“The breast cancer campaign’s activities are essential during these times”

Every October, during breast cancer awareness month, Medical Aid for Palestinians (MAP) and our local partner in Lebanon, Naba’a, organise a campaign to increase community understanding of the disease, promote early detection, and support access to screening and testing for Palestinian women living in the country’s refugee camps. The campaign offers women free consultations with doctors at reproductive health clinics – which are supported by MAP and run by Naba’a – and referrals for mammograms.

During this year’s activities in Ein el Helweh refugee camp, MAP’s Programme Manager in Lebanon, Wafa Dakwar, spoke to women to hear more about the challenges to accessing diagnosis and care in Lebanon, and how MAP and Naba’a are helping overcome these.

Accessing breast cancer testing and treatment in Lebanon has been very difficult for women over the past two years. Amid the overlapping crises of the country’s worst economic crisis in decades and the COVID-19 pandemic, the health system is on the verge of collapse and families have seen their finances diminish dramatically.

“Women are particularly affected [by the economic crisis] as they often prioritise spending whatever little money they have to secure their children’s needs and ignore their own health,” said Kafa, a nurse who is leading the breast cancer awareness campaign with MAP and Naba’a.

“The campaign’s services are needed now more than ever, as the economic crisis has had a severe impact on Palestinian refugees,” said Kafa. “Women are the backbone of society and their health and wellbeing should be prioritised, so dedicating this month to support them is the least we can do. Referrals for free mammograms are given to the diagnostic centres that are closest to the camps, as we know that even minimal transportation costs are no longer affordable for many families.”

Breast cancer is a highly treatable and curable disease, yet mortality rates remain high among Palestinian women. Access to screening and testing promotes early detection and positive outcomes; but many barriers exist, particularly for the most vulnerable groups in society.

Rima*, a Palestinian refugee who was displaced from Syria and took shelter in Ein el Helweh, was only able to access a mammogram through a campaign that took place in her camp. “Last year, I attended an awareness session on breast cancer with nurse Kafa where she taught us how to do a self-examination and explained to us the signs and symptoms,” said Rima. “This information helped me realise that something is not right. The next day I visited the reproductive health clinic and asked to see the doctor. After examination, the doctor referred me to do a mammogram which showed that I have a large recurrent tumor. I underwent surgery and the biopsy confirmed that the tumor was not cancerous.”

“They say that women above 40 years old should do a mammogram every year, but many women like me cannot because of the cost barrier,” explained Rima. “With the breast cancer campaign, regular screening is now possible for us. Some women in the camp do not know about breast cancer and do not consider testing for it as important, but when they attend the awareness sessions they learn a lot. I always attend the sessions and share my experience to help women overcome fears and misconceptions, and encourage them to do the recommended testing,” she said.

39-year-old Mariam*, who is also living in Ein el Helweh camp, was participating in the breast cancer campaign’s activities for the second year running, and has also benefitted from its health education and testing services. “I had multiple lumps under my armpits. I tried seeking UNRWA’s [the UN’s refugee agency for Palestinian refugees] services, but the doctor there was male and at that time he was attending the UNRWA clinic in Saida, which is outside the camp. These issues discouraged me from taking further steps,” said Mariam. “When I heard about the breast cancer campaign taking place in the camp, I went to one of the awareness sessions which included lots of useful information. After the session, I spoke to nurse Kafa about my health problem, and I received a free mammogram. Luckily, the lumps were not cancerous; they were related to an infection in the lymph nodes.”

“I always encourage women to attend the awareness sessions and to do the self-test and the regular screening if they are above 40 or have risk factors,” said Mariam. “The main reason why women do not seek testing is financial. They don’t have the money and they are worried if they were diagnosed with cancer, they will not be able to pay for the treatment costs. They say they prefer not to know, and believe it is better ‘not to open closed doors’. This situation has become more common with the economic crisis. The campaign’s activities are essential during these times.”

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*Names have been changed to protect identity of those involved.

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