The Pioneers

Dr. Bogale Solomon

Dr. Bogale Solomon, Consultant Internist and Clinical Oncologist at radiotherapy unit, TASH, CHS, AAU

Graduated from Gonder University, Dr Bogale Solomon started his career in oncology by “mere chance”. He later joined university of Cairo and completed his training in 1992. He contributed tirelessly towards the realization of the TASH RT center establishment. Lack of skilled man power and paucity of resources were the major challenges he faced back then. He describes his happiest moment to be “what always made me happy was the first patient who was treated for  nasopharyngeal cancer, who lived over 15 years and died of non-oncology related conditions” while he states his saddest moments to be witnessing patients perish while waiting radiotherapy . He retired in 2013 and currently continues his private practice which is based in Addis Ababa.
His advice to young physicians in the field is

…to stay honest to their patients.

Dr. Johan Tausjo

Born in Haugesund, Norway, Johan Tausjo came to Ethiopia when he was 5 years old to live in Nekemte and then Yirga Alem before moving to AddisAbaba and Debrde Zeit to go to School along his missionary families.

Dr Johan Tausjo

Moreover, his growth more like “average typical Ethiopian child” playing football, swimed in Gidabo River with his Ethiopian fellow children and speaking Amharic fluently increased Johan’s passion to our country.  His inspiration to be a physician was partly because of his father who is also a doctor, but his endeavor into Oncology was “more complicated” as he described. Though started a Residency in Surgery, during the second year he was offered a fellowship of one year in Oncology and subsequently switched residency to that specialty training at the University of Wisconsin in Madison (USA) until 1976, and was certified in Norway also the next year. Dr Johan stated that the field was relatively new back then even in Europe, but there were some exciting breakthroughs in the management for Hodgkin’s disease, lymphomas, the development of LINACs and various groups of Chemotherapeutics. The number of Oncologists in Norway when he started was less than 30, now the figure pushed to 300.

Dr Johan Tausjo had immense contribution  to the initiation of the oncology training in Ethiopia. When asked how this all started and what motivated him,  he replied “in 2007, during a private visit to Addis with my wife, she insisted that I should find out whether there was any oncology center there. We finally found it at Tikur Anbessa and met Dr. Bogale. He told us the decision of the government to expand cancer care, and in particular the need to train professionals locally. I brought this idea back to my institution (Oslo University) where it was well received. Then we developed a curriculum, signed an MOU in 2010, and planned on how to involve the various specialists from Oslo in the teaching process. This was during my transition to retirement, and that meant I could devote more time and effort in support of the program. The work has also afforded me a unique opportunity to reconnect with the country I grew up in and its wonderful people”.

Dr Johan thinks that opening session with the first batch of Residents and officials from both government and academia stand out as a very significant moment for Oncology in Ethiopia and milestone in the establishment of the oncology training (picture below).

during start up of Clinical Oncology residence program, Dr. Ahimed Reja (CED, CHS AAU), Dr. Mathewos Assefa, Helle Aanesen, Dr. Abiyu Legesse, Dr. Kibrom Hiluf, Dr. Edom Seife, Dr. Kebede Worku ( FMOH State Minister), Dr. Munir Awol, Dr. Abraham Adamu, Dr. Abdu Adem, Dr. Johan Tausjo, Dr. Kjell Magne Tveit

Dr Johan described the day the first batch graduated and the number of Oncologists in Ethiopia increased from 3 to 8 as one of his happiest moments. Nevertheless, to experience the bureaucracy and difficulties in getting things done, witnessing that simple maintenance and hygiene is difficult to implement systematically here in Addis at times were frustrating for him. Moreover, Dr Johan mentioned the following challenges in establishing the oncology training in Ethiopia:

  • Securing financing and getting the right people at the right time to come and teach
  • The influx of Residents in this relatively small department with limited resources
  • The fact that most things in Ethiopia take more time than anticipated has caused problems for the long-term planning of the Norwegian colleges
Dr Johan Tausjo at his home in Norway using Ethiopian traditional music instrument

Dr Johan’s advice to the young oncologists is “to establish the standards and values of Oncology in all of Ethiopia and beyond, become leaders in their fields and to establish good working relationships within themselves and with other specialties and to do their work to the highest scientific and ethical goals”.

On behalf of ESHO, we want to extend our respect and great thanks for his relentless effort. Based on this, we want to call him

a lifelong selfless man beyond territory” and an “impassioned philanthropist”, to say the least.

Dr Amha GebreMedhin

Dr Amha one of the earliest clinical hematologists, has a prolific career which spans from obtaining his undergraduate doctoral degree in Medicine from the Semmelweis Medical University in 1984 Budapest, Hungary, to completing his residency in internal medicine at Addis Ababa University, and later on fellowship training in clinical hematology at McGill University, in Montreal, Quebec, Canada in 1993. After his return, he once again joined the

Dr. Amha Gebremedhin, Associate Professor of Medicine, Consultant Internist and the first Clinical Hematologist, TASH, CHS, AAU

Department of Internal Medicine and the Hematology/Oncology unit, where he still practices hematology.

He has authored and co-authored numerous articles and peer review publications and has served his nation and institution at several appointments.  He has been also involved in the training of medical students, residents and fellows.

Back in 1993, when the hematology/oncology unit at TASH was the only center in the country that provided specialty care for patients with hematological and oncological malignancies in its once per week follow-up clinic, Dr Amha had the chance to manage patients with solid neoplasms such as breast, ovarian, gastrointestinal, testicular and head and neoplasms in addition to hematological malignancies. During those times, treatment of neoplasms was far from optimal. For example, it was impossible to treat a patient with lymphoma with a standard regimen, because one or two components of the regimen may not be available in the hospital and in the market at large. This problems had tremendous effects not only on treatment outcome of patients but on conducting research as well. Dr Amha also described the inadequate availability of blood products as a depressing and frustrating experience particularly when dealing with patients with acute leukemia in his early practice.

Subsequently, through his relentless effort and communication he gained the support of a Jewish American committee in 1999, a philanthropic organization which provided supplies of chemotherapy which marked the institutional success in introduction of first “optimal” treatment for treating Hodgkin’s lymphoma at that time.

In collaboration with the max foundation and Novartis he also established Glivec International Patient Assistant Program(GIPAP) in 2004 which provides Glivec for patients with CML which have subsequently led to a dramatic improvement in survival and quality of life of patients. To date there more than 1300 patients benefiting from the program.

Because of the increasing number of patients with benign and malignant conditions, currently there are 4 hematology clinics per week.

He states
“cancer care in our country has never been optimal and is still suboptimal to say the least. I don’t believe that the country has significant resource constraints for this purpose. It is probably related to the fact that cancer is not considered as a priority non-communicable disease.
Hence, the government and concerned stakeholders should do more to improve cancer care in our country. In addition to allocation of funds for the proper diagnosis and treatment of cancer; equally, training of hemato-oncologist and pathologists knowledgeable in the diagnosis and treatment of cancer is of paramount importance.”

In conclusion, government policy on non-communicable diseases (NCD) such as Cancer has changed and is changing rapidly. Therefore, strategies for cancer care financing, laws and commitment of funds may improve in the foreseeable future in our country. We have to start country-wide cancer registry as soon as possible similar to our neighboring countries.

Dr. Abubeker Bedri

Abubaker Bedri is a pediatrician who has worked in pediatrics and child health since 1986 and pediatric hematology and oncology after having attachment abroad in the field in 1988/89.

Dr. Abubeker Bedri Pediatrician, the first Pediatrichematooncologist

He started to provide oncology care in Tikur Anbessa Hospital in pediatric Department (1990 up to 2006) with the staff of the hospital as a team establishing a follow up clinic and a dedicated room in the seventh floor ward for children who receive chemotherapy. There were a number of challenges related to diagnostics and availability of drugs. The lab and pathology departments were not able to provide basic services. The support of blood products was suboptimal. Chemotherapy drugs had to be bought by clients from outside pharmacy and at times parents will import from abroad in particular India. The biggest challenge was treating infection in children with malignant disease on chemotherapy due to lack of diagnosis and availability of appropriate antimicrobials. Lack of linear accelerator in radiotherapy unit has hampered this modality of management for children. Comparing cancer care with other countries, first of all there was no tumor registry. Cancer care is far advanced with the development of immunology, in particular monoclonal antibodies and both for stratification and targeted treatment which is not available in Ethiopia.

The impact of cancer on the child and family can’t be underestimated. At times family becomes poor after selling all their belongings in the hope of saving the life of a child. It is difficult for the care giver to discuss prognosis taking cultural background in context. Whatever the outcome is going to be, I believe in giving tender love and care at all times. The government of Ethiopia’s focus on prevention of cancer and also establishing cancer centers in different parts of the country is to be commended highly but this requires support from the community and NGOs.

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