Yemen's uphill battle against cancer

Dr Najeeb al Dubai'e attends one of the patients in the National Oncology Centre while the patients mother stands next to him.

SANA'A // With incidents of cancer growing in Yemen, the country's sole oncology centre is feeling the strain. Hundreds of people arrive at the National Oncology Centre (NOC) in the capital, Sana'a, each day for treatment for a range of cancers, waiting hours to see a doctor, or receive radiotherapy or chemotherapy treatment.

"This is not my first visit. Yet, I have been waiting here for over eight hours to enter [the radiotherapy room]. I have had some doses before but each time I have to wait longer hours. I am tired and have not been able to eat because of the cancer in my neck," said Ahmed Ali Abdullah, who said he was in his 50s. Mr Abdullah has to travel 120km from his village in Thamar governorate to the centre in the capital.

Nadeem Mohammed Saeed, the director of the NOC, said the centre lacks equipment, staff and medicine and cannot address the needs of the increasing number of patients. "There is a lot of pressure on the centre as we receive patients from all over the country. We have only one radiotherapy machine that operates 14 hours a day to provide services to 120 patients per day," said Mr Saeed. He said the overcrowding and lack of facilities affected the quality of their work and caused the long waiting times.

"We are overcrowded and short of some facilities and machines which affect the quality of our services as well as cause patients to wait longer. Patients can get chemotherapy treatment in a week or so but for radiotherapy, they have to wait between three to four weeks," Mr Saeed said. According to Ali al Khawlani, director of the National Cancer Control Foundation (NCCF), a privately supported aid group, there are 360,000 registered cases of cancer in Yemen.

Of the 22,000 cases registered each year, 12,000 will be fatal, he said. There are no comparative figures for previous years. Mr Saeed said that since 2005, the number of new cases the centre is seeing has doubled, from 200 a month to 400 a month. With only 60 spots for in-patients, there is a pressing need to establish similar centres in heavily populated areas. "Such centres will definitely minimise pressure on our centre and save patients the trouble of travelling to the capital from remote areas," he said.

Since the centre was set up three years ago, it has treated about 13,500 cases of cancer, but Mr Saeed admitted this was not a true reflection of the number of cancer cases. "Some go abroad for treatment; some even die without diagnosis. So, our figure does not tell the scale of cancer in Yemen," he said. Many cancers have been linked to the national habit of chewing khat, a mild narcotic popular in Yemen and the Horn of Africa, due to pesticides used to spray the plants.

Among the most commonly found cancers in men are those of the head and neck, including the mouth and gums, and, in women, breast cancer, also followed by head, neck and mouth. "Head and neck cancer is number one among men and number two among women in Yemen. This is related to our bad habits of chewing khat, the chewing of shamah [grind tobacco put under the lip] as well as smoking water pipe," Mr Saeed said.

Khat is popular in Yemen, giving farmers a significant income and because of this, they use pesticides and fertilisers to make the plant grow faster. "As a result of the use of pesticides for khat and vegetable cultivation, about 30 per cent of Yemeni cancer patients have mouth and gum cancers. This is really a frightening figure and it represents one of the world's highest rates for mouth and gum cancers," said Mr Saeed.

The centre, which operates on an annual budget from the government of about US$4 million (Dh14.68m), lacks key equipment such as a Magnetic Resonance Image (MRI) machine and a CT-Scan. It is also does not have a comprehensive diagnostic laboratory, which would save the trouble of sending samples abroad for examination, he said. "Such machines will help patients have free check-ups if provided in the centre," he said.

In order to raise additional funds for the centre, the NCCF launched a fund-raising campaign on Aug 25. "The campaign aims to collect funding to construct the Aden Ideal Centre for Treating Cancer, establish a breast cancer centre in Sana'a and support cancer patients at large," said Mr Khawlani. So far, the campaign has raised $3.4m. The centre is also getting help from abroad. Mr Saeed said an oncology centre is being constructed in the eastern governorate of Hadhramaut by the Saudi government. The Abu Dhabi Development Authority has also agreed to support the centre in Sana'a by providing a radiotherapy machine, a mammography digital machine and an ultrasound machine. "They also agreed to provide us with a complete laboratory set, which would enable us conduct all examinations for all cancer patients," Mr Saeed said.

Abduh Raboh Mansor Hadi, Yemen's vice president, has also asked the government to study the feasibility of allocating a percentage of mobile phone revenues towards fighting cancer. [e-mail]