1. Simone, Joseph V. MD

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For most of us in pediatric oncology, having a role in the construction and development of a new children's cancer hospital is a once in a lifetime event. I have the privilege of recently being invited to help those responsible for building such a hospital. The story behind this effort begins almost 20 years ago, in Guadalajara, Mexico.

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JOSEPH V. SIMONE, MD... - Click to enlarge in new windowJOSEPH V. SIMONE, MD. JOSEPH V. SIMONE, MD, has had leadership roles at St. Jude Children's Research Hospital, Huntsman Cancer Institute, Memorial Sloan Kettering Cancer Center, the University of Florida Shands Cancer Center, the National Comprehensive Cancer Network, and the National Cancer Policy Board, and has served on the NCI's Board of Scientific Advisors.He welcomes comments and suggestions: Email him at


In 1994, Senora Berta Alicia Perez and her husband, Senor Jose Perez, became involved in providing support of children with cancer at the Hospital Civil Fray Antonio Alcalde, a municipal hospital.


They gradually attracted a group of like-minded volunteers to help hospitalized children with cancer and their families. Over time, the group became aware of the multitude of needs of families with a child with cancer. They observed that the hospital was unable to provide all the help that families needed.


As a response, Senora Perez founded "Mi Gran Esperanza"(My Great Hope) as a non-profit association (known as a "501.c.3 foundation" in the U.S.). Since then, this association has been able to help more than 2,800 children under the age of 18 years who have been cared for in public hospitals in Guadalajara, in the state of Jalisco in Mexico.


Senor Perez is a distinguished man in Mexico and beyond because of his pioneering efforts in developing the media in the Americas and around the world. He started his career as a CPA at a radio station in Jalisco, and gradually became the owner of several radio stations and a couple of TV stations, part of his large media organization broadcasts in Mexico and the U.S.

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I point this out for two reasons: He is wealthy and has been very generous in providing help for those without means. Also, he sits at the top of a media organization that could prove very effective for raising philanthropic funds. He has friends and board members who are also prominent in government, the business world, and scientific organizations.


Over time Senora and Senor Perez and their volunteers realized that the public hospitals did not have the resources or the structure to provide the level of care that is common in the United States. After they and their colleagues visited facilities in the U.S. known to provide a wide range of supportive measures in addition to first-rate therapy, they developed an acute appreciation of the range of support that children with cancer need during and after treatment.


Some years ago, after visiting additional facilities that cared for children with cancer, the board members of "Mi Gran Esperanza" began exploring the possibility of building a children's cancer hospital in Guadalajara, which would be named "Hospital Mi Esperanza."


The Honorary Council

Realizing that they needed experienced help to shape the hospital's governance structure and function, the trustees formed the "Honorary Council," which has the same function provided by External Advisory Committees of cancer centers in the U.S. The Council consists of a group of physicians and scientists knowledgeable about children's cancer and the facilities thereof. This Council also includes an American attorney, who advised a client who wished to support a worthy charity; the donor was impressed by Mi Gran Esperanza and made a large donation to help fund the hospital.


Trustees of Mi Gran Esperanza also had friends in Texas, who suggested they contact Dr. Stephen Prescott, the former director of the Huntsman Cancer Institute at the University of Utah and current president of the Oklahoma Medical Research Foundation. They asked him to serve on the Council and to identify others to join. He agreed, and I was one of the physicians he contacted; all agreed to serve.


Four Council members flew to Guadalajara on July 16 of this year for an intensive three days of learning everything possible about the project. Prescott speaks Spanish, and one of the doctors, Rodrigo Mejia from MD Anderson, is originally from Colombia and is fluent in Spanish. Since I do not speak Spanish, having Mejia was a great help in sustaining the clarity of the discussions.


Every important topic was discussed at length, including internal governance, the design of the hospital, recruitment of physicians and nurses, fund-raising, and public relations; each was addressed several times. The Council will meet at least once a year in Guadalajara and several times electronically during the year.


The Hospital

The design and initial construction of the hospital began in late 2010. When we arrived we found the building almost structurally complete. It sits on a hill with a great view of the city and the mountains, with ample land for expansion.


The design was very well thought out with practical and efficient flow patterns for staff and patients. We made a variety of suggestions for minor adjustments during a long and detailed review of the facility. The hospital is almost ready for installation of equipment, furniture, and technical facilities such as operating rooms, pharmacy, inpatient rooms (36), and an ambulatory care area.


The projected completion date is next Spring, but of course, experience says it might be a bit later.


My Reflections

I had a lot to think about on the flight home. First, it is quite common to see one or more women playing a key role in a new pediatric enterprise. This is also true of many U.S. children's hospitals, of course. It seems obvious that the motherly instincts are in play, and it helps when their families are financially able to donate support for the program.


It is also true that important connections in the local society can be effective in moving things along. As in most cities, the elite of society, industry, and politics frequently rub elbows at dinners and black tie events. In the U.S. academic world, in addition to philanthropy, critical support is needed from a dean, provost, or university president to spark the funding of such a major undertaking.


Instituto Nacional

I was unaware of the existence of el Instituto Nacional de Cancerologia before arriving in Mexico. The advisory group saw the cancer institute in Mexico City as a possible game-changer for the new hospital by providing a partnership opportunity with an already funded and successful basic cancer research facility not so far away.


With long and satisfying participation in the Mi Gran Esperanza foundation, its trustees likely will remain strongly committed and see the hospital through its completion and later support. In our personal discussions with them, it was clear that this project was deeply important to them and they were greatly appreciative of our visiting and offering opinions and advice; that is a good sign for the future.


Biggest Imminent Challenge

The biggest imminent challenge will be hiring medical and nursing staff (nurses have more limited roles in Guadalajara and, I believe, in Mexico).


I learned from my experience that there are 151 certified pediatric oncologists in Mexico; many are in private practice and work in municipal hospitals. They are not well paid, and we made it clear that recruiting talented staff would cost substantially more than is currently offered.


On the way home, I realized how privileged I am to be working with people committed to doing something wonderful for children in dire need.


And that glow I felt is still with me.


Guadalajara Quick Facts

Guadalajara is the capital of the state of Jalisco and is considered to be one of the three most prosperous cities in Mexico. It is 5,000 feet above sea level in a valley surrounded by mountains. The city is a major cultural center for Mexico and is host to a wide range of large-scale cultural events. It is the primary center in Mexico of the digital industry, with clients throughout the Americas and beyond. The population of the city proper is 1.5 million, but if the seven surrounding smaller municipalities are included, the total metro population is 4.4 million.

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There are approximately 7,000 new cases of childhood cancer in Mexico annually, and every year in the state of Jalisco 700 children are diagnosed with cancer. The Instituto Nacional de Cancerologia in Mexico City is one of four government-subsidized research institutes that do laboratory research and also have clinical functions. A collaboration of the cancer institute and the new hospital could be useful and mutually productive for both cancer-focused institutions.