Physical symptoms of childhood cancer are diverse but often associated with severe body pain, nausea, fever and sickness. Chemotherapy and radiation weaken the body, causing higher vulnerability to infections, comorbidities and secondary symptoms (WHO, 2018).

• New Hope Children’s hostel nurse daily checks each child’s vital signs ie: systolic blood pressure, pulse, body temperature, MUAC = mid-upper arm circumference as an indicator of malnutrition and weight. Head circumference and height for smaller children.
• Children with severe acute and moderate malnutrition are put on a special diet.
• Pain management through supervising pain medication like oral morphine prescribed at the UCI is done by the hostel nurse.
• Our nurses help the parents give their children other medication prescribed by UCI.
  Wound dressing & cleaning is an important part of the care.
• In the case of an emergency, first aid is provided and then the child is rushed to UCI for treatment.
• When a child’s illness is diagnosed as terminal at UCI, they are referred to a Hospice near their village for end-of-life care. We ensure we link them to the hospice near their home for continuous care.

Other than the physical strain these children and their caregivers often show high psychological distress, displaying symptoms for anxiety, depression, and post-traumatic stress.  (Kreitler, Weyl, Ben – Arush, & Martin, 2012).

• The New Hope Children’s hostel’s social worker assesses the mental health of the children and their caregivers.
• Counselling sessions for children and caregivers are provided by our social worker. Individual counselling sessions are held weekly as well as on demand. Counselling for children and their caregivers focus on ways to help improve an individual's self-image or self.
• Assisted play is an essential component of psychosocial care for the children. The social worker and counsellor observe the children’s play in order to identify children, who show little play, isolated play, repetitive behaviours and aggressive play, as these behaviours are indicators for impaired child mental wellbeing (Chazan & Cohen, 2010; Christian, Russ, & Short, 2011; Lous et al.,2002).
• In daily play sessions, guided by our psychosocial staff, vulnerable children are assisted in their play, according to their needs.  Music therapy is provided weekly including rhythmic exercises, relaxation and singing. The children and even their caregivers join in and love the singing.

Especially for vulnerable and poor families from rural areas, the diagnosis of a life–limiting disease is associated with high social and economic strain. The most common social challenges associated with their child’s cancer are logistic issues, transport costs and general economic strain, followed by a confrontation with stigma and myths around childhood cancer.

• The hostel staff provides a tailored approach to our patients and their families. After the initial referral from UCI, follow-up interviews with our clients are conducted to reassess their social needs.  
• All patients and their caregivers are provided with accommodation, 3 meals a day, and transport to and from the hospital during the child’s treatment.
• Covered are also the costs for secondary prescriptions by UCI.
• Legal assistance is offered through a referral system with  Uganda Network on Law, Ethics and HIV/AIDS (UGANET).
• Follow – Up calls are made to remind families between treatment cycles or investigations at UCI, about their next appointments. Any issues about continuing the treatment are discussed and where possible resolved.
• Informative sessions are held to discuss the facts about cancer and to break the misconceptions and myths about the illness. Caregivers are coached on how to facilitate this information to relatives and community members.

Through our psychosocial care, we also try to generate hope and provide spiritual support to the children and their families. Spiritual themes are incorporated into music therapy and readings with the children. All religious groups are able to pray at the hostel.