Hope beyond U.S. borders


Hope beyond U.S. borders

St. Jude improves survival rates worldwide with help from international health care advocates.


Health care providers in developing countries emulate the work of employees at St. Jude Children’s Research Hospital. Fewer than 30 percent of children treated in developing countries have access to modern treatment. Just as St. Jude needs advocates on Capitol Hill to advance pediatric oncology care in the United States, the hospital needs the same from supporters beyond U.S. borders. To accomplish this, St. Jude collaborates with 16 partner sites in Europe, Africa, Asia and Central and South America through the International Outreach Program (IOP). The goal in this effort is to improve survival rates worldwide through the sharing of knowledge, technology and organizational skills.


Cultural connections

In these resource-poor areas where St. Jude has a presence, cancer ranks low on the list of common childhood diseases. Diarrhea, malaria, malnutrition and infectious diseases prevail as leading causes of death in children.

“Childhood cancer is only 1 percent of all cancers in the world. For a country to undertake a cancer program and sustain it, there has to be a certain level of public health infrastructure in place and a sense of urgency from the Ministry of Health to declare cancer as a public health problem,” says George Velez, IOP administrative director.

Treating the small percentage of these children with cancer presents a challenge for public hospitals in resource-poor countries. But for St. Jude, it’s another opportunity to affect children’s health worldwide. The process to establish a partner site begins with an invitation from ministers of health or from prominent leaders of non-governmental organizations (NGOs), also known as foundations. Ministers of health are senior government officials who manage the health care delivery system in their countries. The foundations consist of a volunteer staff whose drive to establish a partner site parallels the dire need to provide better health care for children in their country.

The IOP faculty and staff are assigned to regions around the world and work with these health care advocates to establish treatment centers in public hospitals; train the medical staff; and open St. Jude protocols, screening and prevention programs. Back at headquarters in Memphis, the IOP staff mirrors the diversity of the partner sites. Employees hail from Mexico, the Dominican Republic, Jordan, India, Canada, the Philippines, Columbia, Brazil, Puerto Rico, China, India, Iran, Paraguay, Peru, Russia and Chile.


Success in Santiago

One example of governmental intervention occurred prior to the establishment of the Santiago, Chile, partner site. After declaring cancer a public health priority, government leaders invited Chilean native Gaston Rivera, MD, a St. Jude physician for more than 30 years, to assess its cancer program at Luis Calvo Mackenna Hospital in Santiago. Rivera found the public hospital to be a fully functional facility capable of offering treatment to children with cancer.

“There was a national pediatric oncology group that treated patients on protocols—many of them based on St. Jude protocols. They had well-trained physicians and nurses, and something we haven’t seen in any other place—the Chilean government funding for 100 percent of treatment for children with cancer,” says Rivera, medical director of the Chilean partner site.

With the ingredients for a successful program already in place, Rivera met with Chilean president Michelle Bachelet, MD, the minister of health and the medical director at Luis Calvo Mackenna Hospital to determine how St. Jude could help. Bachelet, like many international health care professionals, was familiar with the peerless reputation of St. Jude and welcomed the medical and technical expertise needed to boost leukemia survival rates among children in her region.

After two years of planning, Rivera and his team established a bone marrow transplantation program, arranged clinical training for medical staff and successfully advocated for treatment at no cost to parents.

Today, 175 transplants have been performed at the facility, which is a national transplant center and a national School of Excellence for pediatric oncology nurses. The overall three-year, event-free survival estimate is 72 percent, with an 81 percent rate for the cohort treated with matched-related transplants. These results are comparable to those of international transplant centers in the United States and Europe. Rivera says this chain of events would not have been possible without the support from the Chilean government and St. Jude.


Sharing Danny’s dream

In other poor countries with limited governmental support, children can continue to benefit from St. Jude programs, thanks to the goodwill of fundraising foundations. The IOP, with help from ALSAC, equips these volunteer organizations with strategies to generate revenue for costly medications and to sustain programs that model St. Jude clinical and family-centered services.

This far-reaching support sends a clear message to parents and to health care workers abroad: First-class treatment is available and cancer is a curable disease.

“St. Jude cannot do it all,” Velez says. “So we share what we do at St. Jude with institutions in these countries. It’s one way we use our expertise and resources to share Danny Thomas’ dream around the world.”

Reprinted from Corridors Spring 2009

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