Yemen’s lethal lack of cancer awareness

Worldwide, about 1,000 out of every 1 million people suffer from cancer, according to World Health Organization estimates. That suggests that out of Yemen’s population of 20 million, at least 20,000 suffer from some kind of cancer. Yet, since the National Cancer Center—the only cancer center in Yemen—was founded in 2004, it has only received 5,000 cancer cases, which suggests that the majority of people with cancer are still not diagnosed or receiving treatment.

The major reasons for this are ignorance, poverty, and incorrect medical diagnosis, says National Cancer Center manager Dr. Nadeem Mohammed Sa’eed. People often don’t seek help because they do not recognize the symptoms of cancer. Even if they suspect serious disease, they usually lack the money to pay for treatment. “For example, a person may ignore the painless lump on his tongue and continue chewing qat and using shammah (a type of tobacco placed under the tongue), unaware that the small mark may be the first sign of mouth cancer,” said Sa’eed.

“In another case, a person experiencing coughing, chest pain, shortness of breath, hoarseness, and bloody sputum may go to a doctor who diagnoses him with TB and gives him medication, ignorant of the fact that those are lung cancer symptoms.” Recently, the Yemen Observer took a random survey of cancer patients in Sana’a, asking them what they thought could have been done to prevent their illness or to get it treated in its early stages.  The majority of those surveyed at the al-Thawra hospital in Sana’a blamed lack of awareness for their health problems.

The government has done nothing to educate people about the things that cause cancer, and what can be done to prevent cancer, they said. There also is very little information available about what symptoms are warning signs of cancer.  “I did not know that I had cancer until four months after it spread. We are not fully aware of the causes and effects of cancer, or why it is spreading quickly in Yemen. If we knew more about it, we could treat it in its earlier stages, rather than waiting until it gets serious and dangerous,” said Fatima Mohammed al-Faqeeh, a mother who had breast cancer. “It would help a lot if we also knew how to avoid it and also how it develops, in order for us to be more aware.”

Mohammed Ali Aqlan, a cancer patient who left Yemen for Jordan for cancer treatment, said that he does not trust the medical staff in Yemen, and would prefer to leave the country.  He said that he tried to seek treatment in Yemen, but the doctor used to give him his medicine and leave, not explaining to him the reasons behind the cancer.  “We want to know why we had cancer, so we can watch out for our children and make sure that they don’t make the same mistake that we did,” said Aqlan, who stayed in Jordan for one month for treatment. “That is why we prefer to leave the country and be treated in other countries.

At least there they tell us the reasons and explain the cause, thereby limiting its occurrence in other loved ones in the future.”  Some 5,000 Yemeni cancer patients travel abroad annually,  according to the latest Ministry of Health statistics. This means that the number of Yemeni cancer patients leaving the country every year is equal to the number of patients treated in the country.  Tumor specialist Ali al-Ashwal said that Yemen’s most common cancers are also the most treatable. “The lymphoma treatment rate is as high as 80 to 90 percent, particularly if the patient is treated within the first or second stage of infection. The same rate applies to breast cancer and gastrointestinal cancers,” he added.

Lung cancer is one of the most difficult kinds of cancer to cure, but Yemeni people could drastically reduce their chances of getting lung cancer by quitting smoking. Many Yemeni people still scoff at the idea that smoking leads to cancer, despite overwhelming scientific proof. There are hundreds of types of cancer and many of the types are still not well understood.  Some studies have suggested that a family of compounds found in cruciferous vegetables, such as broccoli, cauliflower, and watercress, block lung cancer progression in both animals and humans, say researchers from Georgetown University Medical Center and the Institute for cancer Prevention.

They say the results, published in the current issue of Cancer Research, suggest that these chemicals - put into a veggie pill of sorts - might some day be used to help current and former smokers ward off development of lung cancer, one of the leading causes of cancer death in the world. The WHO expects a substantial increase in cancer in the Eastern Mediterranean region over the next 15 years. The increase is expected to be between 100 and 180 percent. More than 70 percent of these fatal cases were reported in low- and medium-income countries, according to WHO official Raouf Benammar. “Cancer is the fourth most common cause of death in the Eastern Mediterranean region after cardiovascular diseases, contagious disease and physical injuries caused by accidents,” Benammar said.

Cancer specialist Abdul Karim al-Misbahi said that people in Yemen are not aware of the relationship between their daily habits, such as chewing qat and smoking, and cancer.  Kids can be seen smoking as early as 12 years, and chewing at as early as seven years old.  Abdullah Alfa, secretary-general of the National Society for Fighting Smoking, claims that people in Yemen consume YR120 billion worth of cigarettes yearly, and ten times that amount is spent yearly on qat.  “It is very widespread, and is the reason for the spread of cancer in Yemen. In the past it was only among the older males, but today it is among the males, females and children as well, and almost no one is aware of the dangers they are putting their selves in.”

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