Answering the urgent call for more hematologists in Africa

Christable Semondile knows the importance of hope.

As the interim director of the Bristol Myers Squibb Foundation in Africa, she has long seen hope in the work being done to diagnose, treat and support multiple myeloma patients there.

Semondile sees it in the healthcare practitioners who are being trained to understand a multiple myeloma patient’s journey, including barriers they face for early diagnosis and treatment. She sees it in the doctors selected to serve as fellows in a country where there are far too few hematologists. And she sees it in other efforts that support patients and their families.

But most of all, she sees it in the eyes of patients in Africa who are fighting a disease that isn’t curable but can be endured with proper treatment and support.

Semondile is so committed to the BMS Foundation’s work with multiple myeloma and other programs in the country, she stepped away from duties she had in other countries. “I dedicated myself to Africa,” she said. 

She believes the BMS Foundation’s commitment to multiple myeloma can help improve patients’ quality of life and give them more time with their loved ones. 

Investing in programs to meet patients’ needs

Multiple myeloma is one of the focus areas of the BMS Foundation’s Global Cancer Disparities Africa program, which launched in 2016 with a new mandate to focus on cancers. The BMS Foundation supports several programs that are focused on training medical professionals who treat the condition and on efforts that support patients and their families.

The broadest of those is Collaboration for Multiple Myeloma ABCDES (Awareness and Building Capacity to Diagnose Early and Support) Programme, which has two complementary initiatives:

• Healthcare Practitioner Training Project that includes research studies to understand barriers to early diagnosis and care, improving education at post-graduate levels, and reviewing training for healthcare practitioners who work with multiple myeloma patients.
• Patient Support and Survivorship Interventions Project that includes assessing disease awareness and needs of patients and their families, improving access to palliative care for multiple myeloma patients, and support groups for patients and their families.

Semondile said the program also helps improve access to rehabilitation services for patients, like wheelchairs, walkers and other necessities.

It even paid for two hotel rooms for two years, so patients being treated at a hospital can stay a night or two across the street from the facility after getting chemo or other treatment. This is especially helpful for out-of-town patients who need to rest before traveling home or for those who have follow-up appointments the next day. 

Fellowship program is ‘highlight’ of efforts

The need for hematologists in South Africa is especially high. 

That’s why the seven fellows who are part of a three-year program “are the highlight of what we’ve done in South Africa” Semondile said. The program is through the South African Clinical Hematology Society, which received a grant from the BMS Foundation.

One of those fellows, Dr. Romana Jassat, said she was influenced by her family, particularly her father, to go into medicine. One of her early rotations was in hematology, which she said allowed her to build more personal relationships with her patients. “You get to know them and you get to know their families,” Jassat said.

Because cancer doesn’t discriminate, she saw patients who were young, old, those with multiple myeloma and those with other blood diseases. The commonality was the bravery they showed despite their health concerns.

“They are carrying on with their daily life, then they’re handed a terrible diagnosis,” Jassat, 33, said. “They know in a way that they’re dying every day.” 

She said the fellowship gave her many opportunities, including being part of a team that performed a stem cell transplant on a teenage boy with acute myeloid leukemia whose older brother was the donor. The patient is currently in remission and has returned to school.

“When things get too hard,” she said. “I think about him.”

Getting more time with loved ones

Dr. Mahlatse Mankgele, another fellow in the program, learned about biology from his mother, who is a high school teacher. “She would always teach me more and above what was expected for my level of schooling,” he said.

Because of that, and the fact there were very few doctors in his small town, Mankgele decided to become a physician. He was fascinated with the complexities of human blood and spurred on by the fact that multiple myeloma is common in his country.

Mankgele said fellows in the program are the first point of contact for consultations and treatment-related questions in the hematology clinic. They also coordinate the stem cell transplant program, which includes many multiple myeloma patients.

Dealing with patients who are very sick can be overwhelming, he said.

Mankgele said the fellowship has been an amazing learning experience. He knows whatever he does after the program ends will involve giving back to a community away from big cities, where he can help create a much-needed place for hematology and oncology patients to seek medical help.

Getting more time with loved ones

Dr. Moses Chatambudza grew up in Zimbabwe knowing he wanted to be a doctor. He originally wanted to become a cardiac surgeon but realized that wasn’t his passion.

After finishing his fellowship training, he was supposed to go to an HIV clinic. However, in what can perhaps be seen as divine intervention, Chatambudza was instead sent to a clinical hematology unit that had just opened. The two years he spent there changed his career path and, ultimately, the lives of future patients diagnosed with blood disorders like multiple myeloma.