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To Eat or Receive Treatment: Displaced Cancer Patients Endure Double the Challenges

Pascale Sawma
Lebanese Journalist
Lebanon
Published on 18.10.2024
Reading time: 6 minutes

There are over 1.5 million displaced people in Lebanon, most of whom have not found alternative shelter. As many hospitals reach their maximum capacity and others face severe challenges, patients with chronic and critical illnesses, particularly cancer, are enduring immense hardships.

With difficulty, Abu Ali tries to explain his situation, barely able to make his voice heard as he suffers from throat cancer. Instead of resting in bed or receiving care in a hospital, he sits on the roadside at the Beirut seafront in Manara, accompanied by his wife.

Abu Ali fled from the Bekaa Valley with his wife after Israeli bombings on Lebanon intensified on September 23. Now, he struggles not only to secure his treatment but also to find food, water, and safety. He concludes his sorrowful words with, “Praise be to God for everything.”

There are over 1.5 million displaced people in Lebanon, most of whom have not found alternative shelter. As many hospitals reach their maximum capacity and others face severe challenges, patients with chronic and critical illnesses, particularly cancer, are enduring immense hardships.

Since the onset of the 2019 crisis, these patients have struggled to access their medication and treatments. The conditions of the war have forced many to abandon their homes in the south, Bekaa, and the southern suburbs of Beirut.

Lebanon’s caretaker Minister of Health, Firas Al-Abiad, issued a decision to cover 100% of cancer treatment costs, including chemotherapy and radiotherapy, for displaced patients. However, a survey of several patients revealed that this policy has not been uniformly applied across all hospitals. Many facilities still require patients to cover surgical and related expenses. Admission for chemotherapy or radiotherapy often involves fees that patients find unaffordable, in addition to the exorbitant cost of medication, which is beyond the reach of most.

“They Stopped the Surgery Until We Paid”

In a voice laden with pain, Ahmed’s daughter, a seventy-year-old man displaced from southern Lebanon to Tripoli in the north, says, “The hospital stopped his surgery until we could pay the required amount, and we don’t even have $100 to cover it.”

Ahmed suffers from bladder cancer, and if the surgery is not performed soon, there is a risk of the disease spreading throughout his body. However, the patient’s critical condition and the minister’s decision did not change the hospital’s stance, as it insisted on payment, arguing that the ministry only covers part of the surgery cost, not all of it. As a result, Ahmed and his family are left hoping for a miracle to afford the life-saving treatment.

According to a source within the Ministry of Health (an employee who handles public cases but cannot disclose her identity), most displaced patients are now unable to continue their treatments as they did before. Therefore, they turn to the ministry for assistance. She explains, “The ministry is doing its best to help displaced patients, but the sheer number is overwhelming, especially as we are in a state of war, and the healthcare system is on high alert.”

She continues, “We are trying to provide treatment to all displaced patients to the best of our abilities, but the pressure we face often delays the timely delivery of necessary treatments to hospitals. This causes delays in treatment for some patients, which, in many cases, affects their health.”

According to a 2022 World Health Organization report, the five most common types of cancer in Lebanon are breast, lung, prostate, colon, and bladder cancer. Genetic factors account for approximately 10 to 30 percent of cases, while environmental and social factors contribute to a significant 70 to 90 percent of the incidences.

The Struggle to Access Treatment Amid War

Due to displacement from southern Lebanon to Mount Lebanon, nine-year-old Lana, who is battling cancer, went two weeks without treatment, causing her condition to worsen. Her family had to rush her to the nearest public hospital at night, where the Ministry of Health agreed to cover her treatment costs. However, they were unable to find the required medication in the hospital, forcing them to wait until the next day to procure it, even though Lana’s condition was critical and could not withstand delays. Her family fears what the future holds, given the ongoing challenges in securing treatment each time and the increasing strain on hospitals and the Ministry of Health.

From 2017 to 2022, Lebanon recorded more than 33,500 cancer cases, with about 40 percent (13,000 cases) newly diagnosed in 2022 alone. That same year, approximately 7,307 people died from the disease. According to estimates by the International Agency for Research on Cancer under the World Health Organization, at least one out of every 200 residents in Lebanon is diagnosed with cancer, and one out of every 400 succumbs to it. Under the current circumstances of war, displacement, and the growing demand for medical care, along with the daily increase in injuries and casualties, it is hard to imagine how the healthcare system will cope, especially with some hospitals going out of service due to bombings.

Treatment is Covered, but Medical Fees Are Expensive

“The hospital asked me for $100, and the doctor charged $70. But I’m displaced—how am I supposed to afford that?” asks Ibtisam, a cancer patient displaced from Nabatieh to Beirut.

Ibtisam explains that the ministry was able to cover her chemotherapy costs, but she still had to bear the hospital admission fees and the doctor’s charges, which, as she described, are “very expensive.” “I could use that money to live and provide food and drink for my family,” she says.

Ibtisam receives chemotherapy every 21 days, and the cost of the treatment solution alone is $350, excluding the hospital and doctor’s fees. Therefore, a single chemotherapy session costs approximately $600. The ministry covers part of this amount, but Ibtisam and many others must come up with the rest. “We’re displaced, unemployed, waiting for aid and relief—where are we supposed to get this kind of money?” she asks.

According to estimates, the risk of dying from cancer in Lebanon before the age of 75 is 9.7 percent, surpassing the global average of 9.6 percent. This rate indicates the challenges of combating this disease, which are worsening due to rising treatment costs, declining wages, and reduced coverage by social security health insurance.

The Long Journey to Treatment

After being unable to reach Nabih Berri Hospital in southern Lebanon, which ceased operations due to bombings, Rabih is forced to travel daily to Ain Wazein Hospital in the Chouf for his radiation therapy.

Rabih, displaced from Baysariyeh near Sidon to Sarafand, explains that none of the hospitals in his area offer radiation treatment, compelling him to make a long daily journey. Sometimes, he is forced to stay overnight in the hospital courtyard or inside, waiting for the next day’s treatment. “I can’t afford the transportation fees, but I have no choice—I have to come every day for two consecutive months,” he says.

Attacks on healthcare facilities have led to the closure of at least 37 health centers in Lebanon since September 27, including nine supported by the National Social Security Fund, placing immense pressure on the remaining facilities near clusters of displaced populations.

While the Minister of Health’s decision to cover the costs of cancer treatment for displaced patients offers some relief, it appears insufficient given the myriad challenges facing government hospitals, from drug shortages to exorbitant prices. This is especially burdensome for displaced individuals, many of whom struggle to find a bed to sleep in—even if it means sleeping out in the open.