Presentation
Background • • • •
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Cancer is one of the leading causes of deaths in Jamaica, accounting for 21% of all deaths in Jamaica in 2010. More than 30% of cancers could be cured if detected early and treated adequately. Cobalt Machines, which were being used at the two major hospitals were limited with respect to capacity and exceeded their useful life. The shift from Cobalt Radiation Therapy to Linear Accelerators will increase the efficacy of cancer radiation treatment and increase accessibility to cancer care in Jamaica.
Project Origin Former Minister of Health lead a delegation to Sunnybrook, Princess Margaret and Sick Kids hospitals in Canada in 2013 to look at different models of care and best practices in those settings. Arising from these discussions coupled with consultation with local experts the decision was taken to establish the LINAC Steering Committee to drive the process of establishing the Cancer Treatment Centres.
Steering Commitee
The members of the Steering Committee are: Mr. Everton W. Anderson - Chairperson Mr. Billy Heaven - Deputy Chairperson Mrs. Paulette Mitchell - CHASE Fund Mr. Anthony Smikle - Cornwall Regional Hospital Mr. Orett Clarke - Project Manager NHF Dr. Collie Miller - Chief Medical Physicist, SEHRA Prof. Archibald McDonald - Chairman, St Joseph Hospital Mr. Marlon Jones - Ministry of Health Mr. Ivor Corrie - NHF (co-opted member) Ms. Shermaine Robotham - NHF (co-opted member)
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Project Financing The project was completed through the kind donations from the following organizations: • National Health Fund (NHF) - US$ 10 million • Culture Health Arts Sports and Education (CHASE) - US$3.5 million • Tourism Enhancement Fund (TEF) - US$1 million • Vincent Hosang Foundation - US$132,121.25 • Jamaica Association of Administrative Professionals - $US20,869.00
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Development of Technical Specifications The development of technical requirements for such a major project could not be taken lightly. As such, a highly consultative process took place involving then Chief Medical Physicist Dr. Collie Miller, experts from the various hospitals locally and international partners.
Tender Process and Award of Contract:
In keeping with the approval from the National Contracts Commission to utilize the limited tender process, since there were only two suppliers of Linear Accelerator machines, the two companies, Varian and Elekta were invited to submit bids to supply two (2) turn-key Linear Accelerator Cancer Treatment Centres.
Submission and Opening of Bids:
Bids were received from both bidders on the deadline date of September 5, 2014 and opened the same day with representatives from both companies present. The bids
were subsequently evaluated. On the endorsement of the National Contracts Commission negotiations were had directly with Varian on the basis of their bid.
Award of Contract:
Cabinet at meeting held February 16, 2015 approved the award of contract to Varian Medical Systems for the two turn-key cancer treatment centres for a value of US$14,465,745.00 or JA$1,663,560,905.00 - St Joseph Hospital: $860,123,476.90 - Cornwall Regional Hospital: $770,982,089. Under Part B of the Contract additional funding of approximately $10 million for securing permits and required electrical power to operate these state-of-the-art machines. Refurbishment to existing Radiotherapy Department at the tune of JMD$5,500,000.00
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Project Implementation The project has been led by the National Health Fund (NHF) and CHASE Fund through a LINAC Steering Committee. Construction activities began in November 2015 for the first phase of the project at the Cornwall Regional Hospital.
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Expand the Cornwall Regional Hospital Radiotherapy Department to include : • a 2500 sq ft Bunker to house a Linear Accelerator (LINAC) Machine, • a Reception area and a Control Room. A. Groundbreaking Ceremony – November 6, 2015 B. Building completed and handed over - September 2016
Value of contracted infrastructural works was $338,433,711.60
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Supply and Install; • a 3D Simulator, • a High Dose Radiation (HDR)/ Brachytherapy Machine and; • a LINAC Machine.
Value of equipment was $432,548,377.90 A. Equipment placed onsite – November 6, 2016 B. Installation, commissioning, testing and acceptance completed – April 2017
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Training of key staff to use new technology.
Partnership with IAEA Collaboration is being sought with the International Atomic Energy Agency to ensure and assist with the following: • • • • • •
Compliance with international regulatory requirements with respect to nuclear energy Development of radiation shielding standards Technical monitoring and oversight of the project at critical junctures to ensure safety guidelines and quality standards are maintaine Be a repository for knowledge transfer for local technical personnel Provide relevant training in conjunction with the training offered through Varian to local staff Technical assistance and oversight is given for the installation and commissioning of the Linear Accelerators at both sites
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Start-up of Operations The Cancer Treatment Centre is expected to provide • External beam radiation treatments • Image guided radiation treatment • Intensity modulated radiation treatment • High dose rate (HDR) brachytherapy
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Capacity Building A key component and arguable the most important component of any successful radiotherapy program is having qualified personnel. As such training activities are emphasized. All requisite training both overseas and onsite training for all categories of clinicians have been completed. In addition the local clinical staff has been exposed to both theoretical and practical training on the Linear Accelerator (LINAC), the practical training was an imperative as the clinical staff would be transitioning from Cobalt Technology to LINAC technologies.
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Persons in training
Name
program
status
Adia Solomon
Biomedical Engineering
Completed program and returns to Jamaica in December 2017
Latocha Terrelonge
Biomedical Engineering
Program to be completed in 2019
Deon Dick
Medical Physics/ Biomedical Engineering
Program to be completed in 2019
Jelani Scott
Medical Physics
Program to be completed in 2019
Dr. Nadine Badal
Radiation Oncology
Program to be completed in 2019
Dr. Kern Pemberton
Radiation Oncology
Program to be completed in 2023
Dr. Racquel Smith
Radiation Oncology
Program to be completed in 2021
Dr. Stephen Alexander
Radiation Oncology
Program to be completed in 2023
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