At the annual conference of the International Society of Paediatric Oncology (SIOP) in Lyon, France, in October 2019, I was honored to receive the Nursing Lifetime Achievement award. It is difficult to express the depth of my gratitude to all the nurses across the globe who have made me a better nurse, taught me how to do much with so little (since 2003, I have worked only in low- and middle-income countries), and expanded my understanding of the strength and resiliency of nurses, families, and children/adolescents with cancer everywhere. In the earliest days of international pediatric oncology collaborations, nursing was invisible. Only by showing up and insisting that without nurses, no young patient with cancer could be successfully treated, and those nurses needed pediatric oncology nursing knowledge and skills, were we (early nursing colleagues—all volunteers) able to engage with the “twinning” pediatric oncology programs between high-income and lower-income countries around the world.
I came late to nursing as a second career after being a teacher in 1991. I had been a freelance research assistant for one year and then Educational Liaison for children/adolescents with cancer at the University of California San Francisco (UCSF) for 10 years. I was asked to attend the first pediatric oncology conference in Guatemala in 1995 coordinated by my UCSF colleague, Sandra Luna-Fineman (a pediatric oncologist originally from Guatemala), to help translate into Spanish for the nursing presentations. That experience motivated us to start a tiny foundation called “A Tomorrow for Children,” to support pediatric oncology units, first in Guatemala and then across Latin America. As time passed, we supported volunteer Spanish-speaking US pediatric oncology nurses in collaboration with the first dedicated pediatric oncology hospital (Unidad Nacional de Oncología Pediátrica, or UNOP) in Guatemala City, and then local nurses and others caring for children with cancer throughout Latin America. A nurse from UNOP attended the APHON conference twice and a nurse from Nicaragua, to share their local experiences via posters.
In 2004, I moved to the Netherlands and was asked to participate in a new project to support children with cancer at the Tikur Anbessa (Black Lion) Hospital in Addis Ababa, Ethiopia. The Aslan Project, based in Washington, DC, continues this collaboration today with a fellowship program and nursing and family support, and a new unit in the city of Jimma in the southwest. In 2016, I was privileged to participate in the WHO/SIOP/Aslan workshop in Jimma. In particular, I have coordinated African nurses’ participation in a pediatric oncology nursing training program in Karachi, Pakistan, at the Indus Hospital, led by Rehana Punjwani, who received an APHON scholarship to attend the annual conference in Savannah, Georgia, in 2018.
In 2014, as Chair of the APHON International Task Force (now the APHON Global Outreach Committee), I worked with members of our team to create the Spanish-language APHON Chemotherapy/Biotherapy Course (and instructor course). The course has now been taught seven times in four countries (Chile, Argentina, Mexico [2 sites], and the US). It is amazing to see the enthusiasm for this course for which demand always exceeds the available seats.
In 2017, I began a collaboration with a pediatric oncology unit in Delhi, India, at Rajiv Gandhi Cancer Institute. Together with my US adult oncology nursing colleague Annette Galassi, we helped create a nursing leadership and specialized education program as well as competency checklists and SOPs to address clinical care and nursing turnover. One nurse from this unit was awarded an APHON Scholarship in 2018 to attend the annual conference but was unable to secure a visa.
My many international experiences teaching and collaborating have included APHON members from across the US who have generously donated their time and expertise to support our fellow nurses in low- and middle-income countries. The APHON “Essentials of Pediatric Hematology/Oncology Nursing: A Core Curriculum,” 4th Edition (2014), is my “bible,” and I share it with all nurses in settings where I work to start writing their own teaching material using top-notch nursing information.
I am very grateful to APHON for providing a space for me to network and learn and for having the vision to allow us to create the Spanish Chemotherapy/Biotherapy Provider and Instructor courses to reach out to our Latin American colleagues. If I have learned anything, it is that we as nurses do not work alone or in isolation; we need our fellow nurses at home and abroad to teach us how to be the best caregivers we can be. I thank all nurses whom I have known who have done this for me, and allowed me to be recognized as a nursing leader. I am humbled by the power of nurses to make a positive difference in the lives of children/adolescents with cancer everywhere.