13 April 2017 – 12-year old Khedr from Aleppo Governorate was diagnosed with fibrosarcoma – a tumour in the connective fibrous tissue affecting bones and muscles – in January 2016. Because no treatment was available for him in Aleppo, Khedr travelled with his father to the Pediatric Hospital in Damascus, the main referral hospital for children in the country. However, access to Damascus to receive regular chemotherapy treatment was not always easy. Blocked roads and insecurity meant that Khedr was only able to receive treatment once every 3 months, instead of once every 3 weeks as recommended by doctors. Over the past few months, his health has significantly deteriorated, and he is in persistent pain as his tumour grows and presses on the nerves in his lower back. Lying on a bed in the stark hospital room, he winces in agony and the permanent frown lines on his forehead furrow even deeper. Oral analgesics are no longer enough to relieve his severe pain, and doctors are concerned that supplies of intravenous painkillers, such as morphine and tramadol, are no longer easily available.
Khedr is one of 1300 children currently receiving treatment for cancer at the Pediatric Hospital in Damascus. The hospital receives 350–450 new cancer patients each year, with ages ranging from one month to 14 years. The majority are diagnosed with leukaemia, lymphoma and neuroblastoma. As a result of insecurity and limited access to treatment, by the time 50% of children arrive to the hospital for diagnosis, the disease is already at an advanced stage, leaving them with only 20% chance of survival, doctors at the hospital say. With only 52 beds in the cancer ward and an increasing number of children from around the country seeking treatment, some children can wait up to one month before they are admitted, diagnosed and receive treatment.
“The situation is heartbreaking. Services for cancer patients in many parts of the country are limited and children, already victims of this war, are facing delays in their ability to access treatment,” said Elizabeth Hoff, WHO Representative in Syria. “Tragically, this means that many children progress to advanced stages of the disease due to lack of regular treatment.”
To date, with support from the Government of Kuwait, WHO has provided almost 16 500 treatments of anti-cancer medicines sufficient for thousands of children diagnosed with leukaemia. WHO has also enhanced the capacity of more than 400 health staff in the area of rational use of medicines, clinical protocols and good practices on effective treatment for cancer patients. A CT scan machine for diagnosis of patients at Al Baironi Hospital, the main referral oncology facility in the country, was provided with support from WHO.
In late 2016, WHO conducted a rapid assessment in 8 hospitals in 6 governorates to evaluate cancer care management in the country and address gaps in health care delivery. The study’s main findings focused on the need to reduce cancer incidence and mortality and improve the quality of life of cancer patients by: 1) facilitating the provision of essential medicines and medical equipment for cancer care in the country; 2) building the capacity of health workers working in oncology health care in the areas of palliative care, early detection, nutrition and diagnosis services; and 3) supporting the country in establishing a national cancer registry.
WHO requires almost US$ 7 million over the coming 12 months to increase access to treatment for cancer patients by providing medicines and building the capacity of health workers in oncology units in major hospitals in Syria. “With the focus of the world primarily on trauma care patients, it’s easy to forget that there are others whose lives are also at stake. Providing support to WHO will enable us to reduce the suffering of thousands of people with cancer and improve their quality of life,” said Hoff.