4 February 2018 – Breast cancer is not the only tragedy that Asma’a Hamoud, 23, is facing. Poverty, the security situation, shortages of anti-cancer drugs and irregular chemotherapy sessions have exacerbated her pain.

Asma’a was diagnosed with breast cancer 6 years ago. Her recent attempts to continue treatment in Jiblah District, Ibb governorate have failed.

“I had to travel to Taizz for chemotherapy sessions but the ground fighting forced me to travel to Sana’a, where I have no relatives that I can stay with while I receive treatment,” Asma’a said.

Almost forgotten

The life of cancer patients in Yemen have been aggravated by the 3-year-old conflict, which has led to the gradual collapse of the health system and driven millions of people into poverty. Even prior to the crisis, cancer patients suffered from serious economic challenges which hindered the regularity of their treatment.

Most families of cancer patients struggle to afford the cost of treatment, including expensive medicines, transportation and accommodation.

In Yemen, more than 60 000 cancer patients (12 percent of whom are children) receive treatment in the National Oncology Centre in Sana’a since 2005. But the Centre, which receives patients from across the country, had its annual budget totally stopped.

Before the crisis, the Government used to provide the centre with around US$ 12 million a year, but the Centre has not received any funding for around 2 years, leaving it totally dependent on limited external support.

Keeping this lifeline alive

The Centre has been on the verge of closing several times – which would deprive thousands of patients from receiving life-saving chemotherapy and radiation therapy.

“We try to do our best to keep functioning, but we don’t have enough medicines, and we have no choice but to watch our patients die due to lack of treatment. Poor patients simply leave us and die at home because they cannot afford treatment,” said Dr Ali Al-Ashwal, Director of the National Oncology Centre.

Medical beds and recliners inside the Centre are always occupied, with some beds shared by two patients. Akram, 8, and Ashjan, 7, a brother and sister, lie on one bed suffering from lymphoma and a brain tumour, respectively. Their father has brought them from Wesab District in Dhamar Governorate to receive treatment.

The challenges facing the centre are not only confined to shortages of medicines and lack of operational costs. Professional oncologists and other medical staff are leaving the country due to the ongoing conflict, unpaid health care worker salaries and the deteriorating economic situation.

“There has been a major brain drain of senior oncologists and other experienced staff. If the situation doesn’t improve, we will have a big problem, and more doctors will leave the country in search of better opportunities,” said Al-Ashwal. He stressed the risk of the closure of the centre which will not be opened again in foreseeable future.

Life-saving support from donors

With support from the World Bank and Germany, WHO is in the process of providing the centre with US$ 2.5 million worth of anti-cancer medicines and chemotherapy medications, sufficient for almost 30 000 patients. The anti-cancer drugs and chemotherapy medication have been procured and are in the process of being shipped to the country by early 2018. To fill the gap until the arrival of the mentioned shipment, WHO today provided the National Oncology Centre in Sana’a with various cancer drugs and chemotherapy medications sufficient to treat 5000 patients for one month.

“In 2017 alone, more than 10 000 cancer patients were registered but around 40% of them received appropriate complete treatment. This is a clear indication of the critical conditions those patients are going through,” said Dr Nevio Zagaria, WHO Representative in Yemen.

“The families of cancer patients in Yemen are suffering from the agony of watching their children endure the pain or die due to lack of full treatment.”

It is such a tragedy to note that treatment for noncommunicable diseases such as cancer, diabetes and hypertension is available in approximately only 20% of health facilities across Yemen. As a result, these chronic conditions are now killing more people than bullets or bombs, accounting for 39% of all reported deaths in 2017.