Yemen crisis hits cancer patients

Thanks to the charitable and unsparing efforts of local non-government organisations (NGOs) in Yemen, cancer patients are having a shoulder to cry on and share the burden of the disease. However, as the after-effects of months of protests still hurt the country, the NGOs are in a very tight spot as they are unable to respond to the health needs of the influx of cancer patients. In the oil-rich province of Hadramout, Hadramout Cancer Foundation (HCF) is a leading charitable trust that gives a hand to hundreds of cancer patients. In addition to his work as an associate professor of oncology and internal medicine at Hadramout University, Dr. Ahmad Mohammad Badheeb has been in charge of the foundation since its birth in 2006. The HCF was set up five years ago and had a board of trustees from local and Saudi businessmen. Their donation is the generator of the foundation while little of the budget flow from local businessmen. The foundation supplies cancer service to the patients in the provinces of Hadramout, Shabwa and Mahra. "The first objective of the foundation is making an inventory of all cancer cases in the three provinces. We managed to establish Hadramout Cancer Registry that will put the foundation stone for a national foundation which the government failed to make," Dr. Ahmad told Gulf News in his clinic in Mukalla. The foundation runs a centre of two flats in Ibn Sina Hospital. Each flat has six beds and women has their own isolated section. Waiting for his turn Setting quietly on a chair, Fowad Bafaraj is waiting for his turn to see Dr. Ahmad. "Look! He is suffering from chronic myelogenous leukemia (CML). To live normally, he needs a medicine that costs $3,000 [Dh 11,016]," he said. Fowad is unemployed and has a small family. "I do not have a job and I take care of a mentally-challenged sister. I am penniless and when I want to buy medicine I go to Hadramout Foundation. They are very kind and cooperative guys" the 33-year-old man told Gulf News. The man is very poor to provide money for his breakfast let alone pay for the medicines. "We have 15 similar cases of CML and we are working hard to raise at least $22,500 to buy medicines. The company that produces the drugs promise to give us 50 per cent." Dr. Ahmad claimed that one of the problems that faces oncologists in Yemen is lack of accurate figures on the disease and his foundation has registered about 2,150 cases of cancer in the three governorates. "Many foreign oncologists who I met told me that the main problem they face in Yemen is the lack of national registry." Following the registration of the diagnosed patients the most foundation assess what kind of help he/she needs. "We help them morally and financially. We give them drugs and also all kinds of chemotherapy. Patients can get free of charge or affordable examination in the centre." Public awareness As part of raising the public awareness on the disease, HCF have established Sanad (support) society which deals with breast cancer patients. The society arranges awareness campaign to women to encourage them to check for the cancer and how to recognise the disease. Dr. Ahmad thinks that breast awareness activities have been fruitful as increasing number of women flock to the foundation centre for check-up. The foundation's biggest challenge is the availability and high cost of cancer drugs. The foundation has resorted to using generic drugs to treat the patients. "Since we cannot afford buying branded drugs, we use less expensive brands that are made in India. For example, the cost of the original drugs for one patient is $3,000 for each cycle of chemotherapy, while the Indian generic drugs will only cost $500. Treating patients with the Indian-made medicine is better than allowing the patients to develop terminal cancer." Another challenge that impedes the functioning of the foundation is shortage of cash, because many businessmen failed to keep their promises of financially supporting the foundation. As a result, patients have been recently asked to share 25 per cent of their medical bills. Lack of finance "We cannot afford to pay for the original and branded medicines, and we are burdened by debt of more than YR40m (Dh70.000).The businessmen are only willing to buy machines and unwilling to give cash. Our foundation is running without money." As the government turned attention to controlling anti-regime protesters, local charities have been left in the lurch. "The government has left us alone in the ring fighting cancer. We managed to get some machines for our centre from a Saudi businessman, the company has refused to bring it to Yemen because of the crisis." In a country with a high record of illiteracy, people are out of touch with cancer and many think that having cancer means capital punishment. "When we identify a new breast cancer case, we tell the patient that it is not the end of her life." In 2006, the late Saudi prince Sultan Bin Abdul Aziz visited Hadramout province, and promised to build a state-of-the art cancer centre in the province. The Saudi Development Fund earmarked $12 million for the construction of the facility. The project went through red tape and finally a Saudi construction firm was assigned the contract to build the facility. However, due to the current political crisis in Yemen, the project was frozen. Dr. Ahmad thinks that building the centre is not going to solve the problem solely since running a cancer centre is very expensive. Punishing trips Due to lack of diagnostic machines at home, cancer patients usually have to travel overseas, mainly to Jordan and Egypt. In addition to taking the pain of travel, they spend millions of dollars on treatment at cancer centres there. However, before arriving at the overseas centres, the poor Yemeni patient suffer at home due to the lengthy process of diagnosing the disease . When doctors suspect a tumour in a patient in Hadramout, for instance, they ask the patient to do CAT scan which is available only in the capital." As the patient returns, doctors take a sample of the tumour and send it to Saudi Arabia and the patient wait impatiently for the result for a month. In some cases, the Saudis ask their counterparts in Yemen to send another sample which means another period of waiting. In the meantime, the disease reach the terminal stages and the patient dies. But most of the patients travel abroad the moment they see a swelling in their body. However, Dr. Ahmad and his colleagues have put a plan for building a diagnosis centre, but the underfunded foundation financial support to build it. According to Dr. Ahmad, most women patients suffer from breast, cervical and heamatological disorders. Men are commonly diagnosed with heamatological cancers, along those of the colon, lung, bladder, liver and stomach.