCI initiated a system to capture this important information at local Caribbean hospitals. The collection and validation of data on the demographics, disease characteristics and treatment outcomes can inform the design of future interventions. SCI established local hospital-based oncology databases for retroscpective and prospective data collection, allowing for the evaluation of implemented changes in therapy or supportive care. This treatment and outcome data from participating institutions will help to improve the clinical management of children in participating countries who are diagnosed with cancer.

2014/15 Progress • In November 2014 a patient information database was designed and implemented in each partner hospital • Local Data Managers have been hired at each partner hospital to input and validate patient information • 90 patient records have been entered Next Steps • Using the established local hospital-based oncology databases, continue data collection within each hospital, both retrospectively and prospectively • Review and analyze patient data trends from participating sites, such as disease prevalence, survival rate, and treatment outcomes

Next Steps • Launch SCI Paediatric Haematology/Oncology Nursing Program at UWISoN to include student nurses from across all participating countries • Establish alignment with Ministries of Health to support long-term sustainability of specialty nursing education • Continue capacity building through education via monthly telemedicine Patient Care Education Rounds

SICKLE CELL DISEASE Sickle Cell Disease (SCD) is a hereditary blood disorder resulting in a high-risk of severe illness and early death.

Affecting mainly people of African and Caribbean origin, SCD is the most common genetic disorder in much of the Caribbean.

Implementing best practice of screening all newborns for SCD in the Caribbean will allow for early life interventions resulting in decreased mortality and disability. To address existing limitations in diagnostic services in the region, SCI is working collectively to improve the capacity for diagnosis and clinical care of children with this blood disorder in the Caribbean SCI Progress Report 2014-2015 | page 9

through training and collaboration. SCI is working to build diagnostic competencies within designated laboratories and enable the effective, sustainable development of universal newborn screening programs to enhance capacity at comprehensive care centres at which positively diagnosed patients will receive appropriate treatment.

Piloting the Dried Blood Spot System in St. Lucia Universal Newborn Screening (NBS) has been achieved in St. Lucia, but the existing diagnostic method of cord blood sampling results in errors and inefficiencies. Testing dried blood spots by heel-prick is the preferred method, but is unavailable in most Caribbean countries, including St Lucia.

The laboratory at the Sickle Cell Unit, Tropical Medicine Research Institute (TMRI) has the capacity to measure more samples, by both methods, and by centralizing laboratory services in the Caribbean diagnostic capabilities, efficiencies and patient outcomes can be improved. By piloting this proof of concept with St. Lucia using the TMRI laboratory services, this project will continue analysis of samples using traditional methods while initiating the dried blood spot method during a six month study to allow comparisons of accuracy and timeliness of results. The collaboration will allow for more accurate and timely diagnosis of affected infants in St Lucia by facilitating early interventions and can be expanded to other countries within the region.

3-Phase Change in Practice from Wet to Dried Blood Spots 1. Send St Lucia samples out of country to Jamaica’s Sickle Cell Unit for diagnosis and reporting; 2. Proof of concept to run for one year with a period of using both methods in tandem: March 2015 to 2016; 3. Advocate for transition to universal dried blood spot tests

KNOWLEDGE EXCHANGE & SCHOLARLY ACTIVITIES Opportunities to share knowledge and engage in global scholarly activities allow SCI to better investigate, understand, and advocate about the needs of paediatric cancer and blood disorders within the region.

2014/15 Progress: Invited Lectures, Poster Presentations and Peer-Reviewed Publications: Conference/Journal

20th Biennial Immune Paediatric Association Thrombocytopenia. of Jamaica Conference An Approach to Anemia in Children.

Acute Leukemia: Presentation and Management.

Next Steps • Demonstrate proof of concept in using dried blood spot method to diagnose SCD as part of a national NBS Program in St. Lucia • Continue to build capacity for SCD screening and management in the Jamaican public health system including achieving universal screening • Determine country readiness for scale-up/expansion of NBS for Sickle Cell Disease in the region SCI Progress Report 2014-2015 | page 10

Author/Presenter(s) Date Kirby-Allen, M. Kirby-Allen, M.

April 17-19, 2014

Reece-Mills, M.

Caribbean Association Von Willebrand Blanchette, V of Oncology and Disease: How much do Hematology (CAOH) we know?

2015 Conference Challenges in Cancer Bodkyn, C. Care: The Caribbean Perspective.

April 24-25, 2014

Fertility in the Survivors Nathan, C. of Children Cancers.

59th Annual Caribbean SCI: Transforming the Public Health Agency Care of Children with (CARPHA) Health Cancer and Serious Research Conference Blood Disorders.

Allen, U., Adler, E.

May 2 2014

Caribbean Nursing Organization (CNO) Biennial Conference

SickKids-Caribbean Initiative: Enhancing Nursing Capacity for Children with Cancers and Blood Disorders.

Fleming-Carroll, B., Adler, E., de Young, S., Ingram-Martin, P.

Oct. 29 2014

SickKids-Caribbean Initiative: A Focus of Strengthening Nursing Capacity for Children with Cancer and Blood Disorders.

Adler, E., Fleming-Carroll, B., de Young, S., Hubley, P., Ingram-Martin, P.

2014/15 Progress • Supported St. Lucia in launching pilot project in three public hospitals • Enhanced testing capacity at the Sickle Cell Unit, Tropical Medicine Research Institute in Jamaica by hiring Newborn Screening (NBS) Manager to centralize regional screening services on locally procured equipment • Developed and implemented Standard Operating Procedure (SOP), which outlines the process for conducting heel pricks in St. Lucia and sending for testing in Jamaica

Title

21st Canadian Bridging the Distance Conference on Global in Small Island Health Developing States: Telemedicine as a Means to Build Capacity for Care in Paediatric Cancer and Blood Disorders.

International Consortium on Acute Leukemia (iCAL) Workshop

Adler, E., Bodkyn, C.

SickKids-Caribbean Initiative: A Focus of Strengthening Nursing Capacity for Children with Cancer and Blood Disorders.

Adler, E., Fleming-Carroll, B., de Young, S., Hubley, P., Ingram-Martin, P.

Targeting Pediatric and Adult APL in the Caribbean.

Abla, O.

Nov. 2-4, 2014

Dec. 4, 2014

Training and Knowledge Translation Visits: Meeting

Location

Date(s)

RedCAP Database Training Toronto, Canada (SickKids) Aug. 26 & 27, 2014 Toronto, Canada International Society of Paediatric Oncology (SIOP)

Oct. 22-25, 2014

Caribbean Nursing Organization (CNO) Conference

Rodney Bay, St. Lucia

Oct. 25-Nov. 1, 2014

Bleeding Disorders Training Week

Kingston, Jamaica (UWI)

Nov. 23-28, 2014

Transfusion Medicine and Radiation Therapy Site Visits

The Bahamas, Barbados, Jamaica and Trinidad

Jan. 3-10, 2015

Supportive and Clinical Care Guidance Document Review Meetings

Toronto, Canada (SickKids) April 9-12, 2015

2015 SCI Annual General Meeting (AGM)

Toronto, Canada (SickKids) April 13 & 14, 2015

Making a Lasting Impact The United Nations Development Programme (UNDP) defines capacity building as a means of equipping individuals, communities and organizations with the tools necessary to determine, achieve and maintain their own targets for development. SCI addresses local needs and priorities determined by regional stakeholders. SCI, with its strategic focus on building local capacity within and across the six countries, will continue to support the working groups as they build upon the achievements of the past year. While their respective focus areas may vary, the working groups share a common mission: leveraging clinical expertise and interprofessional collaboration to enhance local knowledge and medical infrastructure. This will ultimately strengthen and sustain local capabilities to effectively detect, treat and manage childhood cancer and blood disorders in the Caribbean.

Commitment to Monitoring and Evaluation To illustrate impact of project activities, SCI has imbedded a framework for monitoring, evaluation and knowledge translation. Key performance indicators will be collaboratively produced by all SCI stakeholders to define what constitutes program success in achieving the following outcomes:

Local Oncology Database Training, The Hospital for Sick Children (SickKids), Toronto August 2014 Next Steps: • Advise on research priorities and build research capacity among SCI members in order to address key issues of common interest • Produce and disseminate strategic advocacy messages to influence policy and decision making • Develop a Knowledge Translation Plan to synthesize and share research findings

“

1. Increased utilization of specialized knowledge and skills in patient management.

2. Increased use of data to improve clinical care and decision-making.

3. Increased availability and access to diagnostic services.

4. Increased knowledge translation and dissemination of evidence-based practice Identification of these indicators is part of the SCI’s action plan for sustainability. This action plan will help facilitate the effective transition between commencement and maintenance of the initiative. Early planning for sustainability is key to developing a strategy for long-term impact. A shared value proposition already exists among SCI partners and will become critically more important towards advocating for continued political support and funding.

As such, local champions in each country who are able to understand and communicate the project’s impact will be integral in moving forward to support a second phase.

This collaboration has already surpassed all of our expectations thanks to the support from our amazing donors and committed partners in the Caribbean and Canada. The way forward, focused on children with cancer and blood disorders and their families living in the Caribbean, is incredibly bright. Keep up the great work!

- Dr. Victor Blanchette, SCI McCaig Magee Family Medical Director, Co-Chair, SCI Canada

”

SCI Progress Report 2014-2015 | page 11

“ “ “ “

Although the SCI currently involves 6 Caribbean countries, the partners are acutely aware of the fact that there are other countries in the region that are in need of enhancement of services that relate to children with cancers and serious blood disorders. As the initiative moves forward, we will have the opportunity to evaluate the secondary benefits beyond the boundaries of the initial 6 countries, while actively exploring how best to directly engage other countries within the broader Commonwealth Caribbean and the West Indies.

– Dr. Upton Allen, Co-Chair, SCI Canada

All partners have benefited greatly from the venture. Friendships have been made and a network of collaboration has emerged and more than ever before as Caribbean leaders in the field we are talking to each other and supporting each other even in resource poor situations. The full financial impact of this project is yet to be realised and emphasis has been in the right place under the able guidance of SickKids with the strengthening of our regional foundation (through education and training) while remaining mindful of the importance of measuring our progress (through research). This ensures that the legacy of our efforts will outlive the life of the project and I am therefore very proud to be a part of this.

– Dr. Corinne Sin Quee, Co-Lead Physician Representative, SCI The Bahamas

As we forge forward in the third year of this ambitious project, it continues to exceed my expectations. It has the perfect balance of helping our developing region provide the best care for our children with cancer and blood disorders, while building capacity within the region to ensure that this standard of care is sustainable.

– Dr. Curt Bodkyn, Co-Lead Physician Representative, SCI Trinidad and Tobago

Nursing in the Caribbean has been benefiting greatly from the project. The SCI has brought Nurse leaders together and through information sharing with SickKids and among ourselves, we were able to evaluate our local practices and identify opportunities for improvement. We have planned for, and have implemented strategies/best practices that are relevant, current and standardized, and have started to reap benefits. Not only are we more empowered to give higher standards of care; we are planning to further build capacity with our flagship Paediatric Oncology/ Haemotology Nursing Course, which will commence soon. This will help us to ensure continuity and sustainability in our local environment, thus ensuring better outcomes and brighter futures for our children with cancers and blood disorders.

– Patricia Ingram-Martin, SCI Nursing Working Group Co-Lead, SCI Jamaica

THANK YOU SickKids Foundation thanks our generous donors who have contributed to SCI (in alphabetical order): David and Christine Anderson, The Bahamas Telecommunications Company Ltd. (BTC), CIBC FirstCaribbean, Myron and Berna Garron, Wes and Christine Hall, Holowesko Partners Ltd., Leslois Shaw Foundation, McCaig Magee Family, Mining4Life Charity Challenge, Wayne & Nigela Purboo and QuickPlay Media, Republic Bank Limited, Sandals Foundation, Scotiabank, and Derrick and Gay Smith.

CONTACT

SCI.comms@sickkids.ca 416-813-7654 ext 228916 Follow us on Twitter @SickKidsGlobal SickKids.ca/globalchildhealth

” ” ” ”