PhD defence T.J. (Tara) Rick

Summary:

How does the care of over 100 million people pivot on a single cobalt radiotherapy machine? This thesis explores two-dimensional cobalt radiotherapy utilization patterns for cancer in Ethiopia before a major historical milestone of the transition to more advanced radiotherapy technology. This thesis first explores the history of medical care and radiation oncology in this populated country, the nature of the current health care system, and practical information about practicing oncology care in Ethiopia. Then it describes all radiotherapy patterns of cancer care through a wide lens before focusing specifically on palliative radiotherapy approaches and then on head and neck cancer radiotherapy, a largely curative cancer that is challenging to treat even with the most advanced technology and resources.  This research highlights key findings that provide benchmark data for stakeholders and a framework for progress that aims to meet broader international guidelines and improve quality of care. This work also highlights challenges and lessons learned performing research in a resource limited setting which may give guidance to future researchers. Lastly, this thesis provides a research framework designed to serve as a starting point for cancer research in the next decade as the linear accelerators become available and the care is decentralized into multiple regional cancer centers.