From Damascus to Dohuk, an endless journey for two refugees with cancer

Ibrahim al-Ibrahimi

When the ambulance left the dispensary of the Bardarash refugee camp (in the Kurdistan Region of Iraq, 35 km north of Mosul), heading towards the Azadi Hospital in the city of Dohuk, there were in it a number of patients in addition to two cancer patients coming from the regions bordering northeastern Syria.  

The two patients sit next to each other in a double seat inside the ambulance, whispering about previous rounds of treatment in Damascus, and how war conditions forced them to seek asylum. Others ask them about their condition, avoiding mentioning the name of their disease "cancer", and stating it with Kurdish expressions such as "Êşa pîs", or “horrible illness.”

40-year-old refugee Monira Muhammad Said is from the border city of Serekaniye (Ras al-Ain), which was subjected to a military operation by Turkish forces and their affiliated groups in October. Said grew up there, got married to one of her relatives in 2006 and had two sons and two daughters.  

More than 300,000 people have been displaced from Serekaniye (Ras al-Ain) and Tel Abyad (Gre-Spi) after the Turkish offensive in northern Syria on October 9th last year. About 17,000 of these displaced people headed to the Kurdistan Region of Iraq (KRG), where they crossed via smugglers, and most of them are now in the Bardarash camp, including the two sick women Samira and Monira and their children.

"Reports indicated that travel groups paid an average of $ 3,140 per group to cross the border into the KRG,” according to the UNHCR.

"I forgot to bring my medicine"   

Monira was diagnosed two years ago, when doctors in Damascus told her of the existence of edema in her brain.    

 
Before her displacement, Monira was taking painkillers and other medicines after confirming four fluid pockets on her brain, each about 5mL in volume.

According to a medical checkup that was done in July 2019, and according to the results and scans she brought with her from Damascus, the number of pockets has increased to five.

"During the bombardment I forgot to bring my medicine," she said, grasping the arm of the seat in anticipation of the ambulance’s sudden turn.

Monira's right retina was affected by the disease, and her eyesight weakened to the extent that she cannot see anything but light. The growth of the right side was also affected, and contracted by five centimeters.

Monira, smoking a cigarette despite her disease, added: "I feel a terrible pain in the right side of my head, and the pain radiates to the left side, too."  

The doctors had recommended her not to undergo any operation to remove the fluid because of the high risk, but they advised her to do a "retinal detachment" operation so that the left eye would not be affected either.  

"But my circumstances and capabilities do not allow me to have this operation either."

Like many refugees, Monira is neglected by humanitarian and medical organizations. "I explained my case to dozens of humanitarian and medical organizations in the camp, but none of them even provided me with a pill,” she said.

According to a report issued in September 2018 by the International Agency for Research on Cancer, Syria ranks fifth among Asian countries in the number of cancer cases compared to the population.   

Cancer patients in northern Syria face a lack of treatment and specialized centers, so patients go to Damascus. Though in recent years, the majority head towards the KRG due to the ease of passing through Semalka border crossing between northern Syria and the KRG, where the Autonomous Administration made an exception for emergency humanitarian cases, such as cancer patients, to cross even when the border is closed.

Asylum, disease, and windy winter     

The second patient, Samira Ali Khalil, is a 42-year-old mother of five from the village of Derna Aghi, near the city of Jil Agha in the far northeastern corner of Syria.

Samira discovered her illness at the beginning of September 2015 after a medical exam in Damascus. Doctors decided to remove her breast due to the appearance of malignant tumors.   

For four years, she was treated in Damascus hospitals with radiology and chemicals, and her last medical examination was in mid-October 2019.  

But the current conditions of asylum have added to their suffering, so there is no medicine available in the camps, and no special treatment (chemical doses or radiology sessions) except in city hospitals.   

Samira, who goes by ambulance every month from the camp to the Azadi Hospital in Dohuk, says: "I afford the costs of my treatment in the hospital, but if the situation continues like this, I will not be able to afford medical treatment, especially as we now live without work or a breadwinner."   

"X-rays and medical tests cost me IQD 55,000 (about $45) each month, not including this medicine,” she says.

After the Bardarash camp was hit by severe storms in February, and due to the difficult situation in the camp during the storms, Samira's health deteriorated, according to her latest medical examinations.   

"I suspect that my anxiety for my children during the rainstorms has accelerated the disease in my body," she says, lamenting the difficult conditions in the camp.  

Coronavirus and a call to intensify efforts   

In light of the spread of coronavirus in most countries and societies of the world, those who are afflicted with chronic conditions, including cancer patients, are the most vulnerable to the complications of the disease if they are affected by the virus. This is due to the weakness of their immune system, according to medical reports.   

Cancer is considered one of the biggest challenges facing health care systems in the world due to its wide spread and very high treatment costs, especially for patients from countries suffering from conflict and crises.

On February 4th, 2020, the World Health Organization (WHO) announced the International Day for Combating Cancer in order to intensify cancer treatment services. The organization stated in its call that "cancer kills 9.6 million people every year globally."  
The organization called on governments "to develop policies and create healthy environments that provide access to quality health services for all without financial hardship."   

The ambulance is still traveling with its patients towards the city of Dohuk, and the horror of coronavirus fills the world. Monira and Samira do not know where the journey of asylum and disease will take them after what happened to their country.