Ali, 15, has been in and out of the Mahak Clinic for the last four years. Avedis Hadjian

Four years ago, during a soccer match, Ali’s leg became paralyzed. X-rays revealed a sarcoma — a rare type of cancer that develops in muscles and other tissue — in his hip. Then a tumor was found in his head. And then another one in his thigh. Since then, he has been fighting these three tumors at the Mahak Clinic, a nonprofit pediatric cancer hospital in Tehran with state-of-the-art facilities, staffed by some of Iran’s top oncologists.

Childhood cancer in Iran is deadlier than in the developed world, with a mortality rate of 46 per 1 million children ages 14 and under, according to a study published in The Journal of Pediatric Hematology/Oncology (JPHO) in July 2010. The average mortality rate for the same age group in Canada, the European Union, Japan and the U.S. was 23 deaths per 1 million in 2012, according to the World Health Organization. The JPHO study attributed the high mortality rate to “low education or least awareness of the parents, late diagnosis or the low access to the effective treatment.”

Unbeknownst to Ali, his situation ties him to Germany, which — along with the United States and other nations — enforces U.N. sanctions imposed on Iran for refusing to end its uranium enrichment program. These sanctions prohibit the sale or supply of dual-use goods, meaning items that can be used in nuclear weapon programs.