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IU Simon Cancer Center director helps establish sustainable oncology health care system in Kenya

Feb. 10, 2016

More than a decade ago, Dr. Patrick Loehrer Sr. traveled to Kenya. He returned with a dream.

Although more developed than other African nations, Kenya was by no means immune to the challenges of delivering healthcare to those in rural, resource-limited communities. The HIV/AIDS pandemic continues to ravage the country and chronic diseases, such as cancer, are on the rise. Tens of thousands of people still desperately need treatment.

the chandaria center

The Chandaria Centre is named after a Kenyan businessman and philanthropist who helped fund the building. Significant funding also came from the Ruth Lilly Philanthropic Foundation, Pfizer and the IU Simon Cancer Center. | Photo By neil flick

In response to the increasing cancer cases, Loehrer, director of the IU Melvin and Bren Simon Cancer Center, co-founded the Academic Model Providing Access to Healthcare -- or AMPATH -- Oncology Institute in 2009 to help build a sustainable oncology health care system in western Kenya where none previously existed.

Loehrer’s dream, however, did not become fully realized until 2015, when the program's new outpatient clinic in Eldoret, known as the Chandaria Cancer and Chronic Diseases Centre, opened its doors. Prior to its construction, chemotherapy had been conducted in a tent. Now, Kenyans will be treated in a gleaming, state-of-the-art, four-story facility that will be the largest building on the Moi Teaching and Referral Hospital campus. 

The facility is already screening about 1,000 patients per month for breast and cervical cancer, the latter of which is the leading cause of cancer death among all Kenyans. “This will be the first public facility dedicated to treating people with cancer in western Kenya,” Loehrer said. “It will serve a population of 18 million to 20 million.”

The Chandaria Centre is named after a Kenyan businessman and philanthropist who helped fund the building. Significant funding also came from the Ruth Lilly Philanthropic Foundation, Pfizer and the IU Simon Cancer Center.

In addition to cancer treatment, the first floor will have space dedicated to caring for people afflicted by cardiovascular and pulmonary diseases, diabetes and mental illness. There will also be floors for research and education -- key components of the program’s goal of building a sustainable cancer and chronic disease treatment program.

Several other IU personnel played key roles in moving the Chandaria Centre from dream to reality: Dr. Fredrick Chite Asirwa, a Kenyan doctor who completed his residency and oncology fellowship at the IU School of Medicine, is the current co-director of the program's oncology program; Dr. R. Matthew Strother, who also completed his residency and fellowship at IU, is a former team leader with the organization who helped establish the oncology program in Eldoret; and Dr. Robert Einterz, director of the program and the IU Center for Global Health. Einterz is one of the four co-founders of AMPATH as well.

patrick loehrer

Patrick Loehrer sits outside the Chandaria Cancer and Chronic Disease Centre, where residents of western Kenya can now receive comprehensive care. | Photo By neil flick

Einterz’s team has been involved in everything from the design of the building to fundraising and communications. He said the Chandaria facility is not only a beacon of hope for Kenya and Kenyans, but also for people closer to home.

“It is this partnership between Kenyans and North Americans that awakens the power of academic institutions to help the populations we purport to serve,” Einterz said. “Particularly those who are left out. That’s been a problem all along. Cancer has been a problem over there just as long as it has here.”

The Chandaria Centre is fully staffed and operated by Kenyans, including Asirwa, but Loehrer said the facility’s foundations rest firmly on Hoosier values -- literally. Michael Greven, a Columbus, Ind.-based contractor, oversaw construction of the building. Greven and his wife, Liz Nolan-Greven, own an environmentally friendly construction company known as EcoSource, and in August 2012, they, along with their son, Liam, relocated to Eldoret to devote themselves full-time to the construction of the Chandaria Centre.

Loehrer said the example set by the Greven family -- and the entire organization -- is something of which the best and brightest future oncologists will surely take note.

“It really epitomizes what people from Indiana are like,” he said. “We are relatively self-effacing people who are humble, but we want to make a difference. This is about making a difference for a large disadvantaged population on the other side of the world. Millennials are very interested in international work and global health, so what this does, it’s an attraction for people applying here for medical school and residencies. It is something that makes us stand out from many other universities.”

The oncology institute is part of the consortium. Loehrer said the consortium -- whose efforts have been lauded by the National Cancer Institute as a sterling example of cancer care delivery in low-income countries -- is akin to an international space station for global health.

“We have investigators from a variety of different institutions ... all working together in one place,” Loehrer said. “Most global health initiatives are typically one investigator dealing with another investigator, so you have a partnership of two people, rather than the institutional commitment which has been seen here. In some cases, you might have an institutional commitment to one area, but the fact that you have multiple institutions working together to change a health care system for an entire population is something that’s unheard of.”

Echoing Einterz, Loehrer emphasized that the work the consortium has been doing in Kenya will also serve Americans, particularly Hoosiers. He said an IU-led grant, if funded, will examine how community health care workers can be enlisted to help with cancer screenings in low- and middle-income areas around Indianapolis. “This is a lesson learned from Kenya about how we might be able to get more people involved in promoting good health care behaviors over here.”

The Chandaria Centre is also destined to serve as an enduring physical manifestation of the program's mission, which is to lead with care. That means putting the focus on treating people, first and foremost, Loehrer said.

 “When you go to Kenya, it’s a stark reminder of why we became physicians -- and that’s to help other people. Your soul gets rejuvenated. You get reminded about why you’re a doctor,” Loehrer said.

The project aligns with several priorities in the university's Bicentennial Strategic Plan, including improving the state and nation's health and global engagement.

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