Cancer in My Community is a Cancer.Net Blog series that shows the global impact of cancer and how people work to care for those with cancer in their region. Jazmin Servin, MD, is a pediatric hematologist-oncologist at Hospital de Clínicas in Asunción, Paraguay. You can follow Dr. Servin on Twitter.
Why I care for people with cancer
Since the time that I was a medical student, I always had a special draw toward oncology. However, at the time, I never thought that I would dedicate my life to treating children with cancer.
My interest in caring for children with cancer began during my third year of residency in the clinical pediatrics specialty, when I was doing an internship in the pediatric hematology-oncology unit of my hospital. I fell in love with the specialty as I started caring for these children and their families. While I saw their suffering and their daily struggle, I also saw how the brilliant oncology team at the hospital cared for them down to the smallest details and strived to provide them with the best care, even despite the lack of resources of the hospital. That experience made my heart want so badly to do something for them and join that wonderful team.
I knew that the road to becoming a pediatric oncologist would not be easy, and in truth, it was not. However, today I can honestly say that deciding to dedicate my life to caring for these children and their families was one of the best decisions I have ever made.
What pediatric cancer is like in Paraguay
Paraguay is a country located in the heart of South America, with a population of approximately 7.4 million people. In Paraguay, 21% of people live in poverty, and according to the results of the latest Measurement of Social Exclusion in Health report, around 35% of Paraguayans do not have regular access to health services.
Pediatric cancer in Paraguay represents a public and social health problem due to the devastating consequences it has on patients, their families, their communities, and our health systems. The estimated incidence of childhood cancer in Paraguay is around 300 to 350 new cases per year, and it is the second leading cause of death in children between the ages of 5 and 15.
There are many barriers that exist to treating children with cancer in Paraguay, including:
Economic barriers. Childhood cancer is a catastrophic, high-cost disease in Paraguay, creating high expenses for both the family and the government. These costs contribute to the financial struggles of many families facing a childhood cancer diagnosis.
Political barriers. Despite the recent and very important advances with the creation of the Cancer Law in Paraguay to ensure quality cancer care for people in our country, there is still a lot of work to be done. And, while the law was approved in 2018, the process of implementing the law has taken longer.
Medical training barriers. There are very few training centers in pediatric oncology in Paraguay.
Social barriers. Many families of children affected by cancer face financial challenges due to the high cost of cancer, which can require expensive treatments that may have to be given over long periods of time. Many families take on these expenses in an attempt to save the lives of their children while at the same time reducing their income, as at least 1 parent often must leave their job to care for their child. Families are often also forced to leave their communities to receive their child’s treatment in the capital city of Paraguay. There are no treatment facilities in many of the rural areas of the country. This situation can cause families to stop cancer treatment, which can increase the risk of children dying.
Data collection barriers. There is no national cancer registry system in Paraguay, so little is known about the burden of childhood cancer in our country.
In addition to these barriers, there are areas within oncology that are not yet developed in Paraguay, such as pediatric palliative and supportive care. To date, there is still no pediatric palliative care unit in Paraguay.
The challenges in treating childhood cancer in Paraguay are many, but in the oncology community, we are all working toward the same goals: increase the cure rate for children with cancer, reduce suffering as a result of treatment, and decentralize care to ensure that all children have the same opportunity to access treatment and heal, regardless of where they live. There is still a long way to go, but we are sure that with teamwork, commitment, and love, we will be able to overcome barriers to care for children with cancer in Paraguay, achieve equitable access to care, and create a better chance of cure for children with cancer in our country.
Where children with cancer and their families can find local resources and support
There are 4 public pediatric cancer treatment centers in Paraguay, and treatment is free for patients at these centers. However, resources at these centers are limited, and on many occasions, the centers do not have all of the necessary treatments available for patients. There are also some diagnostic tests that are not available in the public centers. So, in order to access or pay for treatment and even diagnosis, patients often receive help from nonprofit organizations. These nonprofit organizations give their support by helping to pay for chemotherapy, radiation therapy, and diagnostic tests, as well as offering social support for families.
The author has no relevant relationships to disclose.