Blog Global Health Center COVID-19

Shared perspective of the impact of COVID-19 on patients at Liga Nacional Contra El Cancer e Instituto Nacional de Cancerología in Guatemala

Written by Angel Velarde, MD, MSCE, research director at LNCC-Incan & collaborator on the USAID-ASHA grant

Screening temperatures of patients and staff at the entrance of INCAN hospital. In the background is the donated ambulance from Washington University in the background

The President of Liga Nacional Contra El Cáncer (LIGA) e Instituto Nacional de Cancerología (INCAN), Dr. Vicky De Falla, announced that despite the impact of COVID-19 on Guatemala, patients at INCAN are still receiving radiotherapy or chemotherapy treatment, although outpatient care is cancelled due to a ban by the Government Ministry of Health of Guatemala. Screening campaigns of colon, skin and gastric cancer have stopped. Washington University’s donations are coming to good use in these challenging times, such as the ambulance that was donated several years ago, is now used as an ambulatory clinic for patients who need further screening if they were selected after the initial temperature screening. Face masks donated a few months ago are being put to good use. Dr. Vicky is reaching out to other institutions for additional help and funding for the patients.

Dr. Carlos Garcia, the medical director of INCAN, observes that despite the ban on public transportation throughout the country, the patients are making a tremendous effort to come for their treatments, traveling long distances and facing transportation difficulties. The hospital is providing free accommodation to these patients.

Communication in this period is key! INCAN’s administrative director, Erasmo Morales, has the role of communicating with the patients through Facebook to update them on regulations and answer their questions. Erasmo observes that patients are most focused on getting their cancer treatment and less concerned with COVID-19. Though INCAN still has the masks that were donated by Washington University, and new ones are on their way, he is concerned that when they run out how to protect the patients and healthcare providers. He has seen a shift in Guatemala to the production of low quality cloth masks being sold in the market, which can pose serious issues in the spread of the disease.

Mr. Kirk Douglas (no, not the actor), our medical physicist, mentions that patients who had already started radiotherapy are continuing their treatment, however, new patients will not start treatment unless they have an emergency such as bleeding or tumors that are affecting their central nervous system. The Radiotherapy Department has adapted the work schedule so that the physicians and administrative staff work primarily in the mornings. The radiation oncology doctors, alternate their work weeks. Therapists without a car are unable to come to work.

“Radiotherapy continues to play a pivotal role in cancer treatment in the midst of the COVID-19 disaster.” -Kirk Douglas, medical physicist 

The nosocomial committee has played a key role during this pandemic, by establishing protocols of security management of patients. Early on before there were any COVID-19 cases in Guatemala, the committee received training through a workshop from the Ministry of Health on how to manage COVID-19.

From my point of view, this pandemic has shown the unique strength of our patients who not only battle cancer but also struggle with basic needs as transportation to receive their treatment. As Research Director of INCAN, it has being pivotal to continue regular communication with our Washington University partners to share experiences and explore ideas and projects to help our cancer fighting patients to overcome the challenge of the COVID-19 pandemic. In particular I would like to recognize Dr. Hiram Gay, Dr. Lauren Henke, both radiation oncologists, Dr. Sasa Mutic, director of Medical Physics, Maria Ruiz, MD candidate, from University of Chicago Pritzker School of Medicine, and all this steam led by Dr. Jacaranda van Rheenen, manager of the Global Health Center. Together we are stronger and better and I look forward to seeing the solutions to continue safe patient treatment.

Deserted streets in Guatemala City after the curfew was announced on March 23. There are only stops by Municipal Police. Free Press Photo: Óscar Rivas