The story of the world largest childhood cancer center and its founder Dr Sherif Abouelnaga, by Ahmed Kamal Bayoumi

By Ahmed Kamal Bayoumi, SIOP member , Senior clinical specialist, CCHE 57357 Egypt

Dr Abouelnaga has always led the change for upgrading the standards of healthcare provision since his graduation from medical school in 1984, and then faculty appointment at the National Cancer Institute (NCI) in Cairo, Egypt. He advocated for healthcare management regarding it as the key to minimize the waste in resources, and increasing the efficiency of the system. He believed that, scientific based healthcare management is the salvation for the overburdened healthcare systems in developing countries as Egypt.
He’s considered the father of healthcare philanthropy, as he raised more than 9 billion EGP to fund and support numerous projects over the last 30 years.

Starting on 1985, during his early career as an intern at Cairo university teaching hospitals, he established 2 intensive care units (Surgical and Burn unit) and a complete reform of the Blood Bank. He also advocated for the first blood donation program in Egypt.
In 1986, Dr Abouelnaga organized the 1st philanthropic fundraising campaign to increase the capacity, of the pediatric oncology department at the NCI by 10-fold, reaching to 120 beds by 1994, not only that but also, he established the pediatric oncology out-patient clinics. In 1993, he introduced the concept of clinical pharmacy to the Egyptian Healthcare system, and became the first professor to establish a clinical pharmacy unit in the NCI.

Dr Abouelnaga was inspired with the St. Jude Children’s Research Hospital in USA, he began to analyze, and study all the factors related to its success, and how such a model could be reproduced in an over populated and financially burdened community, as Egypt.
In 1998 he founded the Association of Friends of the National Cancer Institute, which later became Association of Friends of the National Cancer Free Initiative (AFNCI), it was initially intended to establish Children’s Cancer Hospital Egypt 57357 (CCHE 57357); however, with the continued analysis of the socio-economic factors of the community, he decided that AFNCI would acquire a broader scope. The AFNCI adopted a more comprehensive approach; setting the 3 axes for human development designated as the “Cancer of Poverty, Cancer of Ignorance, and Cancer of Health”. The projects varied between infrastructural development, education, and healthcare provision to the less privileged regions in Egypt.

CCHE 57357 opened its doors in 2007, it was constructed initially to sustain 180 in-patient beds, and receiving 405 patients. Over the years under his lead, CCHE 57357 continued to accommodate more patients, and expand its resources, reaching in 2020 to receive 3356. patients, sustaining 380 beds accounting for more than 60% of the pediatric cancer patients of Egypt, and becoming the world’s largest comprehensive cancer center for children in terms of capacity; not only that but also, acquiring cutting edge technology in managing childhood cancer such as the Cyclotron, Cyber-Knife, and Proton therapy under one roof.
Since its inception CCHE 57357 received 23,595 patients. This however did not compensate for the technological gap between the Western hemisphere and Egypt; hence Dr Abouelnaga established other supporting entities to facilitate, and sustain the transfer of knowledge. This gave rise to Egypt Cancer Network (ECN) USA in 2011, and Canada in 2015. Through these entities programs were targeted, and then customized to fit the Egyptian healthcare system, also they supervised the introduction of technological advancement in both healthcare provision, and research.

In CCHE 57357 Dr.Abouelnaga established the Education & Development Department, through them he reached out, initiating collaboration to develop unique programs for research, education, and professional development. He adopted the transformative learning philosophy to bring about the needed change for enhancing the quality of healthcare provision. Under his directions programs and strategies were implemented in Egypt, such as the Oncology Fellowship program developed in collaboration with Dana-Farber Boston Children (DFBC) Cancer Center, the International Pharmacy Practice Residency program in collaboration with American Association of Health System Pharmacists (ASHP); and introduced the Pharm-D program to the Egyptian Healthcare system, conducting it in collaboration with University of Colorado, USA. Coping with the online era, CCHE 57357 developed a strong online learning platform in Egypt, for continuous professional development, for the staff members, and healthcare professionals from all over the region; not only that but also, currently constructing the 1st medical simulation center in Egypt, to embed regular, timely, ‘life like’, simulation-based rehearsal opportunities for staff, patients and families.
As Dr. Abouelnaga promoted education, he simultaneously promoted research. He believed it to be an investment in giving hope to those children that have very little of it. He led CCHE 57357 to become one of the most prominent institutions in Egypt combining specialized clinical care with respective dedicated research programs. Six fully equipped laboratories were established with different specializations ranging from tumor biology, genomics, proteomics, and metabolomics to cover the multifaceted challenges in cancer investigations; this along with core technological platforms with diverse applications that serve as a regional/national kernel of technology and expertise. With these infrastructural settings, and a dedicated mindset, Dr Abouelnaga succeeded to attract, and retain the internationally renowned Egyptian scientists from abroad, so that their country would benefit from their knowledge, and experience. Over the years CCHE 57357 has produced over 260 scientific publications in international, peer-reviewed journals.

At this point Dr Abouelnaga started to reach out to all entities in the Middle East, and the African Continent to share, and spread the knowledge, aiming for the benefit of all the developing countries with overburdened healthcare systems. In 2012 with the support and endorsement of the Egyptian Ministry of Foreign Affairs (MFA), he received African Ambassadors from various African Countries to introduce the concept of collaboration. The “Work together sharing talents, vision, and supporting each other in education and health” initiative through implementing, and supporting numerous projects in host countries, as well as receiving their professionals to develop their skills for the transfer of knowledge to their countries.

In 2015 a delegation from 57357 visited Kenya and Ethiopia with the support of MFA, and Egyptian Coptic Mission; the delegation was able to visit numerous key hospitals. CCHE 57357 provided training opportunities, fellowship opportunities, and treatment of patients in CCHE 57357. This resulted to a fellow from Kenya was enrolled in the Oncology Fellowship program, and upon her graduation she returned to apply what she learned in CCHE 57357; today she is the assistant to the Minister of Health of Kenya. Also, a fellow from Ethiopia was enrolled in the same program, and now is a prominent Pediatric Oncology Consultant, and the Head of the Pediatric Oncology Department in Ethiopia.

In 2015 a delegation of clinical pharmacists from Black Lion Hospital, the primary teaching hospital for Addis Ababa University, headed by the Dean of the School of Pharmacy, visited CCHE 57357. In response to their request a delegation visited Black Lion Hospital and conducted a full needs assessment for the clinical pharmacy division. In the same year, a delegation of St. Paul Millennium Hospital visited CCHE 57357, where they expressed interest in cooperation in the fields of pharmacy, quality assurance, fundraising, and human resource planning.
In 2016 H.E. the Minister of Foreign Affairs has invited Dr.Abouelnaga to participate in the Pan African Economic Forum as a keynote speaker in the forum, stating the partnerships between 57357 and EAPD, providing training initiatives and treatment for African children in Cairo.

Over the following years CCHE 57357 received, and trained more than 600 healthcare professionals from various African countries, to develop their skills, and transfer the knowledge to their respective countries.
Currently CCHE 57357 is collaborating with Sudanese officials to replicate the CCHE 57357 model which will be Hospital 7979 in Sudan, and is currently under construction; not only that but also, negotiations are active with Congo, to determine the best means of support for their needs.

As Dr Abouelnaga conducted these activities for the African neighbors, he also reached out to Arab, and Middle East Brother Nations to spread the knowledge and expertise.

Dr Abouelnaga always looks for the silver lining in every cloud, believing that everything could be exploited for the betterhood of humanity, and development. During the COVID-19 global crisis, he established a COVID-19 clinic where more than 5500 suspected patients (children and employee) were screened. He also established a COVID in-patient unit in an isolated building away from the main campus, to protect our children from suspected patients. The COVID clinic was open to the public providing its services to the entire community, allowing for accessible healthcare. Patients hospitalized were managed with a multidisciplinary team including pediatric oncologist, pulmonologist, clinical pharmacists and intensivists. On the other hand, Dr Abouelnaga engaged CCHE in the research marathon for the COVID; CCHE 57357 was the 1st institute in Egypt to perform the genetic sequencing analysis in order to identify the mutation of the virus during PHASE I, and PHASE II of the COVID pandemic in Egypt. Also, he directed towards sharing the latest information about COVID-19 for Healthcare professionals, and Public via a webinar series to discuss the symptoms, risks, precautions and management regarding the ongoing pandemic.