'Welcome packs' help keep Malawi's cancer patients in hospital

A box of matches, 250 grams of sea salt or a pack of tea leaves do not come to mind as an indispensable medical kit. But at the Queen Elizabeth Hospital in Blantyre, the commercial capital of Malawi, they are in the front line of the fight against childhood cancer.

The matches, salt, tea leaves and other domestic items such as cooking oil, soap, sugar, toilet paper and toothpaste are part of what the staff at the paediatric oncology ward describe as "welcome packs", which give people the means to keep their children in hospital.

"The welcome packs are very important because [the patients and their families] come from very far away - when they arrive at the hospital they arrive with nothing," says Sister Agatha Nthundu, the head nurse at the oncology ward.

The doctors and nurses at Queen Elizabeth Hospital have long realised that the best medical treatment means little if they are unable to keep children on the oncology ward for the extended periods needed to battle cancer. In a country where half of the population lives beneath the poverty line, the support is even more crucial. "We tell them: 'this is for you, to help you'," Sister Nthundu says.

The packs are made possible through the involvement of World Child Cancer, the partner in this year's Financial Times Seasonal Appeal, which works with children with cancer in developing countries where survival rates are much lower than in the west.

The support continues in other forms: food rations, including nutritional bars for the children; money to buy firewood; and roofed shelter outside the ward for parents that the hospital built four years ago at a cost of roughly £1,000.

Jamaldeen Idruss, a 30-year-old mother whose son Joseph is receiving chemotherapy, is an example of the difference that the welcome packs make. "When we came to the hospital we had nothing," she says.

Each welcome pack costs the hospital about 2,000 Malawi kwachas - a considerable sum in the impoverished country, but a little less than $5 after the sharp depreciation of the local currency over the past year and a half. The families receive one pack a week.

Betty Chilonda, who helps in the oncology ward playing with the children with toys donated by WCC, says that few parents could afford to pay for the pack themselves. "This is a lot of money [in Malawi]," she says.

Parents of cancer patients in Malawi put themselves through terrible suffering, skipping meals and sleeping on the streets, before taking their children out of hospital and returning to their homes, say doctors and nurses in Blantyre. But they often have to make a difficult calculation: stay with a child in hospital, or return home to a remote village to feed five, or even more, other children.

In a few cases, parents - and their children - disappear at night and when the staff check at dawn they find an empty bed.

"Most people will put themselves through extraordinary inconvenience to come to the hospital," says Elizabeth Molyneux, head of the paediatric oncology ward at Queen Elizabeth Hospital. "But at the end of the day, we are talking about poverty and making decisions such as coming to the hospital with one child or staying home and buying food for five others instead."

Ms Idruss chose to stay at Queen Elizabeth Hospital, in part because of the help of the welcome packs and other support from World Child Cancer. Today, she is celebrating that after three weeks of treatment, her son is about to be discharged.

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