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Ester Demirtshyan
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Pediatric Cancer Center Aims to Heal with ‘Contagious’ Love Plus Cutting-Edge Medicine

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Sona Mirzoyan
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YEREVAN — According to the World Health Organization, annually about 400,000 children up to 19 years old develop cancer. In Armenia each year approximately 8,500 people are diagnosed with cancer, and 80-100 of them are children.

Recently we had a chance to speak with Ester Demirtshyan, Executive Director of City of Smile Charitable Foundation, and Dr. Gevorg Tamamyan, head of the Pediatric Cancer and Blood Disorders Center of Armenia, at the Professor Yeolyan Hematology Center.

Back in 2014, a group of oncologists-hematologists kicked off the City of Smile Foundation with an initial goal of raising awareness about cancer, translating scientific articles and publishing materials for doctors. Two years later, in 2016, jointly with the Dana-Farber Cancer Institute in Boston, the foundation kicked off the program of social-psychological support that allowed local psychologists to work with children and families under the mentorship of their colleagues from Dana-Farber similar service.

The palliative center aims for a more upbeat look.

In 2018, City of Smile started to sponsor the treatment of children with pediatric cancer. “We inherited the best guidelines from similar large funds and put them into practice. But most importantly, we undertook the full funding of cancer treatment, which was a game changer in the field of charity in Armenia,” says Ester Demirtshyan, claiming that the diagnosis of a child should never cause a financial collapse to the family.

Another important accomplishment of the foundation is related to the age limit of beneficiaries. Despite the fact that the official age limit for pediatric cancer is 18, young people up to 25 years old can apply to City of Smile for financial help, and the foundation tries to raise that threshold every five years. The goal is to take away at least the financial burden for parents who are already facing such difficulties.

The slogan of City of Smile reads: “Cancer is not contagious, love is.” Yet outside Yerevan there are regions where the disease is regarded as something contagious, demeaning and shameful. In this, City of Smile plays a big role in removing such destructive and superstitious beliefs. Demirtshyan is sure that casting a positive light in the process has changed the way parents regard this disease. There are many difficult processes beyond the curtain, yet cancer is not a verdict.

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“We show the bright side of the picture, not because the opposite does not exist, but to focus on positive results and provide optimism. Today 7 out of 10 children recover from cancer, and our goal is to raise that bar one day. Stories about recoveries give us strength and pledge for further development and achievements.”

City of Smile encourages the support of volunteers as well as financial donations. Demirtshyan says that volunteers from various fields and backgrounds apply and this helps cover all possible areas, such as teaching children school subjects, organizing concerts for them or engaging them in handcrafting activities.

“We have a senior woman as a volunteer who knits hats for our children. This is a great example that even if you cannot donate money, your help can be transmitted in a different way. The one important thing one needs is the desire to help.”

Important Milestones of 2019 

“Provide world-class conditions for early diagnosis and ensure the availability of all necessary treatment procedures even for rare cancer types: this is our ultimate goal,” says Tamamyan, when asked about his ultimate aspiration. He explains that he believes in a small country such as Armenia, the medical efforts should coalesce rather than be replicated. And for that reason, in 2019 the Pediatric Cancer and Blood Diseases Center was launched to consolidate under one umbrella both oncological and hematological treatments.

Doctors from the Muratsan Center, Liana Safaryan and Gevorg Tamamyan, with Cynthia Kazanjian in Boston in 2018

“A major breakthrough we witnessed in 2019 was the establishment of the Department of Pediatric Oncology and Hematology at Yerevan State Medical University after M. Heratsi. For the first time we hired residents for the specialty of the subspecialty of the pediatric oncologist-hematologist,” noted Tamamyan, highlighting that hiring 12 residents within three years is an impressive number given the fact that the specialty is not popular because of its high-stress level.

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In 2019, Armenia became the first country to join St. Jude Global Alliance – a global movement in pediatric cancer that brings together individuals and institutions dedicated to the shared vision of improving the quality of health care delivery and increasing the survival rates for children with cancer and blood disorders worldwide.

“With the help and guidelines of the alliance we have scanned patients’ medical histories and collected data for 25 years. Now we can proudly claim that the national registry for pediatric cancer is a fait accompli. Next goal is the creation of a population-based cancer registry,” notes Tamamyan.

Covid-19 and War in Artsakh

The pandemic resulted in a drastic crisis for City of Smile, both in Armenia and abroad, the number for donors plummeted. However a group of volunteers and entertainers expressed their willingness to support children, and the foundation organized a virtual concert. It resulted in acquisition of new recurring donors and brought fresh air in times of uncertainty.

City of Smile was just recovering from one crisis when the second occurred – the war in Artsakh. “During that time we were really drowning because we had no idea what we were going to do tomorrow. Throughout the war, until December, we received almost no donations other than recurring ones,” Demirtshyan recalls. But a call from Moscow turned into a lifeline for the foundation. Someone suggested providing medicines, and soon the fund received them. And as of early 2021 City of Smile, gradually has started to return to its previous pace, and fortunately no one was put on a waiting list and not a single parent was told to cover even a small amount of treatment expenses.

Palliative Care

 In September 2021, thanks to the technical support of  St. Jude’s Hospital, the first clinic of pediatric palliative help in the country was launched. The foundation believes that in terms of severe cases when treatment does not give results palliative care is essential to ensure children with humane, dignified conditions.

“By creating this center we try to make everything around children beautiful. The center does not resemble a hospital in any way, and children can communicate with their families and close friends as much as they want. We cannot fight against nature in some cases, but we can give people that palliative and soothing support” says Demirtshyan, adding that she wishes no one needed these rooms.

Besides the treatment itself, there are various needs children with cancer have, and the foundation tries to ensure they are all fulfilled. Children receiving chemotherapy need quality nutrition so that their bodies can cope with the consequences. City of Smile addressed the nutrition issue and now all beneficiaries are provided with fresh meals four times a day. The menu is approved by doctors to ensure all the necessary vitamins for children and protect their body from debilitating effects of chemotherapy.

Besides proper nutrition, children with such a severe diagnosis constantly need a positive environment. Although the contribution of such emotions to healing is not scientifically proven, City of Smile does everything to distract children from the ordeal and bring some joy. The foundation hosts celebrities and creative teams to deliver interesting talks to entertain the young patients.

Children playing board games as a leisure activity

American Chapter 

City of Smile also has a registered chapter in the US and board members from Boston including James Kalustian, Yelena Bisharyan and Cynthia Kazanjian. Founded in 2019, the American chapter had a huge contribution, and a prominent example of this is the banquet organized by the greater Boston area Armenian community on April 5,2019. Close to thirty organizations and churches came together along with many donors to make the April 5 banquet at the Westin Hotel in Waltham a successful effort at raising awareness of the problems of childhood cancer patients in Armenia and fundraising for the City of Smile Charitable Foundation.

The roots of impressive efforts of the Boston Armenians towards helping children with pediatric cancer go back to 2016, when Cynthia Kazanjian and a group of Holy Trinity Armenian Church parishioners visited Muratsan Chemotherapy Clinic in Armenia. Seeing kids suffering from cancer led Cynthia to take action and put all efforts and organize help for those children. And that desire to help continues with the US chapter.

To find out more, to donate or to volunteer, visit https://cityofsmile.org/

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