A glimmer of hope for cancer patients in northwest Syria

"Imagine a cancer patient waiting in the queue on the Syrian border, for I don't know how many days," begins Dr Mohammad Nahel Ghadri.

"He goes inside Turkey and travels 500 or 600 kilometres by bus. He takes a radiotherapy session and he comes back to the border, 500 or 600 kilometres away. He goes alone because he is not allowed a caregiver. 

"Normally after anyone receives a therapy session, their body is exhausted and they can barely walk and barely move. There is physical exhaustion, there is economic exhaustion. Can you imagine how difficult it is?” 

“Can you imagine how difficult it is?... The answer for the vast majority is ‘no’. Not at all"

Dr Mohammad Nahel Ghadri’s explanation puts into perspective the monumental struggle for cancer patients in northwest Syria in need of radiotherapy treatment.

What is for many world citizens a given — local access to comprehensive cancer treatment — is for those in the region a luxury.

But there is at last hope, as the Syrian town of Afrin prepares to host the first-ever radiotherapy machine in the northwest.

Following years of campaigning and advocacy work from a combination of the UN, the Turkish government and NGOs such as Al-Ameen — for whom Dr Ghadri is the Syrian Regional Director — the machine arrived in north-west Syria in early October.

As explained by Dr Ghadri, patients in need of radiotherapy had been dependent on cross-border referrals to Turkey in order to receive a round of treatment.

Between 90 to 100 patients crossed the border each week, before the catastrophic earthquake which took 55,000 lives in Turkey and northwest Syria.

When the earthquake hit, the cancer referral system was shut down for months.

And yet a small silver lining emerged from the most seismic of natural catastrophes. It turned out to be the final push needed to gain permission for a radiotherapy machine in northwest Syria.

For years, efforts to get a radiotherapy machine into northwest Syria had been hampered by the fear of sanctions and the need for permission from the Turkish authorities.

“When you want to bring in anything into Syria that has radiation then there is an American sanction,” Dr Ghadri says. “The first challenge was to get permission.”

After the earthquake, things changed. The halting of the referral system left thousands unable to access the vital and life-saving treatment they so desperately needed.

The system resumed on July 26, but only to a limited capacity. “It was solved, but they are still suffering.”

It became clear the level of dependency from Syrian cancer patients on the Turkish healthcare system was not sustainable — particularly in the face of such unprecedented circumstances as the earthquake.

Advocacy groups were therefore able to push forward vigorously in lobbying the Turkish authorities to allow Syria to be self-dependent in its provision of cancer treatment.

“It [helped our cause] because there has been a lot of advocacy for Syrian people saying: ‘Please, cancer patients have nowhere else to go’. We pushed a lot inside the Turkish Ministry of Health, and finally, we found the right device. The device basically is a donation by the Turkish health authorities,” Dr Ghadri explains.

However, there is significant work to be done before the project is complete. The installation of the special type of bunker required to host a radiotherapy machine is underway, thanks to the financial assistance of the Syrian White Helmets.

A more complex step in the project is the training of Syrian doctors to operate the machine. Dr Ghadri says negotiations are underway with the Turkish company which manufactures the machines.

For one year, the company will send oncologists to Syria, with the promise of a doubled salary to attract them to Afrin. Throughout the year these oncologists will train local staff, the hope being that from then onwards the operation of radiotherapy treatment in northwest Syria will be smooth and plentiful.

And yet one more obstacle remains in this gruelling project: funding. “It will be very exhausting for Al-Ameen,” Dr Ghadri says. “We need to find the funds to support the expert people, the oncologists. And we still have gaps in the diagnostic equipment.

"This is one of the problems we are facing: we have a lot of cancer cases which we don’t know about. And it’s very important, early diagnosis in a cancer treatment. Therefore, we make a call for all concerned people to help us in northwest Syria.”

Al-Ameen’s mission statement is to ensure every individual within its remit of Syria, Turkey, Lebanon, Yemen and Sudan has “access to basic resources and human rights”.

That’s why Dr Ghadri and his team have put so much time into the radiotherapy machine project.

“It will make a big difference. It will make a huge difference,” Dr Ghadri says with pride. “In northwest Syria, people are very poor, they have a high poverty rate. Living in Turkey for five days [i.e. travelling there for radiotherapy treatment] is equal to a monthly salary inside Syria.  The patients make a very long journey, it is a very heavy burden financially and physically.”

“Can you imagine how difficult it is?” The question earlier asked by Dr Ghadri. The answer for the vast majority is ‘no’. Not at all.

But now, thanks to the devoted efforts of Dr Ghadri and Al-Ameen, in partnership with UN departments and the Turkish government, the children of northwest Syria won't be able to imagine it either.

For northwest Syrian cancer patients, there is a glimmer of hope.

Alex Croft is a freelance journalist based in London. His work has appeared in the Daily Mirror, the Hackney Gazette, Ham and High, and more

Follow him on Twitter: @alxcroft