Irene Nzamu: The doctor giving child cancer patients a fighting chance

A paediatric haematologist oncologist is a highly specialised doctor who diagnoses and treats children with blood diseases (haematology) and cancer (oncology).

We treat diseases such as leukemia, solid tumours, sickle cell disease, haemophilia (bleeding disorder), immune thrombocytopenia, blood clots, and all types of anaemias in children.

There are only 16 paediatric haematologist oncologists in Kenya. How does that make you feel to be part of such a small community?

It is truly a humbling. It is a profound calling to care for children battling cancer and blood diseases. I have been working in this field for 10 years now.

Why majority of us are women? I believe it is because this field requires a deep reservoir of soft skills that women often excel in: immense compassion, a nurturing spirit, and innate capacity for caregiving. These qualities are essential to providing not just medical treatment, but holistic healing and support for both the child and their family.

What first drew you to paediatric haematology and oncology

During my medical studies at the University of Nairobi, I volunteered in the children's cancer ward at Kenyatta National Hospital.

My time was spent singing with them, grooming them, and playing alongside them. Through those interactions, my heart truly warmed to these little angels.

I was deeply moved by how these young children fought cancer with such immense courage and strength, often seeming blissfully unaware of the severity of their condition. I realised these children needed far more than bonding and companionship—they needed dedicated, compassionate medical care.

What kind of training is required to become a specialist in this field?

It is a long and rigorous process. It begins with an undergraduate degree in medicine and surgery. After completing this and your internship, you then pursue a postgraduate Master of Medicine degree in Paediatrics and Child Health, which typically takes three to four years. During this residency, you complete rotations in various paediatric subspecialties, including paediatric haematology and oncology.

Once you are a qualified paediatrician, the next step is to undertake a dedicated fellowship in paediatric haematology oncology. This advanced training lasts two to three years and is crucial to gain deep, specialised knowledge solely in childhood cancers and blood disorders.

After the fellowship, you are certified as a paediatric haematologist oncologist. However, the learning never truly ends. To stay current with the rapid advancements in the field, you must continuously engage in professional development through specialised short courses, conferences, and research throughout your career.

Beyond medical expertise, which skills are most critical in your line of work?

First, you need immense patience. You often find yourself explaining complex information repeatedly to families under great stress, and this requires a calm, enduring presence.

Second, resilience is essential. The emotional weight of caring for seriously ill children and supporting their families is profound, and the ability to process difficulty and move forward is vital.

Third, you must possess strong communication skills. Conveying a cancer diagnosis, discussing complex treatment options, and providing support throughout a family's journey requires clarity, honesty, and profound sensitivity.

Above all, the most critical skill is compassion. Without a genuine capacity for empathy it is impossible to thrive in this field.

Which children typically need to see a specialist like you?

We see children who are suspected of having either cancer or a blood disorder. This includes both confirmed cases and those where a diagnosis is still suspected but not yet verified.

For the suspected cases, our role is to conduct a thorough investigation—through various tests—to reach a definitive diagnosis. Once we have a clear picture and confirmation of the condition, we begin the appropriate treatment plan.

What's the most memorable case you handled?

I will never forget this two-year-old girl who came to us with stage four neuroblastoma—an aggressive cancer that had spread throughout her tiny body. When she arrived, she was critically ill and nearly died on three separate occasions. Her treatment was intensely rigorous, filled with moments that tested our hope.

Yet, against all odds, she survived. Today, she is a healthy, bright seven-year-old who comes for annual reviews. Seeing her thriving in school fills my heart with profound joy and reaffirms my purpose.

Her journey is a powerful reminder that even the most severe cases can have hopeful outcomes. She embodies the reason I never give up—every child deserves a fighting chance.

What are the most significant challenges you face working in a resource-limited setting?

First, the high cost of treatments. Many parents struggle to afford the necessary drugs and tests, often having to purchase out-of-stock medications themselves.

Second, late diagnosis. This is the most painful challenge, as children often arrive when the cancer has advanced too far, leaving us with limited options, often only palliative care.

Third, treatment abandonment. Many families begin treatment but cannot finish due to reasons like long distances and a lack of money for transport.

Fourth, cultural beliefs and myths. These often disrupt care, as families are sometimes advised to seek solutions elsewhere, leading them to abandon effective medical treatment.

Fifth, stigma. A cancer diagnosis can lead to isolation and a desire to hide the illness, preventing families from continuing care.

Finally, a lack of specialised equipment and procedures. For example, many children with leukemia need a bone marrow transplant for a cure, but this is not available here.

Families must fundraise for treatment abroad. If our government made these resources available locally, it would transform outcomes for our children.

What aspect of your work gives you sleepless nights?

An avoidable death of one of my children. "Avoidable" means when a patient dies and you feel we failed that child. You think, if this child had come earlier, or if we had diagnosed them at stage one or two, they would have survived. It's also the system issues—like a specific drug not being available—that haunt you.

It pains me that children who need a bone marrow transplant simply die because of poverty. You are left with the feeling that they could have survived if you had the equipment or facilities to offer that care.

As a country, we need to establish centres of excellence to perform procedures like bone marrow transplants. There is a lot of effort and resources directed toward adult cancers, like breast, cervix and prostate cancer, but people forget about children. This is a call to action for the government to fast-track the establishment of a paediatric bone marrow transplant centre.

Your message of hope for parents and families with a child battling cancer?

Most childhood cancers are treatable; it is not the death sentence people often say it is. We have had many children who have been treated successfully and have survived. Early diagnosis is key.

This work is immensely emotionally draining. What keeps you going?

First, it is the resilience of the children. The courage they have to fight cancer at such a young age is incredible. You look at how they fight, their hopefulness, and you think, if they are not giving up, why should I? I cannot afford to fail them.

Second, it is my faith in God. This is a God-given calling. Every morning, I wake up knowing God sent me to care for these children.

I have learned to accept what is God's to handle and what is mine, so I don't struggle with trying to do the impossible.
Finally, I have my ways to debrief. I love to sing and journalling when my heart feels heavy.

What advice would you give to a young medical student who wants to be a paediatric haematology oncologist?

Go for it! I strongly encourage more academically gifted young people to pursue this path. We have many children in need and too few specialists.

To make it, you must work hard to achieve academic excellence and master the scientific foundations of medicine.
Second, and just as importantly, you must have the heart for this work.

The field requires soft, human skills—a genuine capacity to care for children with cancer. This means having the compassion to go beyond your job description, to empathise with these children and their families. It is a specialty that demands both your mind and your heart.

How do you balance your demanding life as a mother and a paediatric haematology oncologist?

I have learned to balance these demanding roles by consciously prioritising and being fully present in every moment.

When I am at the hospital, I give my complete attention to my patients and their families. When I am at home, I dedicate myself wholly to my family.

I strongly believe in the power of quality time over quantity. It’s not about the number of hours spent, but the depth of connection and focus brought to each role that truly matters. This mindful approach allows me to fulfill both my professional calling and my deepest personal joys.

For a parent just starting this journey, you need to know that you are not alone. We walk this path together. You have your part to play, we have ours, and your child has theirs. Do not begin by giving up. We must keep fighting, knowing that it is curable, and we will fight together to achieve a cure.

Parents, please give your child a fighting chance. You never know—that child could survive, just like the little girl I mentioned earlier who almost died three times and is now happy and back in school. Let's bring the children for treatment.

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