title: Addressing regional disparities in pediatric oncology: Results of a collaborative initiative across the Mexican-North American border.
abstract: Cancer is emerging as a major cause of childhood mortality in low- and middle-income countries. In Mexico, cancer is the number one cause of death in children aged 5-14. Until recently, many children with cancer from Baja California, Mexico, went untreated. We reasoned that an initiative inspired by the St. Jude Children's Research Hospital (SJCRH) "twinning" model could successfully be applied to the San Diego-Tijuana border region. In 2008, a twinning project was initiated by Rady Children's Hospital, SJCRH, and the General Hospital Tijuana (GHT). Our aim was to establish a pediatric oncology unit in a culturally sensitive manner, adapted to the local healthcare system.
  
  
  
  An initial assessment revealed that despite existence of basic hospital infrastructure at the GHT, the essential elements of a pediatric cancer unit were lacking, including dedicated space, trained staff, and uniform treatment. A 5-year action plan was designed to offer training, support the staff financially, and improve the infrastructure.
  
  
  
  After 7 years, accomplishments include the opening of a new inpatient unit with updated technology, fully trained staff, and a dedicated, interdisciplinary team. Over 700 children have benefited from accurate diagnosis and treatment.
  
  
  
  Initiatives that implement long-term partnerships between institutions along the Mexican-North American border can be highly effective in establishing successful pediatric cancer control programs. The geographic proximity facilitated accelerated training and close monitoring of project development. Similar initiatives across other disciplines may benefit additional patients and synergize with pediatric oncology programs to reduce health disparities in underserved areas.
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California San Diego, La Jolla, California.|Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital San Diego, San Diego, California.|Reducing Cancer Disparities Program, Moores Cancer Center, University of California San Diego, La Jolla, California.
authors.forename: Paula
authors.initials: P
authors.lastname: Aristizabal
authors.affiliation: School of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Spencer
authors.initials: S
authors.lastname: Fuller
authors.affiliation: Hospital General de Tijuana, Universidad Autonoma de Baja California, Tijuana, Baja California, Mexico.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Rivera-Gomez
authors.affiliation: Hospital General de Tijuana, Universidad Autonoma de Baja California, Tijuana, Baja California, Mexico.
authors.forename: Mario
authors.initials: M
authors.lastname: Ornelas
authors.affiliation: Hospital General de Tijuana, Universidad Autonoma de Baja California, Tijuana, Baja California, Mexico.
authors.forename: Laura
authors.initials: L
authors.lastname: Nuno
authors.affiliation: Department of Global Pediatric Medicine and International Outreach Program, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Galindo
authors.affiliation: Leukemia and Lymphoma Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Raul
authors.initials: R
authors.lastname: Ribeiro
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California San Diego, La Jolla, California.|Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital San Diego, San Diego, California.|Moores Cancer Center, University of California San Diego, La Jolla, California.
authors.forename: William
authors.initials: W
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care; D005260:Female; D014943:Global Health; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy*; D012959:Socioeconomic Factors
keywords: U.S.-Mexico border; global health; international collaboration; international oncology; pediatric cancer disparities; pediatric oncology