Dr. Mel works to enhance radiation oncology capabilities for children in Cambodia

This is one in a series of profiles of the students in the first cohort of the Global Scholars Program, which is comprised of the Master of Science in Global Child Health (MS-GCH) at the St. Jude Children’s Research Hospital Graduate School of Biomedical Sciences and the Global Scholars Projects within the Department of Global Pediatric Medicine at St. Jude Children’s Research Hospital. The transformational Global Scholars Projects can be described as an extension and culmination of the experiential learning experience of the MS-GCH degree program. As the primary proof of concept, the Global Scholars Projects will provide an opportunity for the graduates to apply the academic knowledge and translational and implementation skills and tools, acquired through the program, to real-world problems. The first cohort of the Global Scholars Program began in July 2019, graduated with their MS in Global Child Health in 2021, and will launch their Global Scholars Projects in the coming months.

These have not been easy days for Dr. Mora Mel and his radiation oncology team at the National Cancer Center in Cambodia.

While the country charged toward its goal of 10 million COVID-19 vaccinations by the end of 2021, the threat of the virus still loomed. The unknowns concerning who is infected. The knowledge that any staff member’s direct contact with a positive case would lead to his or her quarantine, further shrinking an already small team.

“We have a lot of bumpy roads right now,” says Mel, a radiation oncologist who has sought to buoy his young team’s spirits by reinforcing the importance of their daily work. “If we can’t continue this work, I remind them that many lives cannot be saved. … They all are scared still, but if a patient [comes in] and we can save the person’s life, then we are doing valued work.”

The National Cancer Center, located in Calmette Hospital in Phnom Penh, the capital of Cambodia, is now more than three years old. From the start, Mel has played a key role in the radiation oncology department. He helped coordinate the installation of the radiotherapy machine —the second one in the country— and is helping his team navigate the pandemic.

 Mel is also the sole radiation oncologist treating pediatric cancer patients in Cambodia. His journey started with a scholarship.

photo of Mora Mel

“We (Mel's team) have a lot of bumpy roads right now. If we can’t continue this work, I remind them that many lives cannot be saved. … They all are scared still, but if a patient [comes in] and we can save the person’s life, then we are doing valued work.” -- Dr. Mora Mel

Unsure of what to do after high school graduation, Mel’s first thought was to find a job as fast as possible to help his family. Everything changed, though, when he received a scholarship from the government to study internal medicine.

That scholarship set him on a course in the medical profession. But he also earned a Bachelor of Arts in English language and worked part-time as an English teacher while pursuing his medical degree. Along the way, however, he noticed how hard it was for some patients to navigate the health care system in Cambodia — and he thought of his family. He wanted to be someone whom a loved one could lean on for advice if they ever got sick.

“While I was approaching my graduation, I thought I had to stay in medicine, because I know the system, and then in case [a family member got sick] at least I could help them get what I think is optimal treatment for their case,” he says.

As Mel continued his training abroad, he learned about other health systems and how they worked. He completed a fellowship to study radiation oncology in Belgium, a four-year radiation oncology residency in the Philippines and then spent three months at St. Jude Children’s Research Hospital.

The training kept him interested in medicine, not just clinical skills but also the bigger picture of the health care system, including how to ensure those who need help can get it.

That sentiment, that curiosity, drew him to the St. Jude Master of Science in Global Child Health. His Global Scholars Project explores ways to strengthen radiotherapy services for childhood cancer patients.

He is setting up a system to track patient outcomes at his hospital, establishing a dataset to optimize and standardize how his center treats pediatric patients. He sees this as an important goal now when children represent about 10% of his daily patients.

“Suddenly, while doing this master’s program, I realized that we are so busy that we don’t know whether we are collecting data,” he says.

Tracking outcomes, gleaning insights and making necessary optimizations are the next steps for a doctor who has been supporting the National Cancer Center since its inception, since before the radiotherapy machine was even installed.

“I think I’m lucky because I got to experience how the health care system works in low- and middle-income countries,” he says. “But at the same time, I also have some experience from the high-income countries like the United States. It shows us which direction we have to go in the future.”