By Asomaniwaa Owusu-Ansah, Erith Health Services

In 2014, I gained an exciting job in a cancer center in Accra-Ghana. I was a young newly qualified pharmacist, and cancer was an emerging disease trend in Ghana and across Africa. I felt truly privileged to be amongst the few Pharmacists helping to combat this disease state. Being the only female Pharmacist in the practice at the time was also such a privilege.

There was however a reason for the low number of Pharmacists in oncology practice-the Pharmacists (and other health practitioners) knew very well the dangers of handling cancer medicines and yet there was no solution in sight on how to adequately protect themselves. They lacked proper training on how to properly handle chemotherapy, what personal protective gear and devices to employ and proper waste management. I faced these challenges everyday in my practice; I did not want to give up my passion to fight cancer yet the reality was scary. 

I saw patients from many African countries and noticed the rise in cancer incidences. I saw that there was so much more to do, so many unmet needs in oncology practice in Ghana and across Africa. My newest fears became Africa’s preparedness in providing a safe aseptic treatment environment to adequately cater to the number of cancer cases that continued to rise. Campaigns had started on early detection and diagnosis of cancer yet health facilities were still inadequately equipped for treatment and health workers were even more at risk due to exposure as they prepared and administered chemotherapy.

I decided that there must be a solution to that aspect of cancer care and oncology practice that seemed neglected. As I read about advancements in protective measures in countries like Australia, the United States and Canada, I was even more convinced that we could build a cost effective solution to the safety concerns of African oncology Pharmacists as well as help create an aseptic environment for proper drug preparation and administration. In 2016, I founded Erith pharmaceutical and health services Ltd, now Erith health services to drive solutions towards safe aseptic environment for oncology professionals.

Our solution
At Erith we have dubbed our work as “Caring for Caregivers”. We have employed the principles of Advocacy, Training and Equipment to drive this agenda. 
●    Advocacy:
Awareness creation- spread the word on the importance of caregiver safety and how it helps improve patient outcomes.
●    Training:
Provide up-to-date information to caregivers and patients that enhances safe practices
●    Equipment:
Providing the most efficient devices and personal protective equipment to enhance safe aseptic practices.

Overall we seek to promote the sustainable development goals 3 and 8: good health and well-being and decent work amongst health workers in oncology practice.

The Impact of ISOPP 2019
The International Society of Oncology Pharmacy Practitioners has been a great influence towards my decision to care for caregivers. The society has always provided information on safe handling of chemotherapy. The standards of practice have been one of the most influential documents in my practice and I was very excited to join the standards review taskforce in 2015. As President-elect Shaun O’Connor addressed the 2019 symposium attendees on the new additions to standards of practice, I started looking at how we can efficiently improve practice based on the new standards. The handling and monitoring of oral chemotherapy especially in community pharmacies forms an essential part of practice gaps; an international standard will help solidify our advocacy for proper handling of oral chemotherapy.

I always followed with keen interest the United Kingdom’s efforts to improve and standardize aseptic preparations. The NHS's long term ambition for aseptic services (as presented during the fundamentals 1: Aseptic Compounding, past, present and future), further informed me of the importance of supporting the oncology workforce, doing things differently to improve aseptic practices, the importance of innovation, data and technology in achieving improved and standardized modes of safe handling of cytotoxic therapies, and the overall creation of the most standardized aseptic services. A multifaceted approach is necessary to achieve the best practices in oncology. Health workers must be willing to indulge in safe practices, non-clinical staff must be educated on the importance of safe practices and facility managers must embrace the cost for best practices.

Now home in Ghana, my team and I have started developing practical tools for standards promotion. We will use this data-driven tool to train and inform oncology staff as well as hospital management. We seek to build a tool which will serve as an essential tool in increasing productivity and efficiency in aseptic preparations as well as improving clinical outcomes. We look forward to launching this tool and sharing it with the entire ISOPP community.

As a social responsibility, we provide education in churches in our communities in Accra with the aim of demystifying cancer diagnosis and treatment. Misleading treatment and quackery has often times led to late hospital presentation and poor treatment outcomes as well as increased mortality. The session on “Is cancer fundraising fuelling quackery?” was a very informative session. 

We have currently scheduled more training sessions to educate as many people as possible in schools, churches, offices and across social media on the proper channels for diagnosis and treatment. It is important to educate the public on issues such as the difference between supplemental medicines and actual treatment. Oftentimes, supplemental medicines are taken instead of treatment medicines which results in poor clinical outcomes.

As we continue to work on effective tools for health professionals, we will provide the best information to the general public as our social responsibility to help eradicate misleading treatment options. This we do with the hope of aiding the improvement of cancer care in Ghana and across Africa.

The crowning moment at the symposium was receiving the Achievement Award for advocacy for caregivers' well-being. The recognition given to our work is a huge encouragement to continue on this path until the best standards of practice are achieved. 

Asomaniwaa Owusu-Ansah	Asomaniwaa Owusu-Ansah
Asomaniwaa Owusu-Ansah is presenting at community in Accra	Asomaniwaa Owusu-Ansah is presenting at community in Accra
Asomaniwaa Owusu-Ansah at ISOPP 2019 Awards & Grants