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Asian Children’s Care League (ACCL) ~ For the Smiles of Children with Cancer in Asia ~

© ACCL

Ms. Kazuyo Watanabe,
Founder and CEO of the Asian Children’s Care League (ACCL).

In recognizing that the 15th of February marks International Childhood Cancer Day, we are pleased to introduce the Asian Children’s Care League (ACCL) in this month’s edition of Close Up. ACCL is a certified non-profit organization (NPO) that works in Asia to support childhood cancer sufferers. With respect to cancer treatment, it should be noted that advances are occurring constantly. Accordingly, three out of every four childhood cancer patients in industrialized nations are now offered the chance of a full remission of their condition. In the developing nations of the world, however, the sad reality is that many patients are still unable to gain access to suitable medical treatment, the outcome being that precious young lives continue to be lost. On this occasion, we spoke at length with Ms. Kazuyo Watanabe, ACCL’s Founder and Chief Executive Officer. During the interview, we discussed the current situation confronting childhood cancer patients in central Vietnam. Moreover, we talked about how ACCL both supports the treatment of cancer, and the measures that it undertakes in both caring for afflicted children and their parents.

Q. Please tell me what led to the establishment of ACCL.

A. Due to my father’s job, I attended high school in the United States, and the experience cultivated an identity within me of being an “Asian person.” Moreover, it was such sentiment that represented the basis of my desire to become active in the region. Anyway, after graduating from university, I initially found employment with a foreign financial institution. However, in that I wanted greater interactions with others, and in that I felt a strong desire to act in a manner that would put me into contact with children, I made up my mind to resign. I then visited Hue in central Vietnam, where I began to get involved in volunteer activities that supported street children in the city. What is more, even after returning to Japan, I continued to work as a volunteer at orphanages and the pediatric wards of hospitals, etc. It was through such work that I encountered children who were battling cancer. Courtesy of those experiences, I realized that there were no groups who were supporting such children, and that factor made me think of establishing an organization that might be active in Asia. Thus, ACCL was established as an NPO in 2005. After it had been established, I then returned to central Vietnam and commenced support activities in conjunction with hospitals in the region, and this year represents the twelve for ACCL activities.

Q. Please give me an outline of those activities.

A. From establishment through until the present, ACCL has worked with the Children’s Center of the National Hue Central Hospital. What is more, we continue to offer support to childhood cancer patients both from the treatment and welfare perspectives. Compared to Hanoi in the north and Ho Chi Min in the south, the pace of economic development in central Vietnam is rather slow, and there are many impoverished households in the region. Additionally, concerning the treatment of childhood cancer cases in developing countries such as Vietnam, there exists a significant gap with the positive treatment outcomes that are now being routinely achieved in industrialized nations. When ACCL commenced its activities, among both doctors and nurses in Vietnam there was a general perception that “childhood cancer was not a condition that could be cured.” Moreover, in that not much attention was being paid to its treatment within hospitals, the starting point of our activities was raising the consciousness of stakeholders and making them aware that “childhood cancer represents a condition that can now be treated successfully.” By grasping local needs and continuing to communicate, over time ACCL became able to offer support that contributed to an improvement in treatment rates. We also became able to offer welfare support that has helped improve the environment that surrounds both patients and their families.

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The Childhood Cancer Families’ Association of Central Vietnam
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Q. Tell me in more detail about the support that you have offered on the medical front.

A. For medical support, concerning the mechanics of how cases of childhood cancer are treated, the treatment environments encountered in developing countries are often less than ideal. Thus, the greatest difficulties traditionally experienced were with respect to the selection of suitable anticancer agents and the regulation of prescription volumes. Such factors meant that in the past the lives of patients were put at risk. To counter such issues, through the receiving of expert instruction from doctors who have gained a wealth of experience both here in Japan and overseas, ACCL has been able to assist local Vietnamese physicians in the establishment of treatment plans that are in accordance with the environmental conditions they are confronted with. What is more, in addition to offering support in the form of the pharmaceuticals and equipment that are required to treat childhood cancer, we have been able to supply the National Hue Central Hospital with dedicated hospital food. To speak for a moment about the traditional situation in Vietnam, it is generally expected that the family of inpatients will prepare their meals for them. In addition to such arrangements placing a significant economic burden on the shoulders of patient families, there have been cases where the food prepared by parents for their sick children led to their demise due to the presence of infectious pathogens. To address this issue, through cooperation that was obtained with the nutrition unit of the National Hue Central Hospital, ACCL commenced a program whereby children with leukemia being treated as inpatients receive three safe meals each day. Furthermore, to raise the knowledge, skills and motivation of local doctors, ACCL has contributed by giving them opportunities to attend workshops and training sessions conducted by leading pediatric cancer specialists from around the world.

Q. And what about on the welfare front?

A. ACCL helped establish the Childhood Cancer Families’ Association of Central Vietnam, and we continue to offer support in its operation. Furthermore, to talk about an issue that does not solely impact central Vietnam, in developing countries more generally, there are a great many parents who perceive that a diagnosis of childhood cancer is equivalent to a death sentence. Traditionally, due to the perception that “cancer cannot be cured,” in the past many parents have refused further treatment for their children and instead have taken them home. However, through the establishment of the Childhood Cancer Families’ Association of Central Vietnam, ACCL has been able to contribute in numerous ways. We have helped in getting patients treated at hospital. We have also conveyed to patient families the importance of continuing treatment. Another important contribution we have made is our organizing of events at the National Hue Central Hospital so that the children being treated there and their families can offer support to one another. Furthermore, in that there are also many cases of families discontinuing treatment due to the economic burden that it places on their shoulders, etc., we have found out that economic support of such families represents an imperative. What is more, to lighten the burden of long periods of hospitalization even just a little, we organize birthday parties for patients and arrange so that they may enjoy the company of medical students from the Hue University of Medicine and Pharmacy who kindly act as volunteers.

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At meetings of the childhood cancer families’ association, educational programs are undertaken during which both children cancer patients and their families are taught by doctors and nurses.
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Q. Please tell me about the results that you have achieved thus far.

A. I mentioned earlier that advances in the treatment of childhood cancer have progressed to the point that three out of every four patients can now be cured. Saying that, however, such positive outcomes are only being achieved when suitable treatment is undertaken. If you consider that approximately 250,000 children each year worldwide will develop some form of cancer, the results that I just mentioned only apply to approximately 20%. For the remainder (roughly 200,000 children), the outlook is bleak. Their diagnosis and the commencement of treatment can be slow, or they might happen to live somewhere where the environment for treatment is insufficient. Also, for socio-economic reasons, etc., many will end up losing their lives. Speaking of our experiences, before ACCL commenced its activities in conjunction with the National Hue Central Hospital, the rate of positive treatment outcomes among childhood cancer patients was very low. For leukemia patients, survivability was under 10%. Through our efforts with the hospital, we have managed to get that figure up to between 60 and 70%. Furthermore, even for cases that upon admission were classified as high-risk due to age and white-cell count factors, current survivability is around 50%. What is more, we have achieved other successes. By establishing economic support frameworks and setting up the Childhood Cancer Families’ Association of Central Vietnam, we have managed to reduce the percentage of families who choose to discontinue treatment to between 0 and 4%. Moreover, due to the wider adoption of mobile phones in the country, it has become easier to keep track of patient families. Thus, we have been able to maintain a dropout rate of 0% during the follow-up phases of treatment.

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A birthday party conducted in a childhood cancer ward (L).Medical student volunteers (R).
© ACCL

Q. So what about the achieving of such results? Does it contribute to increasing the motivation of doctors?

A. Speaking of the treatment frontlines, I believe that it is important that we can instill within the local doctors the belief that they can successfully treat their childhood cancer patients themselves. Furthermore, through the cooperation that ACCL has initiated with doctors who work in the Pediatric Center of the National Hue Central Hospital, there is now more attention being paid towards the treatment of childhood cancer. Through “overseas stakeholders working together with local doctors,” there is the “the feeling that the local doctors also must act,” I feel that one major outcome of ACCL’s activities is that the entire National Hue Central Hospital has organized itself to cooperate with us. Furthermore, advances are being made in the nurturing of specialists in the field of childhood cancer, and through the conducting of workshops, etc., local doctors have an opportunity to get to know colleagues from other institutions. One result of this is that we have been able to establish a local network by which childhood cancer patients from regional hospitals in central Vietnam can be sent to the Pediatric Center of the National Hue Central Hospital.

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Outreach programs are also conducted to strengthen the ties between central and regional hospitals.
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Q. What issues do you face and how do you see your activities developing in the future?

A. Although we have improved the percentage of positive treatment outcomes, many young patients are still dying. Every time a child perishes, it is very hard to think about. We have grasped the needs that exist locally, and we have built up a solid track record of undertaking support at the grassroots level. However, there are limits to the number of lives that we can save. Looking to the future, as to what will become necessary, in addition to bottom-up activities that start with the grassroots of society, it shall also be required to consider top-down actions that strategically think about the treatment and care of childhood cancer patients throughout the whole of Vietnam. To achieve such plans, I would like for ACCL to be proactive both in terms of the approaches that we make to the Ministry of Health, and in terms of the efforts that we make in forming relationships with doctors who are working in the north and south of the country. Furthermore, I would like the Vietnamese to achieve a state of independence, even without ACCL support. I want all the information and networks that ACCL currently possesses to be handed over to the doctors and nurses who are working on the treatment frontlines, most prominently at the National Hue Central Hospital. Concerning the Childhood Cancer Families’ Association of Central Vietnam as well, we have seen one father who lost his daughter take on a leadership role in managing the organization. Of course, we will continue to back them up, however; we would ideally like to see locals take the initiative and run things for themselves.

Q. And the 15th of February marks International Childhood Cancer Day…

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A. In order to save the lives of as many children as possible, from a global perspective, I believe that in working together all of the different organizations involved in childhood cancer must initiate some form of action. In that respect, the 15th of February being recognized as International Childhood Cancer Day represents an important opportunity. Thus, numerous different events will be held worldwide. As is offered by the phrase, “Think globally, Act Locally,”institutions such as the United Nations, World Health Organization and other international organizations that have some involvement in the issue of childhood cancer continue to deepen their relationships with one another, and with respect to Vietnam, I would like to see our own ACCL networks further strengthened and our local activities further increased.