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Angela Sakala, who is currently being treated for cancer, practices her penmanship during a class at Twende Education for All, an organization that provides classes to children receiving long-term treatment. Offering educational opportunities increases the likelihood of children completing the treatment, doctors say. Prudence Phiri, GPJ Zambia

In Zambia, When Children With Cancer Can’t Attend Class, The Classroom Comes to Them


Children receiving long-term cancer treatment in Zambia often can’t attend school. Now, one organization is working to change that by bringing the classroom to the hospital.

LUSAKA, ZAMBIA — Children scream with excitement, clinging to Andrea Mwalula as she walks through the Cancer Diseases Hospital in Zambia’s capital, the only public hospital in the country that treats cancer.

Kids who can’t walk sit up to catch a glimpse of her and smile from their beds.

Mwalula leaves with a trail of children following her, heading to the Twende Education For All center, located near the ward. Another teacher comes in with learning materials to teach those who cannot leave the ward.

Twende Education For All is an organization that provides schooling to children with cancer who are admitted to the hospital for long-term treatment. Since Mwalula founded it over three years ago, the organization has offered education services to children at the Cancer Diseases Hospital.

Cancer is among the top four non-communicable diseases in Zambia, according to Ministry of Health. And survival rates here are low. Of the over 12,000 cancer cases recorded in the country in 2018 more than half were fatal, according to the World Health Organization’s International Agency for Research on Cancer.

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Nkole Lengwe, 9 (right), and Lumpo Gift, 7, two kids currently receiving cancer treatment, work on an art project. They say the opportunity to continue their studies distracts them from their otherwise depressing surroundings.

Prudence Phiri, GPJ Zambia

Dr. Justin Mulindwa, a pediatric oncology consultant at the Cancer Diseases Hospital, says that to date, nearly 300 children with cancer have received treatment. But there are no official national statistics for childhood cancer.

“This can’t be a true representation of the problem in the country,” Mulindwa says. “We know that, practically, we do not get to see every child with cancer.”

Treatment abandonment is common for children with cancer in Zambia, which leads to low survival rates, Mulindwa says.

Of 162 children who began treatment in 2014, only 8% completed it, according to a study in Plos One, a peer-reviewed science journal. The study found that most who abandoned treatment did so because of expenses or long distances between home and the hospital.

But for children with cancer, long hospital stays can halt educational opportunities, too.

“Children on cancer treatment spend a lot of time in hospital, some may even spend years,” Mwalula says. “That is why we opted to give them hope by providing academics, skills and play as part of the treatment therapy.”

Nkole Lengwe, 9, spent more than a year in the hospital with kidney cancer. She says having classes helped her cope with her long treatment.

“This place can be depressing, especially when you see other children dying,” she says. “The learning center keeps us busy.”

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Joseph Nyapende, 9, a child with cancer, completes an assignment with Fridah Mumba, one of the teachers from Twende Education for All Learning. The center is the only one serving children receiving long-term cancer treatment.

Prudence Phiri, GPJ Zambia

Joseph Nyapende, also 9, says he learned how to read and write at the education center during his 10 months at the hospital.

Bringing education into the hospital has other benefits, too. Doctors say the education center is increasing treatment completion rates among children.

Mulindwa says the ward is seeing an increase in the number of children seeking cancer treatment as parents become more aware of treatment options. And educational offerings help to encourage parents to keep their children in treatment for as long as necessary.

“We provide skills training to the parents so that they use the time they spend in hospital productively,” Mwalula says. “We also have a support group where parents share their experiences with each other as a way of providing moral support to each other.”

Prudence Phiri, GPJ, translated some interviews from Nyanja.