THERE is no air-conditioning to cut through the dense Ghanaian heat that rolls through the open windows and across the cots crammed into the gloomy paediatric ward.
Children are examined in full view, with not even curtains for privacy, and in the corridors their parents wait for prescriptions they cannot afford to fill.
The scene at Korle Bu Hospital is not one which 17-year-old Isla Leslie, a Scottish scho
olgirl volunteering there, could easily reconcile with a children's cancer unit. And she knows all too well what one should look like.
Since discovering a lump on her neck three years ago, she has been a regular visitor to the Sick Children's Hospital in Edinburgh, with its games, televisions and toys.
Her battle against Hodgkin's lymphoma has inspired her to study medicine – and her plan is to go into paediatric oncology overseas. Ms Leslie has a conditional place at Oxford University and she and her best friend, Belle Boyle, spent New Year at Korle Bu in the city of Accra.
She said: "The hospitals are pretty grim, but they're fine really. The parents are really cheery and the staff are amazing.
But it's quite a different world from the Sick Kids."
Healthcare funding in Ghana is a huge problem, to the extent that some children have to stay in hospital, even if they are well enough to leave, as their parents cannot pay for their treatment.
Resources are strained, and although hospitals are clean and well-staffed with talented medics, even basics such as anaesthetic cream are difficult to source. Before the pupils at George Watson's in Edinburgh travelled to Ghana, they raised £800 to help out.
The day after she returned, Ms Leslie went to the Sick Kids, where she still has regular checkups with her consultant, Dr Hamish Wallace.
She said: "I noticed all the small things – there's a waiting room, wards and lots of toys."
Ms Leslie, who was speaking just before The Scotsman launches a special three-part series on the changing face of cancer, first met Dr Wallace when she was 14, after tests revealed that the swelling on her neck was cancerous. She had woken up in her home near West Calder, West Lothian, with the growth one morning in the winter of her third year at school.
Ms Leslie said she always suspected the eventual diagnosis. Dr Wallace talked directly to her, rather than her parents Andrew and Mariot – something that as a teenager she appreciated.
She said: "I was quite interested and wanted to know. After that, I definitely wanted to do medicine. I wanted to know what was going on.
"(The doctors] said it was quite common as a teenage cancer and very curable. They just laid it out as six months of treatment and that was it, so I didn't see it as a life-threatening illness – just six months of a rubbish time."
Her treatment consisted of monthly cycles of two types of chemotherapy, and although the side-effects became progressively worse, they were not as bad as expected. Initially, Ms Leslie was able to go to school, with just a few days off for hospital visits.
"You can look at yourself and not feel you have cancer," she said.
"You feel fine. It's quite hard to make yourself think you have cancer, especially as a teenager – it's only old people who get it."
However, towards the end of the treatment, the drugs began to take their toll. She spent three months away from school with exhaustion.
Ms Leslie explained: "I was happier just to sink into myself in a way. Chemo makes you bloated and chubby, because you're on steroids, and it makes your self-confidence pretty low."
At the end of the treatment, Ms Leslie had an ultrasound in Edinburgh, followed by a Pet scan in Aberdeen, both of which came back negative. There was never a definitive moment she was prepared for which would give her the all-clear or otherwise, and she still has to go for regular check ups, but she has effectively beaten cancer.
She said: "There's always the worry it'll come back, but if it happens, it happens. I'm not going to live my life worrying."
Scots expert leads drive to lessen risk of infertility for youngsters having treatmentSCOTLAND'S leading child cancer doctor is spearheading a new European study to radically overhaul treatment for a strain of the disease to prevent patients becoming infertile.
Hodgkin's lymphoma is now largely curable, but the harsh drugs used mean patients could be unable to have children in later life and may go on to develop a second cancer.
Now Dr Hamish Wallace, who is based in Edinburgh, is leading a team of specialists from across Europe to change the treatment in a bid to avoid the devastating side-effects.
He said: "We are working very closely with colleagues in Europe, particularly Germany, to develop a protocol which is going to cure as many, if not more, patients."
The project will begin this year and, taking in 400 children a year, will be the largest Hodgkin's lymphoma study in the world.
At the moment, patients receive Procarbazine, an oral chemotherapy drug which can cause infertility, then large dozes of radiotherapy, which can cause another cancer years later.
In the study, some participants will get two cycles of chemotherapy using a different drug.
They will then receive a Pet scan and, if this is negative, avoid radiotherapy. Their progress will be monitored for the rest of their lives.
If they do need follow-up treatment, they will get a drug called Dacarbazine instead of Procarbazine.
About eight children a year will be from Scotland, and Dr Wallace said that he was "determined to make sure all young people with Hodgkin's get into this study".
The full article contains 977 words and appears in The Scotsman newspaper.
