Reporter: Abdel Nasser Al-Hilali
In January, Hassan Abdul-Rahman, 55, stopped receiving treatment for leukemia from the Ministry of Health in Sana’a after three weeks.
According to the Deputy Director of the National Oncology Center Dr. Abdul-Wahab Al-Nahmi, funding for the treatment of 10,000 cancer patients across the country was seized due to the ongoing civil war. Initially totaling $11.5 million in 2014, they were cut to $5.6 million in 2015. The cuts affected six clinics in Aden, Al Hudaydah, Al Mukalla, Ibb, Sanyyan and Taiz.
The drug costing 107,000 Yemeni rials ($500) for 30 tablets (about a month’s supply) is too expensive for citizens such as Abdul-Rahman, who only earns $350 per month. Before the war, the drug sold for half that amount in a country where the annual per capita income was $1,260.
By February, Abdul-Rahman’s blood tests and pH levels showed that his kidney functions had become imbalanced and his tumor had grown. His son Shadi detailed his father’s recent struggle, confirming that his father had received free medicine from the National Oncology Center since being diagnosed in August 2014 through October 2015.
In November though, the family was forced to buy medicine at a private pharmacy. He dropped the medicine for three weeks as his family negotiated a $2,500 loan to cover five months.
Dr. Jamil Ghazal, a hematologist who helped supervise Abdul-Rahman’s treatment warned that disrupting medical treatment was life-threatening.
By the end of April, it was discovered that 36 percent of the 50 patients doctors surveyed had stopped treatment due to budget cuts.
In the city of Taiz, Ahmed Hassan al-Miqdad, 5, suffers from leukemia. The Center for Hope in Taiz, located 270 kilometers from the capital of Sana’a, seized free treatment to patients on March 2015 as civil war broke out. Ahmed’s father has been unable to afford medicine that costs 115,000 Yemeni rials ($540) per month.
Center Director Mukhtar Ahmed, acknowledged that the last shipment of medicine arrived in June 2015. Prior to the war, their clinic treated 1,418 patients, but budget cuts dropped that to 599 patients.
The doctor said that Ahmed had only received four out of the six months of scheduled intensive treatment before the siege in Taiz. He also added that Ahmed required a new form of medication to counter the cancer growth.
Tasbeeh Abd Mohammad, 6, suffers from cancer at risk of reaching her bone marrow. She was improving until the abrupt stop of medication caused a tumor to grow in her feet. Tasbeeh’s doctor, Ali Hasber, said her worsened condition now requires treatment from outside the country that would cost her family $27,000.
The World Health Organization Representative in Yemen, Dr. Ahmed Chadol, said that all parties involved in the war have exhausted their resources and cannot cover operating expenses for medical centers.
Since March 2015, around 85 percent of 450 varieties of medicine the center provided had been exhausted. In late December, the Ministry of Health alerted both the Ministry of Finance as well as international NGOs of this situation.
Trying to Survive
Al-Nahmi and Dr. Abdullah Rabas believe that interrupting medication during treatment is the main reason for the rise in deaths of cancer patients over the past year. Statistics show that the toll has increased from 810 in 2014 to 893 in 2015.
Rabas noted that the initial two doses given to a patient are to agitate the tumors before the remaining doses kill the cancer cells. It is important to follow treatment schedules to yield the best results .
According to Dr. Haninah Mohammed Haninah, director of medical supply management for the National Oncology Center, said that in May 2016, World Health Organization officials agreed to provide 4 percent of the 450 varieties of medicines available before the war. This was confirmed by a WHO representative in Yemen, Ahmed Chadol.
However, he warned that this would not be enough due to growing medical need.
“We have cancer drugs and intravenous fluids that can be delivered quickly to the centers, but they require larger and more expensive support than we can provide. We are doing our best to help meet their urgent needs.”
Al-Nahmi confirmed that government funds would be available after issues throughout 2015 were resolved in December. He said that the bidding process, will cause further delays in funding. This procedure between pharmaceutical companies will run from December 2015 to March 2016.
Furthermore, Al-Nahmi does not believe that the money allocated would provide for even half the supplies needed and he blames the Ministry of Finance for failure to care for Yemeni citizens.
He understands that the civil war has affected Yemen, but insisted that no one can comprehend the complications patients and their doctors face. He states that a single cancer patient requires $250,000 Yemeni rials ($ 1,250) per year, totaling an annual budget of $25,000,000 Yemeni rials for the country’s needs
The Government Response
According to an anonymous senior official in the Ministry of Finance, the Ministry itself had no problem supporting the full budget for the various Oncology Centers prior to the civil war.
The lack of revenue from customs, oil, gas, and taxes since the war has had a major effect on the nation’s budget. As a result, cancer patients suffer daily from dwindling resources. The Ministry of Finance does not see the situation improving anytime soon.
This investigation was completed with the support of Arab Reporters for Investigative Journalism (ARIJ ) and coached by Khaled Hrouji. The investigation was translated to English by Nicolas Awad.