Childhood cancer care delivery in Nepal is primarily through two government hospitals: One is Kanti Children's Hospital (KCH), and the other is Bharatpur Cancer Hospital, Bharatpur.
KCH, established in 1970, located in Kathmandu, is a 500-bed tertiary level government children's hospital under the Ministry of Health and Population. In 1990, Dr. A D Shrestha was the first pediatrician to start treating children with cancer at KCH. The first pediatric oncology unit in Nepal was established at KCH in 1994 with four inpatient beds and this has now expanded to 20 beds. The first trained pediatric oncologist, Dr Kailash Prasad Sah, started protocol based treatment in 1999 after completing training in Alder Hey Children's hospital at Liverpool in UK. There are currently two pediatric oncologists at KCH and they follow a combination of European and American protocols which have been adapted locally.
All commonly used chemotherapeutic agents are available in Nepal, although there is some degree of inconsistent supply of drugs. The drugs available include vincristine, methotrexate, 6-mercaptopurine, cyclophosphamide, L-asparaginase, cisplatin, carboplatin, and etoposide. These are all available free of charge to patients as funded by the Kanti Oncology Fund and Ministry of Health. The government of Nepal contributes approximately US ,000 per child for treatment.
The number of children with cancer presenting at KCH has been rising since the unit was established in 1994 from 20 cases per year to 140 cases per year at present. The cure rate of cancer at KCH is currently around 40%, with 35% abandonment of therapy due to financial burden and 25% mortality. In order to cherish the children by engaging them in some recreational activities and providing financial support to their families, Astitwa Foundation was established.
Recreation centre:
The number of cancer patients in KCH are increasing day by day and it was essential to establish a center where those children can spend their few hours in playing, reading stories, do paintings, singing, dancing and other fun activities which help them to relief from regular pain and at least can enjoy their life for few moments. In coordination with KCH, a well-equipped recreation centre was established where the children can play and enjoy their time by reading, dancing, painting and doing other educational activities. Full time experienced tutors are available to guide and mentor those children.
Financial support:
The average cost of treatment per patient in KCH is around Rs 7 lakh and most of the parents are from poor family background who could not afford this cost. We aim to provide financial support to at least one or two families per month. Most importantly, we further aim to sponsor the cost of study, of at least 5 students per year, after the patient being discharged from hospital.
Sponsorship:
Most of the patient are from outside the Kathmandu valley and they usually take rooms on rent nearby the hospital areas during the treatment period which ranges from 3 months to 7 months. A study shows in most of the cases, only the mother amongst the families will be with the patient. Our foundation aims to sponsor the cost of food for patient (fruits and diet food- for patient) and his/her family member during their stay at hospital.
Health Campaign:
We aim to provide at least two health camps services a month in rural societies. We have a team of doctors who are paediatric specialized and our focus would be to conduct health camps in those areas where children are far from the reach of health facilities.
Awareness program:
We organize cancer awareness programs to educate patients and their families for early-stage treatments so that they can live longer lives. Awareness program shall be conducted in schools located in rural areas where the children and their parents shall be focused. Awareness program shall be focused to aware about the myth and facts about cancer along with other educational materials.
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The foundation was established with an aim to demote the culture of
redundant expenditure in social and religious functions.
