1. Pacific Island Child Cancer Regional Conference
AN UPDATE FROM SAMOA

2. OVERVIEW INTRODUCTION PAEDIATRIC STAFF SAMOA CANCER SOCIETY
CANCER PATIENTS – update

3. INTRODUCTION Samoa - is a Polynesian Pacific county northeast of Fiji.
- consists of 4 inhabited and 5 uninhabited islands
- capital is Apia and is located on Upolu (most populous island & developed)
- population is approximately 200,000.
independence (1st pacific island to achieve independence)
The chief hospital of Samoa is the Tupua Tamasese Meaole Hospital at Motootua
- provides primary, secondary and tertiary healthcare facilities in addition to offering a range of specialist medical services, surgery and outpatient clinic.
- bed capacity of 200

4. Who are in the paeds unit?

5. STAFF Acting HOU – Dr. Kirtimalini Anand
Snr registrar – Ulugia Dr. Tito Kamu
Snr registrar – Dr. Litara Esera
Snr registrar – Dr. Fiona Hunt (Fiji)
Jnr registrar – Dr. Kuinita Margraff
Jnr registrar – Dr. Maluapapa Siaosi

6. Nursing staff Clinical Nurse Consultant Nurse Manager
13 registered nurses (5 trained for oncology)
2 full time enrolled nurses + 1 part timer
1 auxiliary nurse

7. SAMOA CANCER SOCIETY
An independent, not-for-profit organization deeply committed to reducing the number of people impacted by cancer, as well as ensuring the best possible outcomes for those affected by it.
Established in 1998, and is governed by a voluntary board
Partners
Child cancer foundation NZ
Starship Children's Hospital
Cancer society of NZ
USO Bike Riders NZ
American Samoa Community Cancer Coalition

8. Cancer patients in Samoa

9. Patient name
Diagnosis
Protocol
DOB
Age
Completed treatment
Progress
Female
Wilm’s tumour
Left kidney
Stage III FH
Pl Wilm’s #1
29/10/05 11
May 2014
Likely cured from Wilms. Off treatment 3 years Surgery in Samoa- nephrectomy and splenectomy SSH- radiotherapy and commencement chemotherapy.
Completed chemotherapy in Samoa May Remains well.
Follow-up every 3 months review with Paediatric
Male
Right kidney
Stage II FH
PI Wilm’s #1
28/05/12 4
Jan 2014
Well. Off treatment 2 years
Burkitts Lymphoma
Malawi 2000
18/01/05
April 2012
Cured of Burkitts for 4 years
Histiocytosis
Family disorder
LCH 4
06/10/11 5
Ongoing
Responding well to treatment. 9 cycles left to complete.
Follow-up every three weeks in Paediatric ward. Next chemotherapy due December 12
ALL
PI – ALL 1
07/11/11
Under investigation
Currently in New Zealand
? ALL
19/08/08 8
Currently in America (US national)

10. UPDATE Currently we are only seeing approximately 5 cases/year
There is a lack of national awareness on childhood cancers
Traditional and cultural mind-set that cancer is an ‘adult only disease’
Late presentation to the hospital due to ancient beliefs. Traditional healers over modern medicine.
2016: 1. Ekeroma Sauloa Tulaimalo (Histiocytosis – non Langerhans cell)
2. Jayden Roebeck (currently in NZ)
3. Zarahya Moors (currently in USA)

11. Update We currently do not have anyone on palliative care
Following chemotherapy criteria, only two cases from period were referred to NZ for treatment.
In the past, two paediatric doctors & five nursing staff were trained to administer chemotherapy drugs
Ongoing partnership with the Samoa cancer society. They provide support for the families of those affected as well as financial assistance for patients coming in for chemotherapy.
“Project Paeds” founded by Dr. Salote Vaai. Project also assists in meeting financial needs of low income families, who are struggling to come into the main hospital for treatment.

12. Update Complicated cases are referred overseas for investigation
We can manage febrile neutropenia (Ceftazidime, Gentamicin, Ceftriaxone, Vancomycin)
Our ICU team are equipped to assist with central lines (for chemotherapy patients)
Limitations:
Availability/cost of drugs
Staff shortage
Lab – all tests sent to NZ (takes 2-3weeks for the results)
Family situations (e.g. financial, cultural/traditional beliefs, isolation)
Awareness – we need more especially for our children age group

13. Update
July 2016 Dr. Jane Skeen and Oncology team visited Samoa to review children who were undergoing chemotherapy
Samoa is very fortunate that we have a good relationship with the Starship team in assisting us in diagnosing our cases and ongoing consultation on difficult patients.
Samoa currently has a overseas treatment scheme that allows patients to go over to NZ for investigations as well as treatment.

14. FA’AFETAI 