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.

 


At least 6 Egyptian women die after vehicle slides off ferry and plunges into Nile River

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At least 6 Egyptian women die after vehicle slides off ferry and plunges into Nile River

CAIRO: At least six Egyptian women died Tuesday after a vehicle carrying about two dozen people slid off a ferry and plunged into the Nile River just outside Cairo, authorities said.
The accident, which happened in Monshat el-Kanater town in Giza province, also injured nine other passengers, the Health Ministry said in a statement. Giza is one of three provinces forming Greater Cairo.
The ministry said six of the injured were treated at the site while three others were transferred to hospitals. It didn’t elaborate on their injuries.
Giza provincial Gov. Ahmed Rashed said the microbus was retrieved from the Nile, and rescue efforts were still underway as of midday Tuesday.
The cause of the accident was not immediately clear.
According to the state-owned Akhbar daily, about two dozen passengers, mostly women, were in the vehicle heading to work when the accident occurred.
Ferry, railway and road accidents are common in Egypt mainly because of poor maintenance and lack of regulations. In February, a ferry carrying day laborers sank in the Nile in Giza, killing at least 10 of the 15 people on board.

Syrian first lady Asma Assad has leukemia, presidency says

Updated 21 May 2024
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Syrian first lady Asma Assad has leukemia, presidency says

  • Statement stated that Asma would undergo a special treatment protocol that would require her to isolate

DUBAI: Syria’s first lady, Asma Assad, has been diagnosed with leukemia, the Syrian presidency said on Tuesday, almost five years after she announced she had fully recovered from breast cancer.
The statement said Asma, 48, would undergo a special treatment protocol that would require her to isolate, and that she would step away from public engagements as a result.
In August 2019, Asma said she had fully recovered from breast cancer that she said had been discovered early.
Since Syria plunged into war in 2011, the British-born former investment banker has taken on the public role of leading charity efforts and meeting families of killed soldiers, but has also become hated by the opposition.
She runs the Syria Trust for Development, a large NGO that acts as an umbrella organization for many of the aid and development operations in Syria.
Last year, she accompanied her husband, President Bashar Assad ,on a visit to the United Arab Emirates, her first known official trip abroad with him since 2011. She met Sheikha Fatima bint Mubarak, the Emirati president’s mother, during a trip seen as a public signal of her growing role in public affairs.


Yemen’s Houthis say they downed US drone over Al-Bayda province

Updated 21 May 2024
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Yemen’s Houthis say they downed US drone over Al-Bayda province

  • The Houthis said last Friday they downed another US MQ9 drone over the southeastern province of Maareb

DUBAI: Yemen’s Houthis downed a US MQ9 drone over Al-Bayda province in southern Yemen, the Iran-aligned group’s military spokesperson said in a televised statement on Tuesday.

Yahya Saree said the drone was targeted with a locally made surface-to-air missile and that videos to support the claim would be released.

The Houthis said last Friday they downed another US MQ9 drone over the southeastern province of Maareb.

The group, which controls Yemen’s capital and most populous areas of the Arabian Peninsula state, has attacked international shipping in the Red Sea since November in solidarity with the Palestinians in the war between Israel and Hamas militants, drawing US and British retaliatory strikes since February.


Iranians pay last respects to President Ebrahim Raisi

Updated 21 May 2024
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Iranians pay last respects to President Ebrahim Raisi

  • Mourners set off from a central square in the northwestern city of Tabriz
  • Supreme leader Ayatollah Ali Khamenei declares five days of national mourning

TEHRAN: Tens of thousands of Iranians gathered Tuesday to mourn president Ebrahim Raisi and seven members of his entourage who were killed in a helicopter crash on a fog-shrouded mountainside in the northwest.

Waving Iranian flags and portraits of the late president, mourners set off from a central square in the northwestern city of Tabriz, where Raisi was headed when his helicopter crashed on Sunday.

They walked behind a lorry carrying the coffins of Raisi and his seven aides.

Their helicopter lost communications while it was on its way back to Tabriz after Raisi attended the inauguration of a joint dam project on the Aras river, which forms part of the border with Azerbaijan, in a ceremony with his counterpart Ilham Aliyev.

A massive search and rescue operation was launched on Sunday when two other helicopters flying alongside Raisi’s lost contact with his aircraft in bad weather.

State television announced his death in a report early on Monday, saying “the servant of the Iranian nation, Ayatollah Ebrahim Raisi, has achieved the highest level of martyrdom,” showing pictures of him as a voice recited the Qur’an.

Killed alongside the Iranian president were Foreign Minister Hossein Amir-Abdollahian, provincial officials and members of his security team.

Iran’s armed forces chief of staff Mohammad Bagheri ordered an investigation into the cause of the crash as Iranians in cities nationwide gathered to mourn Raisi and his entourage.

Tens of thousands gathered in the capital’s Valiasr Square on Monday.

Supreme leader Ayatollah Ali Khamenei, who has ultimate authority in Iran, declared five days of national mourning and assigned vice president Mohammad Mokhber, 68, as caretaker president until a presidential election can be held.

State media later announced that the election would will be held on June 28.

Iran’s top nuclear negotiator Ali Bagheri, who served as deputy to Amir-Abdollahian, was named acting foreign minister.

From Tabriz, Raisi’s body will be flown to the Shiite clerical center of Qom on Tuesday before being moved to Tehran that evening.

Processions will be held in in the capital on Wednesday morning before Khamenei leads prayers at a farewell ceremony.

Raisi’s body will then be flown to his home city of Mashhad, in the northeast, where he will be buried on Thursday evening after funeral rites.

Raisi, 63, had been in office since 2021. The ultra-conservative’s time in office saw mass protests, a deepening economic crisis and unprecedented armed exchanges with arch-enemy Israel.

Raisi succeeded the moderate Hassan Rouhani, at a time when the economy was battered by US sanctions imposed over Iran’s nuclear activities.

Condolence messages flooded in from Iran’s allies around the region, including the Syrian government, Palestinian militant group Hamas and Lebanese militant group Hezbollah.

It was an unprecedented Hamas attack on Israel that sparked the devastating war in Gaza, now in its eighth month, and soaring tensions between Israel and the “resistance axis” led by Iran.

Israel’s killing of seven Revolutionary Guards in a drone strike on the Iranian consulate in Damascus on April 1 triggered Iran’s first ever direct attack on Israel, involving hundreds of missiles and drones.

In a speech hours before his death, Raisi underlined Iran’s support for the Palestinians, a centerpiece of its foreign policy since the 1979 Islamic revolution.

Palestinian flags were raised alongside Iranian flags at ceremonies held for the late president.


Israeli army raids West Bank’s Jenin, Palestinians say seven killed

Updated 21 May 2024
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Israeli army raids West Bank’s Jenin, Palestinians say seven killed

  • Among the Palestinians killed was a surgical doctor, the head of the Jenin Governmental Hospital said

JENIN: Israeli forces raided Jenin in the occupied West Bank on Tuesday in an operation that the Palestinian health ministry said killed seven Palestinians, including a doctor, and left nine others wounded.
The army said it was an operation against militants and that a number of Palestinian gunmen were shot. There was no immediate word of any Israeli casualties.
The health ministry account of the casualties was quoted by the official Palestinian news agency WAFA.
Among the Palestinians killed was a surgical doctor, the head of the Jenin Governmental Hospital said. He was killed in the vicinity of the hospital, the director said.
The West Bank is among territories Israel seized in a 1967 Middle East war. The Palestinians want it to be the core of an independent Palestinian state. US-sponsored talks on a two-state solution to the decades-old conflict broke down in 2014.