In my native language, there is a saying that is translated as, “A child who does not travel only appreciates their mother’s cooking.” In the broad sense, as we grow up and experience the different things that life has to offer, two things happen if we allow our minds to open up: we realize there are many ways of doing things that could be better than the way we were brought up to do them and, on the flip side, we may also realize that what we have been handed so far isn’t so bad. The latter promotes an attitude of gratitude, whereas the former
enables you to break barriers.
Dr. Lombe at the 2018 ASCO Annual Meeting.
Awards from ASCO and Conquer Cancer, the ASCO Foundation, have inspired both gratitude and action for me. In 2016, I received an International Development and Education Award (IDEA) and in 2018, a Long-Term International Fellowship (LIFe). The generous awards enable researchers from low-resource settings to step onto the global playing field in oncology. These opportunities are associated with a dignity that I have come to learn is very rare.
Recently, I read a Twitter thread posted by someone with a PhD (in a more resource-rich setting than my home country of Zambia) who was discouraging others from going down the doctorate degree path because of the lack of balance between the reward and financial implications. Incidentally, I was asked to sit on a panel in a scientific forum organized for researchers in Zambia shortly after, and during the discussion, the point was made that for potential clinical researchers in countries like mine, opportunities to participate come at later stages in life, making us less competitive. At that moment I felt very lucky because my opportunities with ASCO have been time-appropriate, and even though I am a recipient, I have always felt very valued as an individual despite being from a low-resource environment.
During my IDEA experience, award recipients were asked to map out the impact of what we were going to do with what we had learned. This map set out a blueprint for the rest of my life. The IDEA came with no strings attached—only the expectation that I would share what I had learned with others. It was clear that the award was preparing recipients for a development plan that was centered on improving outcomes for the global patient with cancer. Not only was I being valued as an aspiring clinical researcher, but I also felt like my patients in Zambia were being valued and were being given an equal chance for a good outcome.
As a woman in the medical field who is married with two children (and with a husband also pursuing an academic career), the LIFe award gave me a truly equal opportunity to smash the glass ceiling. Without trying to perpetuate stereotypes, a postgraduate African woman will typically be of a certain age with a family in tow, usually composed of our little bundles of joy. When funding for opportunities doesn’t offer enough financial bandwidth to allow us to participate with our families, women like me are systematically excluded from programs. The LIFe award was generous enough to allow me to travel with my children and enable them to enjoy my professional growth with me. It was such an adventure for my 8-year-old to spend a year in Canada with me.
Some of these things are never truly spoken about and may be seen as political, but women should not be ashamed to ask for the playing field to be leveled. I am particularly happy that most professional conferences now offer childcare to smart, driven women determined to make their contribution to science.
The programs I have participated in with ASCO have linked me to high-profile icons in the field of oncology who I might never have had a chance to interact with otherwise. This has had a very big impact on my confidence as a professional. My IDEA mentor was Mary Gospodarowicz, MD, FRCR, FRCPC, who hosted me at Princess Margaret Cancer Centre in Toronto. There, I was able to connect with more world-class researchers and oncologists with whom I still have strong networks. My co-mentor Peter Chung, MD, FRCPC, was able to give me insights into my future career that I have held with me and have been extremely useful.
Thanks to my year-long experience with Juanita Crook, MD, FRCPC, and Francois Bachand, MD, FRCPC, at BC Cancer Research Centre in Canada, I returned to Zambia as the first clinical oncologist there trained in advanced brachytherapy techniques. There are few things more gratifying than giving women hope. Zambia has one of the highest rates of cervical cancer and over 75% of Zambian patients present with locally advanced disease. A significant number require interstitial needle intervention at the point of brachytherapy. A lot of focus is put on prevention and screening—rightfully so—but we must not forget about the women who are already living with the disease. These women usually feel rejected at a personal level because of the nature of the disease, and it breaks my heart that they are not given more attention by the system. Since coming back and initiating the brachytherapy program, I have faced many challenges, but my solid training is helping me persevere.
What remains now is to publish my research so that the world can read and learn from our experience here in the low-resource environment, and to continue developing solid research questions and executing their study to find solutions useful for our settings. As we all know, if it is not written, it is not done. ASCO once again is providing opportunities for me, as I have been accepted into its editorial fellowship program. The grant writing workshops at the ASCO Annual Meeting are epic and I am trying to apply the tips I learned there. Additionally, I volunteer on the Resource-Stratified Guidelines Committee. This is a great platform where we are able to address cancer as a global problem and suggest real-world, evidence-based solutions appropriate for different resource settings.
The overload of clinical work and being poorly funded (for now) is not a deterrent for me to pursue a clinical research path, because when I look at the opportunities ASCO offers, I know I have an equal chance if I submit an excellent proposal, regardless of my postal code.
As an emerging oncologist and clinical researcher, I encourage other people like me to join the community at ASCO. I am not shy to say ASCO is like an alma mater for me because, like the original Latin meaning of the phrase, it has been a nourishing and generous mother to my career.
Visit asco.org/international-programs to learn more about professional and educational opportunities for oncologists around the world.
Dr. Lombe is a clinical oncologist with subspecialization in brachytherapy currently working in Zambia. Her area of expertise is gynecologic and genitourinary malignancies as well as Kaposi’s sarcoma. She is a Fellow of the College of Radiation Oncologists with the Colleges of Medicine of South Africa and holds a Master of Medicine degree in radiation oncology from Stellenbosch University. She serves as Chair of the Cervical Cancer Subcommittee of the National Cancer Technical Working Group in Zambia and is a member of the ASCO Resource-Stratified Guidelines Advisory Group. Dr. Lombe writes a weekly features article on cancer for the local Times of Zambia newspaper and volunteers for the Zambian Cancer Society as part of her advocacy work. Follow her on Twitter @lombe_dorothy.
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