Cancer Care In Malawi

The main hospital in Malawi is the Queen Elizabeth Central Hospital (QECH) in Blantyre. Professor Elizabeth Molyneux has treated children with cancer here for over 20 years. Children’s cancer resources at QECH are extremely limited; a small but dedicated team works with families to provide care.

Unlike the UK, many patients cannot receive effective therapies, due to limitations on resources and/or facilities. Simple but effective protocols have been developed for treating African Burkitt’s lymphoma, the commonest childhood cancer in Malawi, which cure 50% of cases. These results have been achieved by the immense efforts of a small number of dedicated doctors and nurses in a very well organised unit.

They are remarkable, considering the major obstacles faced.

The Malawi Hospitals

The main hospital in Malawi is the Queen Elizabeth Central Hospital (QECH) in Blantyre, the largest city, which also has the country’s only medical school. Professor Elizabeth Molyneux has treated children with cancer in the Paediatric Dept at QECH for over 20 years. Her efforts led to the building of a Paediatric Oncology ward in 1995 with 16 beds.


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A Small But Dedicated Team

Children’s cancer resources at QECH are extremely limited. There are only 4 nurses, with only 1 on duty at a time, and no full time doctors, since Prof Molyneux and her colleagues care for all the other children in the hospital. The childrens’ families provide nearly all of their care, even in hospital.

Successful Therapies Developed On Limited Resources

The facilities, both on the ward and in the hospital (eg. availability of X-rays), are very basic. Nevertheless, Prof Molyneux has devised a simple but effective treatment protocol for treating African Burkitt’s lymphoma, the commonest childhood cancer in Malawi. Just 4 weeks of treatment can cure about 50% of children. Many children with Wilm’s tumour are also cured with surgery and a short course of chemotherapy. These children spend very little time in hospital and are followed up at home by a nurse from the unit who travels the country on his motor bike!

Contrast Care With Western Societies

In the UK, we are never in a position of being unable to give proven effective treatment to a child with cancer. Sadly, this happens every day in Malawi, due to the limited resources. Many chemotherapy protocols can not be given, sometimes because the drugs are too expensive, but often because it is not feasible to monitor or treat the side effects of treatment due to a shortage of nurses or lack of drugs. For example, very few children with leukaemia can be treated in Malawi.

Limited Resources and Supplies

The lack of specialised children’s anaesthetists and high-dependency facilities does not allow paediatric surgeons to carry out the major procedures often needed in children with cancer. Furthermore, neither radiotherapy nor neurosurgery are available. The unit even struggles to obtain supplies of the milder but vital chemotherapy drugs that they are using so effectively in Burkitt’s lymphoma.

Positive Progress in a Challenging Environment

Given these difficulties, the results of treatment obtained by Prof Molyneux and her team are even more remarkable. They have been achieved by the immense efforts of a small number of dedicated doctors and nurses in a very well organised unit, who have made the best use of their limited resources despite facing major obstacles.