Kate Westmoreland crouched in the dirt of a courtyard at the Malawi hospital. Under the shade of a tree, a mother was holding her son. He was thin, too weak to hold his head up, and had an obvious abdominal tumor. Working through a translator, Westmoreland spoke to the woman and eventually diagnosed the young boy with Burkitt lymphoma, a cancer that’s common and can be deadly in sub-Saharan Africa. Westmoreland soon began treating him with chemotherapy, as well as for malnourishment, an all too common condition in her pediatric patients. In fact, the majority of her patients in Malawi presented to the hospital moderately to severely malnourished.
“In Malawi, we routinely saw baseline malnutrition, and then children would have cancer on top of that,” she said.
Westmoreland fed the boy nutritional supplements and a formula provided by the World Health Organization (WHO). She also treated him for tuberculosis, a disease caused by a bacterial infection that can lead to weight loss. The disease has been on the decline in the United States since 1992, but it’s still one of the top 10 causes of death worldwide, according to the WHO. The treatment combination led to weight gain, Westmoreland said, which allowed the boy to continue his cancer treatment.
“This child was really, really sick when he came to the hospital. We thought we were going to lose him several times,” she said. “I didn’t even recognize him the next time I saw him. It was great to see him gain weight, smile and be more interactive.”
Westmoreland is on a mission to improve survival for children in sub-Saharan Africa who have cancer, a dream she’s had since childhood. She was able to work toward that goal with the Malawi Cancer Consortium, a partnership between the University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center, the Institute for Global Health and Infectious Disease, the Malawi Ministry of Health, the University of Malawi College of Medicine and others.
With improvements in the management of infectious diseases in sub-Saharan Africa, treatment for chronic and non-communicable diseases like cancer has gained traction. An estimated 84 percent of children with cancer in the world today live in low-and-middle-income countries, according to a report published in The Lancet in 2013.
“Working in Malawi is my passion, and I believe this is what I was meant to do with my career,” Westmoreland said.