Khaled Ghanem, MD is the medical director of the BASMA Pediatric Oncology Unit in Damascus, Syria. We are so grateful to host him on the blog as he tells us more about childhood cancer in his country.
Over the past 14 years, BASMA (the
Arabic word of “a smile”) was the most active non-governmental
organization aiming at supporting children with cancer and their families in
Syria. BASMA was established in 2006 as an initiative by a group of
Syrian volunteers. Initially, the support was limited to providing medications
for patients and food for families. The project grew up significantly over
time, with multiple active programs nowadays, including financial and
psychosocial support programs for patients and families. At BASMA, we believe
that every Syrian child with cancer has the right to receive the best available
medical care without any cost.
In 2009,
BASMA established the first dedicated Pediatric Oncology Unit in Syria with a
maximum capacity of 20 inpatient beds. The unit provides free-of-charge
treatment for any Syrian children (<18 years) with cancer. Since 2009, more
than 1300 patients were enrolled in this program (See chart below for number of
new cases per year between 2011 and 2019). Despite critical challenges (mainly
financial and security related) during the most intensive period of Syrian War
between 2011 and 2018, the unit did not close its doors since 2009.
After
war came to an end in Damascus and Damascus suburb in June 2018, the first
expansion of the unit was planned to be able to serve a larger number of newly
diagnosed patients. Two months ago, the first expansion was completed and put
in service, increasing the number of inpatient beds to 40, in addition to a new
renovated outpatient department with a maximum capacity of 12 chemotherapy
chairs (see below a picture of the waiting area of the expanded unit).
The clinical outcome of patients
enrolled between 2009 and 2018 was difficult to measure due to a high percentage
(18%) of lost to follow up cases because of war. We are sure that at least 50%
of patients diagnosed between 2009 and 2018 survived the disease. Between June
2018 and May 2020, the short-term 2-year overall survival rate of the 363
enrolled patients exceeded 90% with a very low treatment-related mortality rate
of 2%. Multiple research and quality improvement projects are currently ongoing
in the unit, including data management and infection control programs. The unit has very good ties with
regional and international tertiary care pediatric oncology hospitals.
Despite all the challenges facing
Syria over the past decade and a half, BASMA
(www.basma-syria.org) represents one of the most shining projects in the
modern history of the country, where very organized efforts are directed toward
the humanitarian issue of childhood cancer.
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