The global burden of children’s cancer falls disproportionately on children living in Low and Middle-Income Countries (LMICs). Annually 200,000 children are diagnosed with cancer, and of these, 80% live in LMICs. In High Income Countries (HICs), the treatment of pediatric cancer is largely viewed as a success story, with survival rates averaging 80%. By contrast, in LMICs the survival rate averages just 20%. However, with concentrated and coordinated efforts, some LMICs have been able to raise their survival rates to those nearly equal to those in HICs.
The photographs in this series are part of a larger documentary photography and film project titled ‘How I Live With Cancer’. ‘How I Live’ is being created in close partnership with Persistent Productions and the Dana Farber/Boston Children’s Cancer Center and aims to chronicle the healthcare systems – and the patients being treated within the pediatric oncology units — in LMICs that are closing the survival gap between LMICs and HICs around the world.
This selection of images features patients and their families being treated at Centro Medico Ayudame a Vivir for Pediatric Cancer Treatment in San Salvador, El Salvador.
One of the leading causes of treatment failure in LMICs is abandonment of treatment, which may account for as much as one third of the survival gap between HICs and LMICs. Despite the relatively high overall survival rate at Centro Medico Ayudame a Vivir for Pediatric Cancer Treatment, as recently as 2010 the hospital had a consistent abandonment rate of 13% for a decade. However, after implementing a time sensitive adherence tracking computer system that alerts the Psychosocial Team when a patient appointment has been missed, and a system that enlists the help of local community health workers and government officials, they have decreased their abandonments rate to just 3%. The success in reducing treatment abandonment is one of the ways that Centro Medico Ayudame a Vivir for Pediatric Cancer Treatment continues to improve its care and act as a model for other LMICs.
The global cancer burden is set to increase, and the number of people of all ages living with cancer worldwide is expected to rise from 12.7 million in 2008 to an estimated 22.2 million by 2030. And 90% of this anticipated increase will be from people living in LMICs. With this escalation on the horizon it will be critical to look at institutions within LMICs, like Centro Medico Ayudame a Vivir for Pediatric Cancer Treatment, that have had success in increasing survival rates.