Ryan Ba­choo

Lead Ed­i­tor - News­gath­er­ing

ryan.ba­choo@cnc3.co.tt

In the des­o­late en­vi­ron­ment of can­cer care, Dr Jacque­line Pereira-Sab­ga is a bea­con of light to those in the mid­dle of their great­est bat­tle in life.

A gen­er­al prac­ti­tion­er for al­most three decades, Dr Pereira-Sab­ga has mar­ried her pas­sion for can­cer care with prac­ti­cal­i­ty. It is no longer about just treat­ing can­cer pa­tients for her, it is now about rais­ing their stan­dard of liv­ing and restor­ing the dig­ni­ty that is lost with the dis­ease.

She runs in many 5k events to raise char­i­ty for can­cer care. In 2017, she and her friend Cherise Stauble raced from Lon­don to Paris to raise mon­ey for both the T&T Can­cer So­ci­ety and the Just Be­cause Foun­da­tion.

“I think it was just an evo­lu­tion that oc­curred,” she said in an in­ter­view with the Sun­day Guardian’s WE Mag­a­zine.

Now, Dr Pereira-Sab­ga is rev­o­lu­tion­is­ing how she cares for can­cer pa­tients. Along with Stauble, Te­nille Main­got, Chris­tine Sab­ga, and He­le­na Sab­ga, she es­tab­lished Promise House TT last June. “We start­ed to iden­ti­fy what we thought was a need. There is a home away from home that is run by Just Be­cause Foun­da­tion and when we looked at it, we thought we could take that idea and put in­to it many more re­sources that we thought were nec­es­sary for these chil­dren as they stayed,” she told us.

The fa­cil­i­ty is pae­di­atric on­col­o­gy and is avail­able for free to any­body in need. It has six beds that house chil­dren with can­cer or chron­ic dis­ease, chil­dren who are well enough to not be in the hos­pi­tal but may not be able to be at home in their present con­di­tion. Promise House TT of­fers the chil­dren play ther­a­py, art ther­a­py and a holis­tic ad­dress­ing of each child.

“How do you say the num­bers are not big, but the need is great?” Dr Sab­ga re­spond­ed when asked about the num­ber of chil­dren in T&T who need can­cer care.

She re­called that pre-pan­dem­ic, T&T’s on­col­o­gy de­part­ment would care for many Caribbean chil­dren with can­cer while al­so man­ag­ing lo­cal kids. Post-pan­dem­ic, Dr Pereira-Sab­ga said, the Caribbean num­bers have dwin­dled, but lo­cal chil­dren who suf­fer from can­cer still re­quire a lot of at­ten­tion.

She added, “When you have a sick child, it is very hard for a fam­i­ly. You may have one sick child and two nor­mal and healthy chil­dren, how do you make that jug­gle and fo­cus on the child who is sick? In any chron­ic dis­ease, it is ex­pen­sive and you might have sick chil­dren [and] well chil­dren in the same house­hold and so there is al­ways need like that.”

In mid-June 2013, Dr Pereira-Sab­ga sat down with this news­pa­per as she as­sumed the lead­er­ship of the T&T Can­cer So­ci­ety. At the time, she was a gen­er­al prac­ti­tion­er, chair­man and med­ical di­rec­tor of Vi­tas House Hos­pice when she re­placed Dr George Laquis, who had been at the helm of the Can­cer So­ci­ety for over 40 years.

Hum­bled by Woman of the Year award

Her con­sis­tent ser­vice down the years was recog­nised by the In­ter­Club of T&T on March 10, when she was named Woman of the Year. “Her forth­right call to pro­vide hu­mane pal­lia­tive care to peo­ple in their last days is a call to our con­science, and in par­tic­u­lar to those who hold the pow­er to re­lieve the suf­fer­ing of the ter­mi­nal­ly ill,” the or­gan­i­sa­tion said of Dr Pereira-Sab­ga. The award hum­bled her.

“Promise House TT is way big­ger than what I dreamt of. I don’t think the team en­vi­sioned the spec­tac­u­lar struc­ture that came to fruition,” she said. Then, an army of vol­un­teers de­scend­ed on San­ta Cruz one week­end to help pow­er wash, paint and clean the build­ing. “Peo­ple I knew, peo­ple I didn’t know, and peo­ple you would least ex­pect to show up on a week­end,” she added with a smile.

But, as those clos­est to Dr Pereira-Sab­ga have come to know when one of her dreams comes true, she dreams up an­oth­er. She told us what the Promise House TT team is work­ing on next, “On that prop­er­ty, there are three build­ings. The sec­ond build­ing will be a nurs­es’ rest area and an adult can­cer hos­pice, which will al­so be free to any­body who needs it.” It has al­ready been com­plet­ed and will be com­mis­sioned soon. But it doesn’t stop there.

The fi­nal phase of the project, she said, is to ren­o­vate the home for the age which al­ready ex­ists. “We want to cre­ate a city for them,” she said. When ful­ly com­plet­ed, Promise House TT will en­cap­su­late chil­dren with can­cer, adults with can­cer and a home for the age. “We want to cre­ate an ecosys­tem,” Dr Pereira-Sab­ga ex­plained.

How­ev­er, for this woman, who is in­fat­u­at­ed with giv­ing, her hands will for­ev­er re­main out­stretched. While at­tend­ing an An­gos­tu­ra Youth Awards, she would meet chil­dren who came from some of the most ad­verse ar­eas of the coun­try. “I asked the or­gan­is­ers if I could just talk to the kids by my­self. We start­ed to talk about what would help them, and they said home­work cen­tres,” she said.

At that mo­ment, an­oth­er dream was born. This is how she would be able to help chil­dren who live in at-risk com­mu­ni­ties and want to find a bet­ter life for them­selves. She ex­plained to us more about the idea, “Home­work cen­tres for them are safe spaces, where, in­stead of be­ing on the block or on the street, where you might get your­self in a lit­tle trou­ble, a home­work cen­tre is some­where they would come, they’d be ac­count­able so we can or­gan­ise to have vol­un­teers to help them get their home­work done, feed them and then send them home.”

That, Dr Pereira-Sab­ga said, can nul­li­fy some of the neigh­bour­hood lim­ing that may not be in their best in­ter­est. The chil­dren she spoke to at An­gos­tu­ra’s Youth Awards helped her iden­ti­fy four ar­eas that they think will be im­por­tant to start such a project.

Life has nev­er re­al­ly slowed down for Dr Pereira-Sab­ga but she is pas­sion­ate about help­ing peo­ple. When asked about what mo­ti­vates and dri­ves her to keep tire­less­ly pur­su­ing dream af­ter dream, she smiled and point­ed to her hus­band who was qui­et­ly sit­ting in the cor­ner of the room.

She’s been mar­ried to Howard Sab­ga for 30 years and she said, “Howard is an en­gi­neered hu­man­i­tar­i­an, and I don’t know any­body else who sac­ri­fices him­self every sin­gle day like my hus­band.”

She al­so has a spe­cial place for her Promise House team. “They are the most en­deared, dri­ven, de­vot­ed and pow­er­ful women who stand right next to me and when In­ter­Club gave me this beau­ti­ful award, I felt they didn’t just recog­nise me, it was a recog­ni­tion of my team as well. There are no words to de­scribe how hard these women work and it is on the shoul­ders of gi­ants that I stand, and they are the gi­ants,” she said.

Many dream of a bet­ter life for them­selves, but Dr Jacque­line Pereira-Sab­ga dreams of a bet­ter life for those dec­i­mat­ed by a dis­ease with no known cure, and her will is to save young peo­ple from the can­cer of crim­i­nal­i­ty spread­ing across the na­tion’s com­mu­ni­ties. She will nev­er stop dream­ing.

Q&A with Dr Pereira-Sab­ga

With can­cer treat­ment be­ing a crit­i­cal part of this coun­try’s health sys­tem, Dr Pereira-Sab­ga al­so an­swered some one-on-one ques­tions with the Sun­day Guardian’s WE Mag­a­zine on how the glob­al and do­mes­tic sys­tems can im­prove.

Q: When you look at how far we’ve come with can­cer treat­ment in this coun­try, how far have we come?

A:  I think strides made world­wide in can­cer treat­ment have been what I would say mod­er­ate. I think what we have start­ed to re­alise in can­cer treat­ment is that we have this pletho­ra of drugs, but we al­so have to ad­dress a lot of the needs of pa­tients; psy­cho­log­i­cal needs and nu­tri­tion­al needs are al­so things that are very im­por­tant to be more suc­cess­ful in our treat­ment of can­cer pa­tients.

 How far do we have to go?

You know, peo­ple might say, do we have all the re­sources? Do we have all the drugs? We might not have all the drugs, but I think the Gov­ern­ment has re­al­ly made an ef­fort to sup­ply these med­ica­tions. And at places like Na­tion­al Ra­dio­ther­a­py Cen­tre, of course, they are free to the pub­lic. And that, to me, is a ser­vice that we can nev­er speak about enough. And the staff and doc­tors that ex­ist there. It’s a hard job. And, you know, I think that it’s won­der­ful that it ex­ists. So what kind of strides do we need to make? I think, as a world, we have nev­er-end­ing strides to make. That’s the hon­est truth.

 Do you think we will ever find a cure for can­cer?

 So, the eter­nal op­ti­mist in me will tell you, I hope that one day, yes. The re­al­ist might tell you that I don’t fore­see that cer­tain­ly in our life­time we will see a cure for can­cer. But I’m hop­ing that in our life­time–I hope we have a lot more decades to live–I’m hop­ing that in our life­time, we will def­i­nite­ly see some of the pos­i­tive strides that we’ve been talk­ing about be­ing made in the care of can­cer pa­tients, at pae­di­atric and adult lev­el.

Over the last few decades, par­tic­u­lar­ly with the rise of fast food in the mass way that the world now con­sumes it, are processed foods con­tribut­ing in a way to a rise in can­cer like nev­er seen be­fore?

 I would have to tell you that, off the bat, what we would see is that, of course, choos­ing fast food or processed foods over fresh foods. Let’s be hon­est, and on a Caribbean is­land, the avail­abil­i­ty of fresh foods is right there. You might want to have lux­u­ry foods, and that might be hard­er for you to find, but ba­sic pro­vi­sions, pro­teins and stuff, they’re right there for us, they’re read­i­ly ac­ces­si­ble. And I would say that what I see in my prac­tice is cer­tain­ly the ac­cess and the easy avail­abil­i­ty of fast foods have steered pa­tients to­wards it be­cause it might be eco­nom­i­cal­ly friend­ly, and it might be eas­i­ly ac­ces­si­ble, ver­sus hav­ing to go and seek and cook your own food. But, I do be­lieve it re­sults in cer­tain­ly chron­ic dis­ease. I be­lieve it re­sults in the rise of hy­per­ten­sion, di­a­betes, obe­si­ty, all of those things.

 In the case of Aneesa Doon, who re­quired can­cer med­ica­tion from In­dia, what would you say to those fam­i­lies that are nurs­ing can­cer pa­tients, es­pe­cial­ly in rur­al com­mu­ni­ties?

One of the drug com­pa­nies reached out to me re­cent­ly and said, ‘How can we help, and how can drug com­pa­nies help?’ Well, I un­der­stand that a drug com­pa­ny is a busi­ness. But I al­so un­der­stand that look­ing at nov­el and odd drugs, bring­ing them in and hav­ing them here might not nec­es­sar­i­ly be the right thing.

But, if we can iden­ti­fy–and I ac­tu­al­ly told them–we need to get to­geth­er, maybe my­self, Dr Capildeo and Dr Din­di­al, all the play­ers that help pa­tients, pae­di­atric and adult in this coun­try, as doc­tors and get them to­geth­er. And let’s com­pile a list of the drugs that we feel are im­por­tant. And then those drug com­pa­nies should make it eas­i­er.

So, if I might need a drug, what­ev­er the drug is, that’s not read­i­ly avail­able in this coun­try, but the need has come up. If drug com­pa­nies are re­al­ly hon­est and gen­uine and want to help this plight and these pa­tients, they need to form the tracks. So form the tracks so that if a doc­tor says I need ‘Drug A’ that’s not avail­able here in Trinidad in the mass, we can source that and get it im­me­di­ate­ly so that those path­ways are ex­is­tent.

Right now, all the drug com­pa­nies I feel do is they want to find out what’s fi­nan­cial­ly lu­cra­tive and bring it in, you know, so that that’s not al­ways the right thing. And I feel that that’s im­por­tant. And drug com­pa­nies, I think, could be taxed a lit­tle bit when I say, bring them to the fore­front and say, ‘Lis­ten, these are the drugs that we want to come in, al­low Gov­ern­ment to al­low that ac­ces­si­bil­i­ty what­ev­er pa­per­work needs to be done.’ So not nec­es­sar­i­ly that we bring the drug, but if I need that drug, I can get it here in a day or two.

 Do we al­so need to look at gov­ern­ment reg­u­la­tion?

If we can sort out that, with Gov­ern­ment and with drug com­pa­nies and the doc­tors. Let’s get to­geth­er. We ap­pre­ci­ate all the drugs that Gov­ern­ment is bring­ing in. We ap­pre­ci­ate their val­ue, they’re use­ful and their quan­ti­ties, but there are some nov­el drugs that don’t need to be pur­chased and have to sit down here and then ex­pire or not be used.

But, let’s forge those path­ways. Let’s get the pa­per­work done. Let’s make sure that the reg­u­la­tions on those par­tic­u­lar drugs are not as te­dious so that if we need a drug, we say ‘Right, drug com­pa­ny X, this is your drug. And we need to source this amount of drug for this pa­tient, bring it in.’

And so that that ac­ces­si­bil­i­ty, I think it’s, I mean ... I’m not a busi­ness per­son by na­ture ... But to me, that seems much more fi­nan­cial­ly fea­si­ble than bring­ing in, say, 30 vials of a drug, when on­ly two might be used. So have the ac­ces­si­bil­i­ty there so that we af­ford the path­ways to make it hap­pen if we need, and that, to an­swer your ques­tion on this young girl, if those path­ways were forged, she would have been one of the rules or one of the pa­tients that had a need.

But now we have, if we had that put in place where the drug com­pa­ny, where Gov­ern­ment, the reg­u­la­tions are sort­ed out, we then tap in­to that path­way and say, ‘Right, so this young girl need­ed Drug X, we can get that.’ In­stead of hav­ing 30, or 50, or 100 of drug X vials here, we’re not go­ing to use them.