Meet paediatric oncologist, Dr Nihad Salifu
Dr Nihad Salifu was the first graduate from Ghana’s first paediatric oncology fellowship. She shares her story.
My Background
“There were not many doctors in the northern part of Ghana where I am from so most of what they did to cure the large volume of patients were seen as miracles. I enjoyed science at school but I suppose I mainly studied medicine out of curiosity to know about these ‘miracles’ of cure.
After medical school my focus was on becoming an obstetrician. However, I found I enjoyed paediatrics more than anything else. It was very uplifting to see a very ill child bounce back so quickly.
Working in paediatrics
I started my residency training in paediatrics at Korle-Bu Teaching Hospital (KBTH), Accra, in 2010.
My first rotation on the oncology ward was under the supervision of Dr Cathy Segbefia. We saw many children coming in with advanced disease, at a point when it was really difficult to treat. One afternoon, I asked Cathy why she went into a speciality where the mortality was really high. She replied ‘in the West, 80% of children with cancer are cured. This shows that with the right infrastructure, investment in treatment and the right human resources we can get there.’
After that conversation with her I reflected on HIV. In 1994, when I was still at senior high school, I met someone who was suffering with AIDS. She was shrunken and just incredibly sick and many more like her was the only picture of the disease. However, by the time I was working as a doctor, 12 years later, people lived with HIV and only a few progressed to AIDS.
In my lifetime I saw a disease that was uniformly fatal become a treatable illness where a person who is HIV positive could live a productive life.
Hope inspires people and Cathy gave me hope that afternoon. The following day I went to her and told that I wouldn’t mind becoming a paediatric oncologist.
Professor Lorna Awo Renner is the lead clinician in charge of the Paediatric Oncology service at KBTH and World Child Cancer’s programme lead in Ghana. With her support I went to SIOP South Africa in 2012 and gave a presentation. It was an opportunity to meet with some of the key figures in the world of paediatric oncology. I had never pictured myself interacting with people who were working at this level!
Further training
I have been blessed with incredible mentorship and leadership throughout my career. When I finished my paediatric training, I was posted to a district hospital to work for two years, when I was leaving Cathy reminded me that Prof Renner would not allow me to renege on my promise to do paediatric oncology, I laughed but she was not joking; Prof Renner made sure she never lost touch with me.
With her encouragement, I applied for a one-year fellowship in paediatric oncology in India sponsored by the Merck Foundation. Within four weeks I was on a plane. World Child Cancer gave me financial support during that training.
It was monsoon season when I arrived and it rained 24/7; something that was completely new for me. I also had to adapt quickly to new challenges, like the fact that 90% of patients only spoke Hindi.
However, exposure in the hospital was fantastic and we saw unimaginable numbers of cancer patients.
KBTH has the biggest paediatric oncology unit in Ghana – if we saw 20 patients at the day-care that was a lot for us. In India, the outpatient department was divided into two. Every day about 200 patients came in who had solid tumours and 300 blood cancer patients. It meant that in the year I was there I saw patients with rare conditions that you would not see in four or five years in Ghana. What’s more, the system coped well with these huge numbers – the referral pathways were streamlined and healthcare staff used technology to communicate effectively. This meant diagnosis and treatment started very quickly. Healthcare workers were highly specialised and the hospital was very well-resourced, resulting in comprehensive care for patients in that hospital.
This fellowship gave me a really strong foundation. I also had opportunities for further development, attending conferences and being given the chance to serve in leadership positions. For me, having World Child Cancer in the picture when I expressed an interest in paediatric oncology helped a lot. I would not have been able to do all these things without sponsorship.
When I came back to Ghana in 2017, Prof Renner was finalising the accreditation for the paediatric oncology fellowship. They considered all of the work that I had done in India and I was the first person they admitted onto the programme in January 2018.
Being back in Ghana meant adapting again. Whereas India had been a specialist cancer centre, back home we had to share resources with other specialties.
The second thing was that waiting times were much longer in Ghana. In India there had been an emphasis on multi-disciplinary meetings, meaning you are not just hearing from the paediatric oncologist, but many other specialties involved in the child’s care to ensure that they are cured on time with minimal side effects.
An improving situation in Ghana
Over time a lot has improved. With the help of the first lady of the country and a parents’ group we are providing accommodation. World Child Cancer is also supporting families with transport costs so they can get to the hospital for treatment. They have also funded a Child Life Specialist, as it is vital that we consider children’s mental health alongside their physical health.
Back in 2004 when I was still a medical student there were just six beds on the paediatric oncology ward and they were rarely all full but now the 24-bed capacity ward is always full with oncology patients scattered on other wards.
Increasing awareness of childhood cancer
We are now seeing many more patients now thanks to an increase in awareness. Every resident in training, regardless of their specialty of interest, has been equipped with the skill to recognise the warning signs of childhood cancer. World Child Cancer have also supported numerous awareness activities – in churches, communities, schools etc over the year. And awareness has really increased.
World Child Cancer has also helped with giving assurance to parents that support is available and that there should not be financial barriers to getting treatment. This too has meant a dramatic increase in the numbers of children completing their treatment.
We are blessed to see children recovering. It is always a joy to see them coming back and telling their stories.
There is still a long way to go and the real emphasis now needs to be on early diagnosis, as we are still seeing late presentation in too many cases. Now I have started a paediatric oncology unit in a regional hospital and when it gets difficult I ask myself, ‘what would Lorna and Cathy do?’
Naa’s Story
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Naa’s Story
We first met Naa in 2016 when she was diagnosed with Wilm’s Tumour at 7 years old. In 2021 the cancer returned and Naa underwent treatment again. She has battled cancer twice and is now back in school.
Read moreJoseph’s update
We first met Joseph in 2019 after he was diagnosed with Leukaemia. Find out more how he is doing after his successful treatment.
Read moreKayin’s story
Kayin was diagnosed with Burkitt’s Lymphoma. He is now working as a carpenter and is feeling happy and strong.
Read moreRebecca’s Update
Read more about our catch-up with Rebecca after undergoing cancer treatment through World Child Cancer in Ghana six years ago.
Read moreHassan’s story
14-year-old Hassan from the Machinga district of Malawi was diagnosed with Acute lymphoblastic leukaemia (ALL) last year.
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