Setting up a cancer centreDr C Nyongesa

Watta, MMED (Wits), FC Rad Onc(SA)

Introduction

• Justification

Cancer treatment offers good palliation and even cure for cancer

• Where are our patients seeking treatment ? locally; regionally and internationally

• Kenya is loosing over 300million Kenya shillings annually on treatment overseas and this is increasing tremendously as there are strong efforts to pull more patients to India

Lip Cancer

Before Radiotherapy After Radiotherapy

Kaposi sarcoma

KS BEFORE DXT KS after DXT

Sinonasal Carcinoma

BEFORE AFTER

17 yr old patient with head neck cancer

before after

HIV RELATED H/N Carcinoma

before after

TONGUE CANCER

BEFORE AFTER

Eye cancer

before after

Sketchy brief

• Operating Theaters

• Radiotherapy-bunker and machines, Radiology

• Chemotherapy- biological safety cabinets

• Pharmacy, Laboratory, accounts

• Out patient, In patient

• Administration block

Setting up a new Centre

• Population

• Location

• Cost

• Funding

• Type of machines

COBALT 60

Linear accelerator

COSTS- cancer centers

• The Nairobi Hospital Cancer Center one billion Ksh

• Cancer Care Kenya- 900 million Ksh

• Kenyatta National Hospital phase one KSH300 million-needs a total of 2.5 billion K to complete

• MTRH 5Million USD

Cancer & Chronic Diseases Management Centre MTRH Eldoret

campus, Kenya• The donor -the Indiana Institute for Global

Health Kenya based in Indianapolis,

• and Moi Teaching and Referral Hospital (MTRH)

Architect MTRH

• The brief statement to the Architect was “design a Centre for Cancer and Chronic Disease Centre Building and Cardiac Care Centre”.

• The site was slightly over an acre located in between the main MTRH administration block and the Nyayo wards on west and east respectively.

Cancer Centre MTRH Eldoret Kenya

• The donor had a fixed budget with no variations allowed.

• Architects and design team had to design to the dollar.

• The brief was essentially non-existent and had to be developed by the Architect as the lead consultant

• Brief development therefore took long – from December 2011 to July 2012 – to firm up though there were still post contracts adjustments.

Project Team MTRH

• Client: Indiana University, USA

• Architect: Atticspace Architects

• Quantity Survey: Zimaki Consult

• Civil and Structural Engineers: Maiyo and Partners

• M&E Engineers: Metroeng Consultants

• Environmental Experts: Eco Plan Management Limited

• Main Contractor: Vishva Builders Limited

• Electrical contractor, Plumbing and Drainage,Mechanical Ventilation

MTRH CANCER AND CHRONIC

DISEASE BUILDING

Dr N. BUSAKHALA

Radiation Oncology

• Radiation Oncology Wing costs:  55,000,000 ksh for 1007 sm +/-excludes design fees

• Radiation oncology wing includes one each Universal bunker, one HDR bunker and one CT simulator room along with necessary support services.

Radiation oncology wing

Medical Oncology

• Oncology portion ground floor, cost 35,000,000 ksh for 1250 sm +/-This is primarily clinical space.

• Costs include structure, finishes, mechanical, electrical, plumbing and civil however no IT, furnishings or equipment

Medical Oncology

TCC Texas Cancer Centre

• A case in point is Texas Cancer Centre (TCC)

• TCC has purely contracted local firms to implement the project.

• Design took 1 year to develop

Team for TCC

PROJECT TEAM TCC

• Client: Texas Cancer Centre

• Architects: The Centric Architects

• Civil & Structural Engineers: Abba and Wandu Engineers

• Quantity Surveyors: Buildafrique Consulting

• Mechanical and Electrical Engineers: Erihast Associates

• Main Contractor: Jipsy Civil and Building Contractors

• Subcontractors: ICONET Solutions Ltd, WENA Technical Services, Muga Electrical Contractors, Seven Fourteen Ltd

Texas Cancer Centre

Texas Cancer Center

Texas Cancer Centre

TEXAS CANCER CENTRE

KNH cancer Centre

KNH

THANK YOU !!!