How cancer patients in Gaza are coping under Israeli bombardment and embargo

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Palestinian children suffering from cancer receive treatment, main, at a hospital in prewar Gaza. The enclave once had a well-developed healthcare system. (AFP/File)
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A Palestinian youth transports a body in a donkey-pulled cart, near the Ahli Arabi hospital in Gaza City, on January 31, 2024, amid the ongoing conflict between Israel and the Palestinian militant group Hamas. (Photo by AFP)
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Medical equipment are scattered outside the Indonesian Hospital at the edge of the Jabalia refugee camp in the northern Gaza Strip, after Israeli troops reportedly raided the medical facility, on November 24, 2023. (AFP)
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An injured man is treated on the floor of Gaza City's al-Shifa hospital following an Israeli strike that killed at least 20 and wounded more than 150 as they waited for humanitarian aid. (AFP photo)
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Updated 04 February 2024
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How cancer patients in Gaza are coping under Israeli bombardment and embargo

  • Displacement, destruction of clinics, and loss of treatments amount to a death sentence for many cancer patients
  • Early diagnosis and life-saving treatment abroad now completely out of reach for thousands of Palestinians

DUBAI: Being diagnosed with cancer and undergoing a lengthy course of treatment is a frightening prospect at any time. Enduring such an ordeal in wartime is a different league of terror altogether.

Some 2 million Palestinian civilians in Gaza have been displaced by months of intense Israeli bombardment, while strict controls on the entry of humanitarian assistance have deprived them of even the most basic resources.

According to the World Health Organization, almost two-thirds of Gaza’s 36 hospitals have been knocked out of action by the fighting, while 13 are “partially functioning” with inadequate fuel and supplies, operating at many times their intended capacity.




Injured people receive treatment in Gaza City's Al-Shifa hospital following a reported Israeli strike that killed at least 20 and wounded more than 150 as they waited for treatment on January 25, 2024.(AFP)

For people undergoing cancer treatment, the destruction of healthcare infrastructure, loss of access to life-sustaining drugs and therapies, and the discomfort of life in displacement could amount to a death sentence.

An article published in The Cureus Journal of Medical Science, citing figures from a Palestinian Ministry of Health report, put the cancer incidence rate in the region at 91.3 cases per 100,000 people in 2021.

“The situation is particularly exacerbated when conflicts prolong,” Dr. Soha Abdelbaky, an oncology consultant at Medcare Hospital Sharjah, told Arab News.




Emergency workers bring a Palestinian man, who was released after being detained with other civilians for questioning by Israeli forces, waits at Al-Najjar Hospital in Rafah on Feb. 1, 2024. (AFP)

“Cancer patients in areas of conflict are often diagnosed at later stages and are less likely to receive the optimal treatment. For cancer patients, even a one-day delay is important, as the disease progresses at a rapid pace.”

Israel launched its military campaign in Gaza in response to Hamas’ Oct. 7 attack on southern Israel, in which 1,200 people were killed, most of them civilians, and 240, including foreign nationals, were taken hostage.

INNUMBERS

2,000 Recorded cancer patients in Gaza prior to conflict.

300 Healthcare workers killed in Gaza since conflict began.

26% Rise in death rate owing to 3-month cancer treatment delay.

Since then, it has waged a ferocious air and ground campaign against Hamas, which has controlled the Gaza Strip since 2007, killing more than 26,000 Palestinians, according to the Gaza Health Ministry.

With some 130 hostages still thought to be held in Gaza, the Israeli government said it was determined to continue operations until Hamas was defeated. Plans for the post-war governance of Gaza or a wider peace process, however, are yet to be determined.




Gaza once had a reasonably well-developed healthcare system with a workforce of about 25,000 doctors, nurses and specialists. (AFP)

Meanwhile, more than 2,000 cancer patients, over 1,000 people in need of dialysis to survive, 50,000 cardiovascular patients and about 60,000 diabetics have been left in urgent need of basic health services amid the carnage, according to Euro-Med Monitor.

Even prior to the current bombardment, 16 years of strict Israeli embargo had left people with chronic health conditions facing intense difficulties in accessing medical care.




This infographic was shared on social media by the Palestinian Ministry of Health three years ago. With the destruction of most of the hospitals in Gaza since October 7, 2023, the fate of many of the patients is uncertain. 

In November, the Palestinian Health Authority reported that the Turkish-Palestinian Friendship Hospital — the sole facility providing cancer treatment in the Gaza Strip — had ceased operations after sustaining damage.

Days later, fuel shortages reportedly led to the death of four of its patients, while 70 cancer patients were transferred to Dar Al-Salam Hospital in war-torn Khan Younis in southern Gaza.




Palestinian cancer patients, who had crossed from Gaza into Egypt, arrived at the Esenboga Airport in Ankara on November 16, 2023. Two planes carrying more than two dozen Palestinian cancer patients, many of them children, arrived in Turkey for treatment in the early hours of November 16. (AFP)

Gaza once had a reasonably well-developed healthcare system with a workforce of about 25,000 doctors, nurses and specialists. But months of fighting have brought the enclave’s medical infrastructure to its knees.

Aid agencies have been forced to prioritize emergency services. As a result, those with cancer symptoms or managing complex chronic conditions have been left to fend for themselves, reducing their chances of survival.

“Early detection is crucial,” Dr. Maya Bizri, assistant professor of psychiatry and psychosomatic medicine and director of psycho-oncology at the American University of Beirut, told Arab News.

“It’s important to note the up to 8 percent increase in mortality risk for every four weeks’ delay in getting a surgery needed for cancer.”

MOST PREVALENT TYPES OF CANCER

Breast cancer:

• Estimated new cases in 2018: 119,985.

• Deaths in 2018: 48,661.

• Worldwide estimated cases in 2020: 2.3 million.

• Prevalence attributed to lifestyle, environmental changes among females.

Lung cancer:

• Leading cause of global cancer incidence and mortality.

• Estimated diagnoses: 2 million

• Reported deaths: 1.8 million

• Prevalence linked to increased tobacco access and industrialization.

Prostate cancer:

• Second most common solid tumor in men.

• Fifth leading cause of cancer mortality.

• Occurs due to age, family history, genetic mutations.

Colorectal cancer:

• Increasing incidence in Middle East, especially among under-50s.

A 2020 study by the health journal Cancer Medicine showed that a three-month delay in surgery for a patient undergoing breast cancer treatment resulted in a 26 percent increase in the risk of death.

Another study by JCO Global Oncology in 2022 projected that a delay in care of only four months for five common types of cancer would lead to more than 3,600 additional deaths.

“Four weeks is just 30 days — the Gaza war has (lasted more than) 100 days now. So, if we reframe it, cancer care disruption is weaponized as another way that war kills civilians,” Bizri said.

“The weaponization of healthcare has been documented across different wars, with targeting of healthcare workers, despite it breaching the Geneva Convention in Ukraine, in Syria and most recently in Gaza.”




This aerial view shows people standing before destroyed buildings at the site of the Ahli Arab hospital in central Gaza on October 18, 2023 in the aftermath of an overnight Israeli strike. (AFP)

Israel denies accusations that its military deliberately targets health workers and civilian infrastructure. Instead, it has accused Hamas of using tunnel networks beneath Gaza’s hospitals to direct attacks, store weapons and conceal hostages.

Any damage to medical facilities, therefore, is the fault of Hamas, Israeli authorities say, accusing the group of using patients and doctors as human shields.

In other conflict zones around the world, the collapse of healthcare infrastructure usually compels those who can afford it to seek refuge in neighboring countries, frequently opting for temporary resettlement in order to access medical treatment.




Israeli bombardment since Oct. 7 is blamed for the destruction of lifesaving services, including ambulances. (AFP)

In 2022, 122 children in Gaza were diagnosed with cancer, mainly leukemia, according to the World Health Organization. They received only a portion of their care in Gaza owing to the lack of some services and many were routinely referred to hospitals in the West Bank, including East Jerusalem, Egypt, Israel and Jordan for further treatment.

Early in the latest conflict, the WHO and St. Jude Children’s Research Hospital launched a campaign to evacuate sick children so they could be treated abroad. But that option is not available to the majority of cancer patients in Gaza because of the long-standing Israeli blockade.

Obstacles in obtaining the necessary permits for travel outside the enclave further hinder the ability of cancer patients to access optimal care.




Children wounded following Israeli bombardment awaits treatment at Nasser hospital in Khan Yunis in the southern Gaza Strip on December 20, 2023. (AFP)

Prior to the conflict, patients and their relatives had to submit a medical permit request to the Israeli Coordination and Liaison Administration. About 20,000 patients a year, almost a third of them children, sought permits to leave Gaza for healthcare.

According to the WHO, Israel approved just 63 percent of those requests in 2022.

Health agencies have repeatedly called for a ceasefire to allow humanitarian access, urged the warring parties to protect health personnel and infrastructure in line with international humanitarian law, and pleaded with Israeli authorities to prevent delays at checkpoints.




Emergency workers bring a Palestinian man, who was released after being detained with other civilians for questioning by Israeli forces, waits at Al-Najjar Hospital in Rafah on February 1, 2024. (AFP)

In one instance, the WHO said, the detention of health partners during the transfer of critically ill individuals and the delivery of supplies to a hospital in northern Gaza resulted in the death of one patient.

There have also been multiple reported instances of ambulances and aid trucks coming under fire, resulting in the death of more than 300 healthcare personnel since the war began.

With limited staff and resources to cope with the enormous pressure of treating wounded civilians, the skills of Gaza’s remaining cancer specialists are needed for the more immediate demands of the war.

As a consequence, Dr. Bizri said: “Physicians with very advanced skills are now mostly tending to war injuries and life-saving interventions.”




As a result of the war, many doctors in Gaza have been relegated to tend to wounded patients, being unable to practice their specializations.  (AFP)

What is also often overlooked are the psychological repercussions of a cancer diagnosis on patients. Delayed or interrupted treatment can exacerbate such feelings during wartime, when patients report feeling more of a burden.

According to Dr. Abdelbaky, individuals undergoing cancer treatment in conflict zones also experience heightened fear anxiety and distress.

Worsening psychological conditions, including depressive disorders, “can have detrimental effects on the patient’s ability to cope with the diagnosis, treatment, prognosis and maintenance plans,” she said.




Repairing shattered infrastructure and training new health professionals will take years, all while caring for a maimed and deeply traumatized population. (AFP photo)

Even when the current conflict ends, the situation for cancer patients is unlikely to improve fast. Repairing shattered infrastructure and training new health professionals will take years, all while caring for a maimed and deeply traumatized population.

Shortages of equipment for diagnosis, chemotherapy and radiotherapy are also likely to continue well after the end of hostilities owing to supply chain disruptions, aid dependency and the unresolved issue of postwar governance.

Unless a ceasefire is declared and aid agencies are given sufficient access to the Gaza Strip to respond to the immediate health needs of the population, the prognosis for those with chronic conditions like cancer is poor.

 


Three US troops have non-combat injuries during Gaza pier operation

Updated 9 sec ago
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Three US troops have non-combat injuries during Gaza pier operation

WASHINGTON: Three US troops suffered non-combat injuries in the effort to make a temporary pier off the coast of Gaza into a conduit for humanitarian aid, with one in critical condition at an Israeli hospital, US officials said on Thursday.

The injuries were the first for US forces during the latest operation to bring humanitarian aid to Palestinians.

The pier was announced by US President Joe Biden in March and involved the military assembling the floating structure off the coast. Estimated to cost $320 million for the first 90 days and involve about 1,000 US service members, it went into operation last week.

US Vice Admiral Brad Cooper, the deputy commander of US Central Command, told reporters that two of the troops had a sprained ankle and a minor back injury.

“Two were very minor, routine injuries. Those individuals returned to duty,” Cooper said.

A third service member, injured on a ship at sea, was medically evacuated to a hospital in Israel, he said. A US defense official, speaking on the condition of anonymity, said the individual was in critical condition.

US lawmakers have voiced concern about the risks to positioning US troops off the coast of Gaza. Biden has said they will not step foot in the war-torn city itself.

The Pentagon has said it will prioritize the safety of US military personnel.

“We’re clear eyed and we continue to look at force protection all day, every day and as it stands now we assess the operations can continue,” Cooper said.

Social media images showed a US air defense system, known as the Counter Rockets, Artillery and Mortars (CRAM), firing into the sky while on the pier. US officials said troops were testing the system.

Daniel Dieckhaus of the US Agency for International Development said that since the pier opened last week, about 506 metric tons of aid had been handed off to humanitarian groups inside Gaza. About a third of that has not yet been distributed but would be soon, he said.


Medic says Gaza hospital under Israeli siege for fifth day

Updated 23 May 2024
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Medic says Gaza hospital under Israeli siege for fifth day

GAZA STRIP: A senior official at Al-Awda Hospital in northern Gaza said it was under Israeli military siege for a fifth straight day on Thursday after soldiers stormed it the previous day.

“We are still under siege for the fifth day in a row,” said the hospital’s acting director, Dr. Mohammed Saleh.

“Soldiers are present in the hospital’s courtyard and nearby houses,” he said, adding that there was “continuous gunfire and shelling” toward it.

Troops stormed the hospital building on Wednesday evening, he said.

“The hospital was stormed, and staff were forced to leave. I currently have only 13 staff, 11 patients, and two women accompanying wounded children,” Saleh said.

World Health Organization chief Tedros Adhanom Ghebreyesus said on social media platform X that 140 staff, patients, and accompanying adults were inside the hospital when troops stormed it.

The WHO visited Al-Awda regularly in April to deliver medical supplies and fuel, but on Tuesday Ghebreyesus said snipers were targeting the building and artillery had hit the fifth floor.

On Tuesday, patients and staff were also evacuated from another hospital in northern Gaza, Kamal Adwan, its director, Dr. Hossam Abu Safia, said at the time.

“These are the only two functional hospitals remaining in northern Gaza. Ensuring their ability to deliver health services is imperative,” Ghebreyesus said in Geneva.

Israeli troops have previously raided other medical facilities in Gaza, including Al-Shifa in Gaza City, the territory’s largest hospital, which was reduced to rubble after an operation in March, the WHO said.


Bahrain’s King Hamad says he is looking forward to improved relations with Iran

Russian President Vladimir receives Bahrain's King Hamad at the Kremlin in Moscow, Russia, May 23, 2024. (BNA)
Updated 23 May 2024
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Bahrain’s King Hamad says he is looking forward to improved relations with Iran

  • King meets Russian President Vladimir Putin at the Kremlin 

RIYADH: Bahrain’s King Hamad said his country was looking forward to improving its relations with Iran during a meeting with Russian President Vladimir Putin at the Kremlin.
The king added that there was no reason for Bahrain to postpone the resumption of diplomatic relations with Iran, the Bahrain News Agency reported on Thursday.
The king and Putin discussed the war in Gaza, regional and international efforts aimed at reaching a ceasefire, and the release of hostages and detainees. They also focused on providing humanitarian aid without obstacles to the territory’s civilian population.
They highlighted the importance of advancing the course of diplomatic action to settle the Palestinian-Israeli conflict, and achieving a Palestinian state with East Jerusalem as its capital. The leaders also said efforts to recognize the Palestinian state and accept it as a permanent member of the UN should be supported.
They also stressed the importance of the UN Security Council assuming its responsibilities toward resolving and ending global conflicts, and working to settle them in accordance with the rules of international law and the UN Charter to maintain international peace and security.
The king informed the Russian president of the outcomes of the Arab Summit held recently in Bahrain, adding that Arab countries appreciated Russia’s sympathy for just Arab causes.
The king and Palestinian President Mahmoud Abbas called for the convening of an international conference at the summit, which would take place under the auspices of the UN, to resolve the Palestinian issue on the basis of a two-state solution.
The king added that he hoped to host the conference and requested Russia’s support for it.


Arab Parliament welcomes move to recognize Palestinian state

Updated 23 May 2024
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Arab Parliament welcomes move to recognize Palestinian state

  • The parliament described the move as a victory for justice and the right of the Palestinian people to establish an independent state
  • Growing international recognition of a Palestinian state represented a practical response to Israel’s plans to “liquidate the Palestinian cause, which will not succeed”

CAIRO: The Arab Parliament has welcomed a decision by the governments of Spain, Norway and Ireland to recognize the state of Palestine.
The prime ministers of the three countries said on Wednesday that they would formally recognize Palestine as a state on May 28.
All three said they hoped the decision would accelerate efforts toward securing a ceasefire in Israel’s war against Hamas in Gaza, now in its eighth month.
The parliament described the move as a victory for justice and the right of the Palestinian people to establish an independent state.
It said the decision was a “new victory for the Palestinian cause and Palestinian diplomacy,” and an important step toward recognition by many countries worldwide.
The parliament said the recognition supported the legitimate rights of the Palestinian people, foremost of which is the establishment of an independent state with the city of Jerusalem as its capital.
It said that the announcements come at a time when Israel is working to destroy the Palestinian cause through “ethnic cleansing and forced displacement against civilians, including children, women, and the elderly, against whom war crimes and crimes against humanity are being committed.”
Growing international recognition of a Palestinian state represented a practical response to Israel’s plans to “liquidate the Palestinian cause, which will not succeed,” it added.
The parliament called on countries that have not yet recognized the state of Palestine to take a step toward “ending the historical injustice to which the Palestinian people have been exposed for decades of occupation and per the internationally recognized two-state solution based on international legitimacy resolutions.”
It called on the international community and all countries to stand with the Palestinian people and their just cause.
Ireland has said it will upgrade its representative office in the West Bank to a full embassy, while the Palestinian mission in Ireland will also be offered full embassy status.


Egyptians held nearly a year over deadly shipwreck are released from Greek jail after case dismissed

Updated 23 May 2024
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Egyptians held nearly a year over deadly shipwreck are released from Greek jail after case dismissed

  • The Egyptians’ defense team had argued that the nine were not crew members of the ill-fated trawler
  • Eight of the nine were released from a jail outside the southern city of Nafplio on Wednesday evening

NAFPLIO, Greece: A group of Egyptians jailed for nearly a year pending trial for a deadly shipwreck were released from jail Wednesday, a day after a Greek court threw out the case against them on grounds that it had no jurisdiction to try it.
Nine Egyptians had been charged with being part of the crew of the Adriana, a massively overcrowded trawler that capsized and sank near Greece last June with an estimated 700 people on board while sailing from Libya to Italy. Only 104 people survived – all men, mostly from Syria, Egypt and Pakistan — and 82 bodies were recovered.
The nine, who have been in pretrial custody since their rescue last year, had been charged with being members of a migrant smuggling ring and were accused of having caused the shipwreck. They had faced several life sentences if convicted.
But a court in the southern Greek city of Kalamata on Tuesday ruled it had no jurisdiction to try the case, as the shipwreck occurred in international waters, none of those involved had been trying to enter Greece, the ship was not Greek flagged and no Greek citizens were on board.
The Egyptians’ defense team had argued that the nine were not crew members of the ill-fated trawler but had been paying passengers who were mistakenly identified as crew by nine other survivors, and that they were being used as scapegoats by authorities eager to put all the blame for the tragedy on the trawler’s crew.
Eight of the nine were released from a jail outside the southern city of Nafplio on Wednesday evening. They were transferred to a police station in the city, where they were to remain in custody overnight pending further procedures. It was not immediately clear when they would be fully released from custody.
The ninth defendant was to be released from a different jail.
The massive loss of life in the sinking of the Adriana in the early hours of June 14, 2023, renewed pressure on European governments to protect the lives of migrants and asylum seekers trying to reach the continent. The European border protection agency Frontex says illegal border detections at EU frontiers increased for three consecutive years through 2023, reaching the highest level since the 2015-2016 migration crisis, driven largely by arrivals by sea.
The exact circumstances of how the Adriana sank remain unclear. The trawler was sailing in international waters but within Greece’s search and rescue area of operations, and a coast guard patrol boat and passing merchant ships were near the vessel for several hours. Greek authorities have said the trawler’s crew repeatedly refused offers of help, insisting it wanted to continue to Italy.
Several survivors have said the boat capsized after the Greek coast guard attempted to tow it, an accusation Greek authorities have vehemently denied. A Naval Court investigation into the sinking is still underway.
Speaking at the courthouse after the case was dismissed on Tuesday, Dimitris Choulis, one of the lawyers in the defense team for the nine Egyptians, said attention should turn to how the Adriana sank.
“The court today had to be very brave to issue this decision, and to say that these people are not the smugglers,” Choulis said.
The lawyer blamed the tragedy on the Greek coast guard and Europe’s migration policies, and said it was essential to “make sure that nothing like that would happen again.”