Enab Baladi – Yamen Moghrabi

The door of treatment has been closed to cancer patients in northern Syria since the devastating February 6 earthquake, with insufficient centers to help them at home and the low number of patients received by hospitals in Turkey.

This comes amid the discovery of three daily cases, according to official figures, and hundreds of cases since the earthquake until the moment of writing this report.

Thousands of Syrians suffering from cancer and other diseases live with their daily physical pain, waiting for a decision from Turkey to allow them to enter and receive treatment in its government hospitals.

In an attempt to draw attention to their suffering, dozens of cancer patients decided to organize an open sit-in near the Bab al-Hawa border crossing, which began on July 22, amid great interaction from activists and civil society organizations through social media.

Thousands of medical cases face their fate

Mohamad Haitham Sattouf told Enab Baladi that he sold everything, “Only my house is left, and I have already placed an advertisement to sell it as soon as possible for my son to undergo the operation,” he added.

Sattouf, who suffers from sarcoma cancer that begins in the bones and the soft tissues, is in need of large sums of money for his treatment.

He is one of the 3,000 cancer patients in northern Syria, including 65% of children and women, while three daily cancer cases are diagnosed there, according to the director of the media office of the Idlib Health Directorate, Imad Zahran.

He told Enab Baladi that 600 cases were diagnosed after the February 6 earthquake, including 150 children and 200 women. These cases require entry to Turkey to receive treatment, specifically radiation.

With the earthquake that hit southern Turkey and northern Syria, Turkey stopped receiving patients after the collapse of the health sector and hospitals in those areas, and the decision continued until the Bab al-Hawa border crossing announced, on June 1, the resumption of the crossing movement.

Zahran said that the patients’ lack of Turkish temporary protection cards (Kimlik) is a second reason for not receiving cases in Turkey.

Mustafa Hallaq of the media office of the Bab al-Hawa crossing told Enab Baladi that the total number of patients who were transferred from the specialized medical centers in Idlib to Turkey from May 3 to July 17, reached 1,650 patients, of whom 867 had cancer, including old and newly diagnosed cases, and 783 other diseases, of which only 323 patients were admitted.

Currently, there are 608 new cancer cases that did not receive any treatment and need to be admitted to Turkey, including 91 girls and boys, 282 females, and 235 men, according to Hallaq.

The Turkish authorities allow only the necessary emergency cases to enter in small numbers after direct coordination between the hospital to which the patient is referred and the emergency point. As for non-urgent cases, they enter after obtaining a new medical referral from the accredited specialist, according to the Medical Coordination Office at Bab al-Hawa crossing.

The solution to the issue is completely in the hands of the Turkish authorities, amid the accumulation of cases of a large number of cancer patients in northern Syria who need chemotherapy and radiotherapy in Turkey, Mazen Kawara, director of Turkey and Northern Syria Office at the Syrian American Medical Society (SAMS), told Enab Baladi.

According to Kawara, SAMS contacted the World Health Organization (WHO) and the health sector of the United Nations Office for Humanitarian Affairs (OCHA) for the same purpose.

The director of the advisory department of the SAMS office in Turkey, Dr. Abdulrahman al-Omar, told Enab Baladi that last June witnessed the transfer of 400 patients to Turkish hospitals, of which only 100 were admitted, with daily registration of new cases, while the year 2022 witnessed the diagnosis of 1,400 new cases of cancer patients.

Journalist Aladdin Ismail, who resides in Idlib and suffers from cancer (he has a lump in the upper eyelid of the right eye), told Enab Baladi that the sums required for his complete treatment (removal, plastic surgery, and radiation doses) amount to $20,000.

Ismail told Enab Baladi that the cases that the Turkish state allowed entry for treatment are the only cases that have Kimlik, and there are cases that need $2,000 per month for the cost of their treatment.

In addition to the difficulties related to obtaining travel permits to move between Turkish states when they are transferred to other hospitals inside Turkey and the varying dates between doses.

“It is very necessary to facilitate the admission of cases as soon as possible, as cancer patients cannot have their treatment delayed, and there are cases that died due to the delay,” Ismail said.

Open sit-in until admission for treatment

With the increase in the suffering of cancer patients and waiting for their entry into Turkey, they decided to organize an open sit-in until their demands are fulfilled as part of a campaign organized by activists and civil society organizations that carried the slogan “Save Cancer Patients,” aiming for the entry of 608 patients, with at least one escort, whose cases were discovered after the earthquake.

The media coordinator of the campaign, Ahmed Rahal, told Enab Baladi that the patients’ health condition does not tolerate delay, and the idea and management of the campaign came from the patients themselves, and civil society organizations and activists are trying to help them.

There is no coordination between patients and any official agency, whether in areas outside the control of the Syrian regime, or in Turkey, according to Rahal.

The campaign issued a statement on July 21, which was seen by Enab Baladi, in which it called on the Turkish authorities to facilitate the immediate admission of patients to Turkish hospitals and to find a sustainable mechanism to ensure this. It also called on the international community to expedite the creation of a new mechanism for providing humanitarian aid across borders.

This includes medical aid for patients with cancer and other incurable diseases, or the establishment of mobile treatment centers, and providing this aid without obtaining the approval of the Syrian regime.

“We are aware of Turkey’s current problems after the earthquake, but it is a big country, and it can find solutions because cancer does not wait,” Rahal told Enab Baladi.

Obstacles to treatment in northern Syria

In the regions of northern Syria, there are four centers for the treatment of blood diseases and tumors, the largest of which is located in the Al-Mohafaza Hospital in Idlib, which includes three clinics for adults and two clinics for children, and a center in Bab al-Hawa Hospital, in addition to the centers located in al-Bab Hospital, and Jarablus Hospital in the countryside of Aleppo governorate.

One of the main obstacles to treatment in northern Syria is related to the absence of radiotherapy, immunotherapy, and unsupported cancer medicines, which are very expensive.

The director of the advisory department of the Syrian American Medical Society (SAMS) in Turkey, Dr. Abdulrahman al-Omar, explained to Enab Baladi that SAMS currently fully supports six types of cancer drug doses.

These are breast cancers, Hodgkin’s lymphoma, Non-Hodgkin lymphoma, colon, ovaries, and testicular cancer. It also supports pediatric leukemia, the service of blood transfusion and its derivatives and histopathology (recently introduced) under the supervision of specialists from the United States, and an early detection service for breast cancer.

In addition to the obstacles to medicine, the laws for patients entering Turkey are the most prominent obstacles to treatment, and the regions of northern Syria are witnessing a lack of support for current efforts and the export of medicine from Turkey to Syria.

The volume of doses required for pediatric patients increased to 260% and 50% for adults, and this is “a very large burden that requires state capabilities,” said al-Omar.

The statistics of the Oncology Center in the Al-Mohafaza (governorate) Hospital in Idlib indicate that 2,063 oncology patients benefited from treatment during the past May and June.

While the number of beneficiaries of chemical doses reached 909 people, and 85 beneficiaries were children.

According to al-Omar, SAMS referred 362 patients over the age of 18 for treatment in Turkey last June, in addition to 61 children.

On Tuesday, July 25, the administration of the Bab al-Hawa border crossing announced that starting Wednesday, July 26, Syrian cancer patients will be allowed to enter Turkish territory to continue their essential treatment.