At the risk of stating the obvious, Africa is a large continent with several regional differences in terms of climate, socio-economic circumstances and access to health care. Several countries have state-funded cancer treatment centres, with a few countries offering private health care facilities for oncology treatments. Oncology care in Africa is developing gradually, with the focus necessarily being on aspects of prevention, screening and early detection of disease as access to treatment is a challenge in most African countries. Psycho-oncology is still an under-resourced aspect of cancer care across the continent.
In the early 1990s a small group known as PAPOS (Pan-African Psycho-Oncology Society) was formed and held its inaugural conference in Cape Town in 1992. Several PAPOS conferences followed into the early 2000’s, embracing practitioners from different disciplines across Africa and including input from professionals from further afield such as the United Kingdom, Australia and the United States. Sadly PAPOS was unable to maintain its momentum and no longer exists.
Since then, the palliative care and Hospice movement have offered much training and guidance across Africa in terms of end of life care, with a particular focus on psycho-social needs of patients and families. Discipline-specific groups such as National Oncology Nursing Society of South Africa (NONSA) and South African Oncology Social Work Forum (SAOSWF) were formed at the beginning of this century. In Nigeria the Association for Psycho-Oncology in Africa (POSON) is active, as is evident in the pieces below. 1993 saw the formation of AORTIC (African Organisation for Research and Training in Cancer) and this organisation has grown in terms of scientific input, but has latterly offered specialised input from psycho-oncology experts such as Dr Jimmie Holland, Dr David Kissane, Dr Maggie Watson, Dr Andrea Patenaude and others from IPOS who have generously shared their time and knowledge.
The possibility of a new psycho-oncology organisation for the whole continent was explored during an AORTIC conference in 2013 resulting in further discussions at the 2015 conference with the formal inauguration of the Association for Psycho-Oncology in Africa taking place this year (see (2) below). With closer connections between the scattered individuals practising psycho-oncology in different countries, there is once more a possibility of sharing resources and skills, and of reaching communities that are remote. Working in environments where logistics can be challenging and access to information difficult, it makes a huge amount of sense for practitioners to work together to increase the awareness of psycho-social needs of our patients and their families, and improve the care that we can provide!
News from IPOS in Africa kindly contributed by Dr. Jimmie Holland:
1) African Organisation for Research and Training In Cancer (AORTIC) Conference Marrakech, Morocco, November 19, 2015
The 4th Biennial International AORTIC IPOS-WHO Academy on Psychosocial and Behavioral Aspects of Cancer Care in Africa was held on the topic of Special Issues for Children, Adolescents and Young Adults. This is part of the continuing IPOS efforts to improve education and clinical care in Low-Middle Income countries. The convenors were Chioma Asuzu, PhD, psychologist, University of Ibadan; Jimmie Holland, MD, Memorial, New York and Maggie Watson, PhD, Royal Marsden, UK. Andrea Patenaude was Chair of the Program Committee. Ten African professionals were awarded competitive travel scholarships. (See photo)
Attendees and Faculty Members of the 4th Biennial International AORTIC IPOS-WHO Academy on Psychosocial and Behavioral Aspects of Cancer Care in Africa
2) Formation of the Association for Psycho-Oncology in Africa (APOA)
At the Marrakesh meeting, a Task Force of approximately 15 people met and agreed on the formation of APOA to encourage and network professionals across the 52 countries in Africa in education and clinical issues in the psychosocial care of patients with cancer. This builds on the Nigerian Psycho-oncology Society which is already a member of the IPOS Federation, and efforts to form a Kenya Society. The inaugural meeting of APOA will be in late July, 2016. Dr. Asuzu was asked to serve as President until such a time that an election can be held. The meeting will be held in Calabar Convention Center in Nigeria. APOA will encourage work in Nairobi, Kenya with nurses doing palliative care through Philip Odiyo, and training opportunities for professionals from francophone countries, through Sokhna Ndiaye who works in Dakar, Senegal with children with cancer.
3) Winner of American Association for Cancer Research scholarship - Chioma Asuzu, PhD.
Chioma Asuzu is the seminal figure who has moved psychosocial oncology forward in Africa. Beginning as a member of AORTIC and supporter of psychosocial issues there, she applied and was awarded one of the first grants given by the National Cancer Institute to African investigators through AORTIC. Her study is an important one in providing information on a major reason for delay in diagnosis in Africa: treatment first by traditional healers. She interviewed patients who came to the University Hospital in Ibadan about their experience and then spoke with their traditional healers who were interviewed. Overall, they expressed a wish to know more about the early symptoms of cancer and wanted to cooperate with cancer care in their community, referring those with early disease. She is submitting to the AORTIC second round of grants to pilot an educational program for traditional healers in the region around Ibadan. She is also proposed as the Chair of the Psychosocial Research Core of a grant to NCI for a Center of Excellence in Cancer Research in Ibadan.
In addition, Dr.Asuzu has developed, with the Departments of Psychology in Ibadan University and Radiation Oncology in the University Hospital, an accredited Masters level program to train clinicians from any background in psychosocial oncology over a two year period. The program is in its second year and she proposes to add a PhD level in the future. She plans to work with the Ibadan Distance Learning Office and explore ways that professionals from other countries can train in the program, taking part at home through online education, and then spending time in Ibadan for the clinical supervised training component. Dr. Asuzu is the moving force for psychosocial oncology in Africa
In March 2016, Dr. Asuzu was awarded a competitive AACR Scholarship to attend the American Association for Cancer Research in New Orleans in April, 2016. There were over 150 applications and she was awarded one of six. She is now also on the Research Committee of AORTIC and on the IPOS Board of Directors.