Trainee Spotlight: Marriam Mponda, M.B.B.S.
, by Marriam Mponda, M.B.B.S.
Note: The views expressed here are those of the grantee/trainee and do not represent any official position of the National Cancer Institute.
Realizing My Dream of a Cancer Research Career in Malawi
What is your program, research area/project overview?
Marriam Mponda, M.B.B.S.
I am a Malawian doctor currently studying for a Master of Medicine in clinical oncology at Muhimbili University of Health and Allied Sciences in Tanzania. This is my first year of study.
What motivated you to pursue your research topic?
My passion for oncology began when I was in medical school. During my rotation in the oncology department, I noticed that the numbers of cancer patients were increasing each day and most of them presented with advanced disease. In my interactions with them, I learned that there was an information gap regarding cancer in the communities and that was one of the reasons why they presented late to the hospital. To make matters worse, unlike other diseases, there were few cancer specialists to care for these patients. I started thinking that it would be most fulfilling to me to develop specialized skills that can help me serve patients and families living with cancer. This passion drove me to work as a medical officer in the cancer department after I graduated with my Bachelor of Medicine, Bachelor of Surgery (MBBS).
Along the way, I came across a vacancy for a research medical officer in cancer. I felt this was a great opportunity for me to develop skills that would help me increase my expertise in cancer and support patient-centered research that could impact the burden and suffering caused by cancer in my country. In this position, I also worked with the University of North Carolina (UNC) Project Malawi as a cancer research coordinator. This was a unique and amazing opportunity to work with committed and passionate researchers working to improve the health of cancer patients and was in line with my dream to be a clinician scientist in oncology. Recently, through the NCI-supported GlobTREC (D43) training initiative, I was awarded a scholarship to obtain a Master of Medicine (MMed) in clinical oncology. This is a dream come true for me, and I hope it will help me gain more expertise in clinical cancer research.
What inspired you to choose the setting where you are working?
I chose to study at Muhimbili University because this institution is currently offering an MMed in clinical oncology and is a great university ranking number three, in 2023, in Sub-Saharan Africa.
What were some of the challenges that you faced and lessons you learned from your project?
One of the major challenges I faced while embarking on this journey is discouragement from friends and some colleagues. People view cancer as a terminal disease. In Malawi, there are several challenges to cancer treatment. These include limited medication availability and absence of radiotherapy for treating cancer. As a result, we are not able to save as many patients as we would like. Though some consider oncology to be a depressing field to specialize in, I am motivated to focus on this because this is where special expertise is needed. Rather than choose other specialties in medicine, there should be more people specializing as oncologists so that their expertise can help in saving these patients’ lives. As oncologists, we can educate patients and note that many cancers can be effectively treated – this can help dispel the fear and stigma associated with seeking care for cancer in Malawi. Most importantly, as oncology researchers we can generate Malawi-specific research questions and data that can be used to support the need for resources that will enhance patient treatment and survivorship. With all the counsel I got from people, one lesson I have learned is that it is very important to stick to your goals and most importantly do what you feel will make you happy and satisfied.
How do you hope your work will advance the field of global cancer research/support cancer control efforts?
By becoming an oncologist, I will be more knowledgeable in cancer clinical research and discover gaps in the field. I am looking forward to conducting more research and publishing more papers which would provide data that will improve different aspects of cancer management starting from prevention, screening, diagnosis, management, and follow-up of cancer patients which eventually will have a positive impact on cancer research and control efforts in my country. Such research will also likely help other countries.
What are some opportunities/unanswered questions in global cancer research in your setting?
The research I worked on with the UNC Project team was looking at ABVD chemotherapy treatment for Hodgkin lymphoma in Malawi. Most patients with Hodgkin lymphoma in Malawi present with advanced disease (65%) or unfavourable prognosis (77%) and this was somewhat similar to other studies done in sub-Saharan Africa (1). This is because there are are limited services to help with early diagnosis. Our study found that treatment with ABVD is effective and well tolerated in Malawi with most patients achieving complete response and remaining in remission. Continued improvements are needed to advance early diagnosis and improve therapy options especially for relapsed/refractory disease after first-line ABVD. Additionally, when I was working in Malawi, I noticed that information about cancer prevention and control is not widely available to the community and many cadres of health workers. There is an opportunity to work on information dissemination to communities about cancer so that they are aware of early signs and symptoms and can present early to the hospital for diagnosis. Likewise, health care cadres which are usually the first contact with patients and should be imparted with knowledge on how to recognize signs of cancer.
The oncology teaching hospital at Muhimbili University in Tanzania.
Please share some interesting facts and pictures about the setting where you work.
My experience from my short time at the teaching hospital in Tanzania is that the team here is well coordinated, the flow of patient care is well organized, and patients tend to be assisted on time. There are a variety of treatment modalities like radiotherapy and brachytherapy which are not available in Malawi, hence cancer treatment outcomes tend to be better here.
What are some highlights and reflections on your career path?
I struggled in the beginning with making a decision but eventually once I decided to follow the oncology pathway, everything fell into place and sticking to my goal led to being awarded a scholarship which got me here. I am so grateful to the UNC Project for the scholarship, without which my career of studying oncology might have not been possible. I am looking forward to one day becoming a leading clinical oncology researcher who can help advance progress in my country and Africa more generally.