Sharing global pediatric oncology lessons in Armenia



It’s always fascinating to visit a new country as a team and learn about how the culture, politics, economics and healthcare systems all impact pediatric oncology care.

I recently returned from a week-long trip to Yerevan, Armenia, where my colleagues and I conducted a preliminary needs assessment and explored ways to improve childhood cancer care in the country. The Dana-Farber/Boston Children’s Cancer and Blood Disorders  Center Global Health Initiative (GHI) team, including Leslie Lehmann, MD, GHI Medical/Faculty Director, Kathleen Houlahan, MSN, MHA, RN, Jorge Fernandez, LICSW, and Brian Delaney, PsyD, met with faculty and staff at the Clinic of Chemotherapy at Muratsan Hospital Complex of Yerevan State Medical University, government officials and nonprofit organizations.

Knowledge-sharing among our international partners is an essential part of our institution’s global health efforts.

Knowledge-sharing among our international partners is an essential part of our institution’s global health efforts. Collaborating with health care professionals from a wide variety of specialties and perspectives is a core part of GHI’s mission.

Before this most recent trip, our team met with two graduate students from Harvard T. H. Chan School of Public Health who had completed a practicum on oncology in Armenia. As part of their coursework, Akhila Annamreddi, MBBS, MPH and John Scott, JD, MPH spent three weeks in Armenia this winter interviewing more than 40 stakeholders from the Minister of Health to industry representatives, and developed a comprehensive report on the challenges, gaps and strengths of the oncology care in Armenia.  Their findings and insights helped educate us about the pediatric oncology situation in Armenia prior to our trip.

Mentoring and working closely with graduate students gives us the chance to familiarize future public health leaders with real-world issues and empower them to become problem-solvers. For their part, Annamreddi and Scott were excited to learn about Armenia’s rich history, explore the role of diaspora and philanthropy in the development of the country, and perform a SWOT analysis (SWOT stands for “strengths, weaknesses, opportunities, threats”) that summarizes the Armenian oncology care situation.

Irini and colleagues in Armenia
Irini, (second from right) and colleagues at the American University of Armenia

The role of psychology in cancer care

Delaney and Fernandez worked closely with the two psychologists at Muratsan to advance their existing psychosocial partnership with the GHI. The two groups regularly collaborate on case discussions and the development of supportive psychosocial programs for patients and families. Delaney and Fernandez were impressed with the medical team’s receptivity to psychosocial services. They discussed interventions designed to promote adherence and improve coping for children and families being treated at the hospital.  Since the stigma of meeting with mental health providers is significant in Armenia, much of the material that Delaney and Fernandez discussed was designed to promote existing strengths and facilitate coping in easily acceptable, non-anthologizing approaches that children and families often readily see as helpful.

Promoting team-oriented care

This year, as part of our GLOBE Scholars program and education activities, we invited one physician and one nurse from Muratsan to apply to our GLOBE Scholars Fall 2016 rotation. If accepted, it will be the first time that we are not only accepting nurse Scholars, but hosting a physician-nurse pair for a team-based learning experience.

The move is a reflection of our multidisciplinary approach to care delivery.  We hope this model will help the scholars share the skills they acquire during the program and implement change back home as a team.

Over the past five years, GHI has hosted more than 40 GLOBE Scholars. Lessons from the patient- and family-centered care at Dana-Farber/Boston Children’s help our alumni enact organizational culture and patient safety improvements back home. Most importantly, when they advocate for these changes as a team, they are more likely to have an impact at their countries and, ultimately, improve survival rates for children with cancer and blood disorders.

The GHI team also lectured at the Global Health Symposium at the American University of Armenia School of Public Health and the “Conquer Cancer in Armenia with a Smile” International Oncology Conference as well as provided Master Classes for oncology, nursing and psychosocial providers.

“It was wonderful to visit Armenia and participate in brainstorming sessions with local stakeholders,” said Medical/Faculty Director Leslie Lehmann, MD.  “We were able to better appreciate the existing gaps and how care could be improved, including the possible development of a new pediatric oncology facility, through a collaborative effort.”

Irini_Albanti_2016 4Irini Albanti, MPH, MA is the Director at the Global Health Initiative at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. She is originally from Greece and currently finishing her doctorate degree dissertation at Boston University School of Public Health. She has more than 12 years of experience in hospital management and global health, and has been leading projects in Central and South America, the Middle-East, Africa, the Caucasus Region, South-East Asia, and post-conflict countries such as Libya, South Sudan and Iraq. She is also mentoring MPH students on global health research projects and is interested in hospital capacity-building in low-resource countries.

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