6 October 2017
October is Breast Cancer Awareness Month, an annual worldwide campaign to raise understanding of the importance of breast cancer treatment, education and research. Breast cancer is now one of the best understood and most treatable forms of cancer, with 81 per cent of women in the UK living beyond five years after being diagnosed. However, for women in the occupied Palestinian territory (oPt), the situation is far bleaker, with as few as 40 per cent of women diagnosed with breast cancer living beyond five years.
This Breast Cancer Awareness Month, MAP is encouraging supporters to write to their MP, to call on the UK government and take action to support patients and healthcare in Gaza.
Palestinian women with breast cancer face numerous challenges to accessing continuous and effective medical care.
Early diagnosis is one of the most important factors for breast cancer recovery. Women in the West Bank and Gaza, however, face significant barriers to accessing screening and diagnosis services. Fear and cultural factors, and a lack of population screening for the disease, means that many women enter treatment at a later stage than is typical in the UK.
When diagnosed, patients also encounter obstacles to receiving effective treatment. Hospitals in Gaza suffer chronic shortages of many essential medicines, including many cancer drugs. In August 2017, 40 percent of essential medicines were at ‘zero stock’ in Gaza, meaning that less than one month’s supply was left on shelves.
Access to radiotherapy treatment in Gaza is also limited so many surgeons choose not to add additional risk to the lives of patients, who may face a long wait for radiotherapy while waiting for permits, by performing an operation called a mastectomy – which means the removal of the breast – and full clearance of the axillary lymph nodes which sit under the armpit. This is believed to be happening in many cases regardless of whether the cancer has spread to the lymph nodes or not, and can have painful and uncomfortable life-long side-effects including lymphodema of the arm.
Limitations to medicine and current medical technology in Gaza means women often need to travel to East Jerusalem, the West Bank or further afield, for treatment. However, Israel’s restrictive permit regime prevents many patients from attending appointments on time and receiving the consistent care fundamental to recovery. At least four Palestinian women in Gaza have died this year after their access to breast cancer treatment was denied.
Israel’s permit regime, also prevents breast cancer surgeons from leaving the West Bank and Gaza to update and specialise their skills.
In 2017, four Palestinian women from Gaza have sadly lost their lives to breast cancer as they were denied access to effective treatment.
Farha Al Fayomi, aged 53, died in April after losing three radiotherapy appointments due to delayed travel permit requests from Israeli authorities. Three days after her death, her permit was approved.
In June, Abeer Abu Jayyab, aged 46, died as the Israeli authorities rejected her permit requests to access Augusta Victoria Hospital in Jerusalem for a course of Herceptin. She was forced to miss three appointments in February, March and April.
In August, Nadia Hamad, aged 53, died whilst awaiting her permit to exit Gaza for palliative radiotherapy. She had previously lost four hospital appointments due to permit delays by Israeli authorities.
Ibtesam Nabhan, aged 53, died in September after Israel authorities refused her and her travel companion permits on several occasions. Ibtesam was also subjected to distressing interrogations from the Israeli authorities.
MAP continues to support a wide range of women’s health projects across the oPt, including the Dunya Women’s Cancer Centre, the only dedicated cancer diagnosis centre for women’s cancers in occupied Palestine.
MAP is also helping to improve breast cancer care for Palestinian women living under occupation. Last year MAP supported, Dr Philippa Whitford, a breast cancer surgeon and UK Member of Parliament, to travel to the oPt to perform surgeries on Palestinian women at Augusta Victoria Hospital in East Jerusalem, provide educational seminars to Palestinian medics and assess breast cancer care provision in the West Bank and Gaza. Last month, Dr Whitford returned as part of a MAP-supported multi-disciplinary breast cancer care team, to undertake surgeries, assess current levels of care provision, and provide further training.
