30/12/2015

Breast course for nurses: 2015




Sr Lieske has had a really busy 2015. (Amongst other things, she got married in September).  I would like to thank her for all the hard work she has done for the Breast Course for Nurses and take this opportunity to personally thank Brad for his support.

Just before the end of the year, she compiled this summary of all the activities of the BCN.  

Breast Course for Nurses 2015

The Breast Course for Nurses has had another busy year and of course none of it would have been possible without your help! This is an update on all the activities that we have been involved with throughout the year!
Courses

1.     Harare, Zimbabwe: we completed this course in February at the very lovely Bronte Hotel and Conference Facility. A variety of nurses attended the course with the majority being from the oncology unit of the Parirenyatwa Hospital. A total of 40 nurses were trained. We were very fortunate to have Dr Anna Nyakabau and Dr Miata Mvere assist with lectures. Thank you to Sr Lieske Wegelin and Primrose Mafunda for helping with the admin side. Many thanks to the sponsors involved. Day 1 Day 2

2.     Bulawayo, Zimbabwe: we completed this course in February at a venue next door to the Mater Dei Hospital. This course was a part of a programme being run by Dr Phil Mitchell with staff from Knoxville, Tennessee. It was mostly due to a collaboration between Dr Mitchell, Dr King, Sr Jamieson and the rotary clubs of Knoxville and Bulawayo. A total of just over 80 health personnel attended the course. We also had a few doctors participate in the course. We had many local doctors join us for the 2 days and they also assisted with the lectures. We were fortunate to have 2 professors of nursing from Knoxville, Sr Karen and Sr Lynne, join and assist us for the 2 days! Day 1 Day 2

3.     Cape Town, South Africa: we completed this course in March. Fifteen nurses attended. The group was made up of mostly surgical nurses and volunteers. We were very fortunate to have Vaunda Parsonage present the lymphoedema session which the students all really enjoyed. A special thanks to Dr Miriam Mutebi and Dr Ronelle de Villiers for their assistance with the lecturing. Thank you to Sr Lieske Wegelin, Michelle Norris and Sr Sheila Correia for all their assistance and involvement with the course.
  
4.     Lilongwe, Malawi: Dr Edge travelled to Malawi to teach a group of 26 students at the Tidziwe Centre at the Kamuzu Central Hospital. The students consisted of nurses, doctors (registrars and interns) and clinical officers. Thank you to Dr Lily Gutnik and Dr Satish Gopal for their assistance and involvement in setting up this course. Day 1 Day 2

5.     Windhoek, Namibia: Twenty three nurses attended this course. It was held at the University of Namibia Medical School. The deputy permanent secretary from the Ministry of Health, Dr N Forster, opened the course and we were also joined by the Dean of the University of Namibia Medical School, Prof Peter Nyarango. Prof Celestine Mbangtang assisted with the lectures. Thank you to Oscar and Susan of Novartis for assisting with this course. Day 1 Day 2

6.     Ongwediva, Namibia: Thirty nurses attended this course. The course was at the Destiny Hotel in Oshakati. We were joined by Dr Brown and The Minister of Health, Dr Haufiku, and Prof Nyarango. Thank you to the sponsors, Novartis and Pathcare, and to each and every person that helped to organise the course.  Day 1 Day 2

7.     Johannesburg, South Africa: We have recently commenced a course in Johannesburg. This course is being run by Dr Sarah Nietz and Sr Sheila Correia with the assistance of Sr Tumeka Nojoko and Sr Colleen Davis. This is the first course that is being run without Dr Edge being present. We aim to have more courses like this as we would like to start with train-the-trainer courses in 2016. Just over 70 health care workers attended the course and we look forward to the follow up course early in 2016.


News from 2015

Ø  We visited the Well WomanClinic in Harare – they have facilities for cervical screening, breast screening and bone density scans. They combine clinical examination with a mammogram.


Ø  Dr Edge presented a session at the Radiographers Course in Cape Town where she taught about the clinical aspect of the management of breast cancer. Bergman, Ross and Partners sponsored a Breast Care book for each student. A big thank you to them for that.

Ø  Jessica Knight and her sister Juliet Baxter (the Santa Sisters team) completed the Joberg2c mountain bike race. They cycled to support the Breast Course for Nurses. The Santa sisters started a blog before the race began to keep us up to date on their preparation and training and continued to blog and tweet throughout the race.


Ø  The Breast Course for Nurses featured in the May edition of the Fairlady Magazine. Thank you to Liesl Robertson for writing the article.

Ø  We had a successful fundraiser at the Atlantic Imbizo Conference facility. We had a delicious high tea followed by an auction and raffle prizes. We were entertained by Belinda Prinsloo. There were many sponsors for the day and many people that assisted to make the morning so special! A very big thank you to Michelle Norris and all others involved.
         
Ø  We were invited by medical students from UCT to assist them with a project to educate refugees about breast examination and breast cancer.

Ø  Darren Francis, a photographer from Cape Town, exhibited portrait photographs of women affected by breast cancer and women involved in the care of women with breast cancer at the Breaking Dawn photography exhibition at the Young Blood Art Gallery in Cape Town. He included the Breast Course for Nurses in his campaign to bring across the message that early detection and treatment saves lives.

  
Ø  We visited 2 of the hospitals in the north of Namibia. We travelled with Prof Celestine Mbangtang and were welcomed in the hospitals that we visited. It was a very interesting and eye opening day.

Ø  Dr Edge went to the AORTIC conference in Marrakech, Morocco. She was fortunate enough to be able to present a talk about the Breast Course for Nurses and to represent the course at this cancer conference.  Many thanks to Well Woman Diagnostics for their sponsorship.


Future plans

In 2016 we will continue to run courses in South Africa and other countries in Southern Africa and Africa. We will be commencing with train-the-trainers courses so that future courses can be run without Dr Edge being present.

Contact us

Ø  The Breast Course for Nurses is very proudly on Facebook and Twitter! These sites are continuously updated and should be used to stay up to date with us and with what the Breast Course for Nurses is busy with! Our website is updated every few months therefore it is more reliable to stay up to date with us via social media.

·      Please “like” us on Facebook to hear all of our latest news! Search for “Breast Course 4 Nurses”
·      We are tweeting! Follow us on twitter: @breastcourse
·      To get in contact with us either go to the Breast Course for Nurses website or get hold of us via info@breastcourse4nurses.co.za or alternatively lieskewegelin@gmail.com
·      Dr Jenny Edge’s blog: www.jennyedge.co.za

Thank you!

The Breast Course for Nurses would not be possible without the help of our sponsors! Many thanks to the following people (in no specific order) that have helped in many various ways:


  • ·       Sr Sheila Correia
  • ·       Sr Lieske Wegelin
  • ·       Sr Jill Bilyard
  • ·       Sr Karen Hill
  • ·       Sr Yvonne Jackman
  • ·       Sr Vaunda Parsonage
  • ·       Sr Colleen Davis
  • ·       Sr Maureen Jamieson
  • ·       Sr Tumeka Nojoko
  • ·       Dr Jenny Edge                                        
  • ·       Prof David Woods
  • ·       Dr Anne Gudgeon
  • ·       Dr Ronelle de Villiers
  • ·       Dr Paul Whitehead
  • ·     Dr Miriam Mutebi
  • ·       Dr Judith Whittaker
  • ·       Dr Anna Nyakabau
  • ·       Dr Miata Mvere
  • ·       Dr Phil Mitchell
  • ·       Dr Lily Gutnik
  • ·       Dr Satish Gopal
  • ·       Novartis
  • ·       Dig-It
  • ·       Nexion
  • ·       BARD medical
  • ·       Well Woman Diagnostics
  • ·       Morton and Partners
  • ·       Bergman, Ross and Partners
  • ·       Atlantic Imbizo Conference Facility
  • ·       Fairlady Magazine
  • ·       Netcare CBMH
  • ·       UCT IASSS
  • ·       Bakenwa Spa
  • ·       Pathcare
  • ·       Carecross
  • ·       Primrose Mafundu
  • ·       The Myerson family
  • ·       The Levy family
  • ·       The Blachowitz family
  • ·       The Collopy Family
  • ·       Mrs Colleen Crosier
  • ·       Dr Sarah Nietz
  • ·       Prof Peter Nyarango
  • ·       Prof Celestine Mbangtang
  • ·       Dr Oscar Benyera
  • ·       Dr Conrad Pienaar
  • ·       Dr Clare Neser
  • ·       Dr Paul Skoll
  • ·       Cape Heritage Hotel
  • ·       Michelle Norris
  • ·       Chris Tilney
  • ·       Karen
  • ·       Lynne
  • ·       Vaunda Parsonage
  • ·       Susan van Zyl
  • ·       Sue Serebro
  • ·       Ian Black
  • ·       Brendan Marshall
  • ·       Jean-Claude Smith
  • ·       Gadija Kippie
  • ·       Nadia Abrahams
  • ·       Darren Francis
  • ·       Maryan Haefele
  • ·       Anna Richerby
  • ·       Belinda Prinsloo
  • ·       Salome Meyer
  • ·       Jessica Knight
  • ·       Juliet Baxter
  • ·      Carl Wessling

If you would like to donate to the Breast Course for Nurses please contact us

29/12/2015

Alcohol and Breast Cancer: a perspective Happy New Year.



I am often asked if I find my job depressing.  I don't.  one of the reasons is that I enjoy catching up with women I have treated at a different stage of their lives.  Nearly ten years ago, Janet Gourand came to see me as a patient.  Recently, she returned to see me and told me about her new project.:World Without Wine. She asked me whether she would have got breast cancer if she was a teetotaller.  

As New year's Eve approaches, I thought it would be a good time to post her blog

         Breast Cancer and Alcohol
Janet Gourand

"Back in 2006 I was diagnosed with breast cancer – although almost 10 years ago I can remember that day as if it was yesterday. 

"I was sent to breast cancer surgeon Dr Jenny Edge in Cape Town.  She took one look at my breasts and  suggested that I had a malignant tumour in my left breast.  She was very kind and told me gently that I was going to have a very busy day as she sent me round the hospital to have various tests to ascertain if the cancer had spread – fortunately it hadn’t although it was in my lymph nodes, many of which had to be removed along with my breast.

"One of the ways I coped with my year of treatment was by blogging – my blog is still up there in cyberspace under www.breastcancerbattle.blogspot.com

"I was vaguely aware of the fact that there was a link between alcohol and breast cancer but that was not something I wanted to dwell on when coping with my diagnosis and the tough treatment regime that followed. 


"According to website www.breastcancer.org :-

 “Research consistently shows that drinking alcohol does increase a woman’s risk of hormone-receptor-positive breast cancer.  Alcohol can increase levels of estrogen and other hormones associated with hormone-receptor-positive breast cancer and may also damage the DNA in cells.

Compared to women who don’t drink at all, women who have three alcoholic drinks per week have a 15% higher risk of breast cancer”



"Now that almost a decade has passed I felt brave enough to talk to Dr Jenny Edge about the possible link between alcohol and breast cancer.

"Her first words were that “its complicated” and she reminded me that the biggest risk factors are being female and getting older!

"Having said that Dr Edge was kind enough to share with me some key points from a recent presentation she had made at the University of Cape Town:-



  -  The World Health Organisation has classified alcohol as being
     “carcinogenic to humans”

   -  Alcohol metabolises into acetaldehyde which can damage
      healthy cells

-       Alcohol could affect the response of the breast to circulating
estrogen



"Dr Edge also mentioned the “Nurses Health Study (2011: JAMA) which looked at alcohol consumption and breast cancer risk.

"Conclusions of this significant study were that “low levels of alcohol consumption were associated with a small increase in breast cancer risk, with the most consistent measure being cumulative alcohol intake throughout adult life.”



"There was no statistical difference found between:-

-       - types of alcohol consumed
-       - age of drinking
-      -  regular vs binge drinking


"So I can see why Dr Edge says “it’s complicated” but if I could give some advice to my younger self I think it would include some tips about drinking moderately.  As a result of recent research the “safe” levels for alcohol consumption are likely to be reduced in the UK.  Currently 14 units a week – that’s just one and a half bottles of wine!  Let’s hope that SA will follow the UK example – and lets hope that people will actually follow that advice!"


25/11/2015

AORTIC: Global surgery



AORTIC: Global surgery


The use of technology has been discussed in many sessions in AORTIC.  Internet access is not comprehensive but the majority of people in Africa have a cell phone.  The problem with cell phone communication is that it is expensive.

How can cell phones (smart or otherwise) be used to improve patient care in a low income setting?

1.     Many patients get lost to follow up.  The reasons are multifactorial.  If a clinic has a contact number for a patient, they can be kept in the system.  There are several projects that have shown the successful use of cell phone communication with patients.
2.     Health information can be disseminated via phone.  In Zambia, in a project run by pinkribbon:redribbon,, they have partnered with Vodacom and have sponsored SMSes sending out health advice
In Tanzania, mobile technology has been used to tell women where to go to get health care.  (Vodacom also sponsored the transport for women to get to the appropriate clinic).
3.     In the radiotherapy session, a whole presentation was devoted to the use of smart phones in radiotherapy. 

The most interesting session I attended was called “An African Surgical Network”.  The speakers were all excellent: Dr Anderson , Dr Ousadden, Prof Gueye and Prof Smith.  The concept of global surgery was discussed.  Somehow, surgery has fallen down the list of global health priorities and as a result;
5 billion people do not have access to safe surgery.  
143m more surgical procedures need to be performed in LMIC annually if health standards are to be optimized.    
Less 5% of all cancer research is about surgical management.  
There is a paucity of specialists in Africa for example, there is 1 urologist in Nigeria per 3 m people.

What can be done?  What is being done?

There was a general consensus that there is a need for appropriate training to be done in centres of excellence in Africa.  It is not ideal for surgeon to have to go out of the continent for training.  Prof Gueye from Senegal discussed the plan for training centres in West Africa and gave examples of what has been achieved.  Technology can be integrated into the process of training.  He lamented the brain flight from Africa and said that Senegalese doctors end up working as nurses in Europe.

Research from LMIC must be published.  There was a general plea for international journals to accept studies from low income countries. (As an aside, even at AORTIC, which is an African cancer organization, only 36% of the keynote speakers of those in the plenary session were from Africa).

The relevant government departments must be lobbied. They must ensure visa requirements are appropriate for trainees. (Travelling with an African passport can be problematic even to neighboring countries.)  The DoH has a responsibility to provide the necessary environment for a specialist to be able to practice the skills that have been learnt.  A trained surgeon will leave for greener pastures if they have to constantly contend with shortages, poor administration and inadequate basic facilities. (We heard many stories of no electricity, toilets that don’t work, no paper to write notes).

Training programmes should be combined with service delivery projects.  For example, if a surgeon goes for an out reach programme, the opportunity to train local medical personal must not be missed.  Conversely, a training programme should be used to provide a service to the local community.

It was a refreshing and important session.   Many thanks to the organisers for including it in the programme.   

Lastly, the Breast Course for Nurses would like to thank Well Woman Diagnostics for sponsoring my travel.