build their infrastructure more efficiently and to adopt new
technologies more rapidly. This experience pushed us to
recommend a hospital-based assessment of needs combined
with "out of the box" ideas to fund and incorporate the
solutions. Although the non-conventional way of answering
the needs of a hospital, beyond the available governmental
role, is seductive, it should nevertheless be well controlled
by legislation and be evidence-based. l
Dr Amr Shafik Saad, MD is a lecturer in clinical oncology, Faculty
of Medicine, Ain Shams University. He is also a visiting lecturer
in clinical pharmacy at multiple universities. He undertook part
of his training at the H Lee Moffitt Cancer Center, USF-USA. He
is currently the Director of Ain Shams University Chemotherapy
Unit.
Dr Abdalla Abo Taleb, MD is a World Health Organization
expert. He is also a consultant on health economics at the
Egyptian Ministry of Health, as well as a member of the
Egyptian health care reforming committee Ispor (member, judge
and reviewer).
Dr Khaled Kamal, MSc is an assistant lecturer in clinical
oncology at the Faculty of medicine, Ain Shams University,
where he is responsible for electronic medical records. He is also
the Ain Shams University clinical oncology conference
coordinator.
REGIONAL INITIATIVES
CANCER CONTROL 2015 123
linear accelerator and a cobalt machine. The linear
accelerator treats approximately 80 patients per day, which
is a large number for a single machine. Whenever there is a
technical malfunction, maintenance is slow, partially due to
time taken to import spare parts. These delays have a major
impact on cancer patients survival and disease control. The
cobalt machine has limited indications now and cannot be
used in the majority of patients.
Solution: Many hospitals are able to improve their
infrastructure through grants and donations from big
corporates. In our department, we increased our
radiotherapy armamentarium through the acquisition of a
new Linear accelerator with improved technology and
capabilities in comparison to previous machines. The funding
for this project was donated by one of the biggest banks in
Egypt, through their corporate social responsibility
department. These kinds of opportunities are not usually
well exploited by hospital policy-makers. An important clue
for these types of projects to work, is to let the funding body
be responsible of the delivery and installation process, thus
neutralizing the hindering effect of a centralized
bureaucratic process.
Conclusion
These examples of decentralized initiatives allow facilities to
properly evaluate their customized needs, to develop and
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