East Ghouta cancer center rolls back chemotherapy services as siege tightens

When government forces severed the underground supply routes to the encircled rebel-held east suburbs of Damascus in February, the price of goods tripled overnight.

Residents rushed to hoard food, fearing the prospect of an airtight siege and imminent shortages.

In the ensuing weeks, medical supplies began running out, outbreaks of contagious diseases gripped the opposition stronghold and the World Health Organization declared that “time is running out” for the 450,000 residents of East Ghouta.

Today, as East Ghouta faces near-daily bombardment from the Assad regime, the resident oncologist of the region’s only cancer center wonders how she will replenish her medical supply.

 Dr. Wisam a-Roz in the Dar a-Rahma center, January 2017. Photo courtesy of Moubader.

Since the regime’s February offensive began, “all medicine, which used to come in via black market dealers from Damascus, is cut off,” Dr. Wisam a-Roz, of the Dar a-Rahma center in encircled East Ghouta, tells Syria Direct’s Bahira al-Zarier.

The cancer center was founded in 2014 to provide chemotherapy and palliative treatment free of charge to East Ghouta residents.

Q: In February, regime forces launched a campaign to cut off East Ghouta’s vital food and medical supply routes via underground tunnels. Although the fighting is largely stalemated with little ground changing hands, how have these battles affected your ability to treat cancer patients in the area?

The blockade has had an undeniable impact. The tunnels were the primary point of entry for medicine, but now they’re closed given the escalation in bombing in Qaboun. [Ed.: The military offensive is causing mass displacement within the dozen or so towns that comprise East Ghouta. Douma, the de facto capital of East Ghouta and the town that is home to the cancer center, recently experienced an influx of hundreds of residents from nearby Qaboun, the origin of East Ghouta’s black-market tunnels, 5km west. Qaboun is the focal point of the regime’s ongoing military campaign.]

In turn, all medicine, which used to come in via black-market dealers from Damascus, is cut off.

With the way things are going—medicine running out and food shortages—our patients are getting worse. They need their medicine for everything from their daily treatment to blood transfusions, but it’s all in short supply because of the siege.

In addition, we’re also facing new difficulties when it comes to diagnoses because we used to send biopsies and other samples outside East Ghouta for examination. It just goes to show that there are challenges at every level.

Our patients are in a very delicate position, one that is only made worse by the encirclement of East Ghouta. They need three things: psychological comfort, proper nutrition and chemotherapy treatment. The encirclement shatters any hopes of living a long life. Still, people can hold on to hope, hold on to life through treatment, but death is coming at them from every direction. If it’s not from their cancer and the lack of treatment options, then it’s death from the encirclement.

Q: Have any cancer patients died as a result of medical shortages? What supplies do you have left?

Yes, unfortunately, a patient died last week because he was unable to complete his chemotherapy regimen. Additionally, there are around 15–20 patients who face an imminent risk of dying, and that number may only go up.

While some types of medicine have entirely run out, we do still have reserves of others. Unfortunately, the ones that remain are often nothing more than painkillers. We do work to ensure a reserve of chemotherapy medicine in anticipation of such a crisis, but even with these precautions in place, we’ve still been running out of certain medications. This is largely due to the added pressure due to the influx of patients coming from Qaboun.

 A nurse treats a cancer patient at East Ghouta’s Dar a-Rahma center. Photo courtesy of Dr. Wisam a-Roz.

Q: For someone with cancer in East Ghouta, is the Dar a-Rahma center the only option?

Yes, this is the only such center in all of East Ghouta. As of today, 1,115 patients have come to the center—including men, women and children—and of those, more than 500 people receive treatment in the form of chemotherapy.

At the Dar a-Rahma center, we’ve received patients who have fled from the bombing in Qaboun. The encirclement has made it such that we’ve been unable to complete their treatment.

Q: How does the cancer center get its funding?

[In 2014] the idea was pitched to the Unified Medical Office [an independent collection of doctors and medical staff in East Ghouta with headquarters in Douma] to have them fund the center at its inception. However, they were unable to do so, saying there were just too many injuries [to pay for] amid the repeated bombing of the area. And so the center got started with the support of Syrians living abroad and organizations such as SAMS (Syrian American Medical Society).

We reached out to Doctors Without Borders at the beginning of this year for financial support, but there’s been no response.

Bahira al-Zarier

Bahira is from Damascus. She studied business and marketing before moving to Jordan in 2013. She did volunteer work in support of many refugee organizations before joining Syria Direct.

Justin Schuster

Justin was a 2015-2016 fellow at the Center for Arabic Study Abroad program (CASA I) in Amman, Jordan. He received his BA from Yale University with a double major in Global Affairs and Modern Middle Eastern Studies. While at Yale, he served as the Editor-in-Chief of the political journal, The Politic. His previous work and research in the Middle East includes time spent in Egypt, Lebanon, Tunisia, Jordan, and the West Bank.