Addressing cancer disparities in the border region: A NOVEL MODEL of “twinning” in pediatric oncology

Background: Health institutions located along the borders of countries with profound economic disparities often face difficulties in providing care for children with cancer. Until recently, many children with cancer from Baja California went untreated. We postulated that the St. Jude Children's Research Hospital (SJCRH) “twinning” model used to improve pediatric cancer care in low-income countries could successfully be applied in this particular setting.

Objectives: In 2008, Rady Children's Hospital San Diego (RCHSD) in partnership with SJCRH and Hospital General-Tijuana (HGT), the largest hospital in northwestern Mexico, initiated an outreach project to establish a pediatric oncology unit in a culturally sensitive manner and adapted to the local health care system.

Methods: The initial assessment revealed that, although the basic hospital infrastructure was in place, the essential elements of a pediatric cancer unit including, dedicated space, trained physicians and nurses and uniform treatment were lacking. A 5-year plan was designed to provide salary supplementation for staff, intensive education and training, and infrastructure improvement.

Results: After 4.5 years, accomplishments include: the opening of a new inpatient unit with updated technology, the training of healthcare providers, and the establishment of a dedicated inter-disciplinary team. Over 200 patients have benefited from accurate diagnosis and treatment and from psychosocial and nutritional support programs.

Conclusion: Border towns have a high need for the development of programs to address health disparities. Initiatives in the border region are highly effective, since the proximity permits close follow-up and leads to establishment of programs in record time, benefiting hundreds of children.