Cancer patients forced from their own countries can't access treatment

CONFLICT REFUGEES SUFFER some of the worst human tragedies the modern world knows.

They lose their homes, their country and, often, many of their loved ones.

But as conflicts play on around them, ordinary and everyday issues continue to wreak havoc on their lives as well.

Cancer doesn’t stay away from refugee camps, just because the residents lives are hard enough. It just makes them even more difficult – and tragic.

According to a new study, published in The Lancet Oncology, there is currently a “high demand” among refugees from Iraq and Syria for cancer treatment.

And somebody has to pay to treat it.

Currently, the onus is on the host countries of these refugees to find the money and the medicine to look after their new patients.

In the first four months of 2013, Jordan’s Ministry of Health said it spent €53 million for medical care for refugees.

The United Nations has recognised this system needs to change and has called for “innovative financing schemes to improve access to affordable high-quality cancer care for refugees”.

It also wants better primary care – including screening for common cancers (colonoscopies and mammograms) – and the development of electronic web-based cancer registries to prevent interruption of treatment.

Dr Paul Spiegel, the UNHCR Chief Medical Expert, has been examining data from funding applications made to the UNHCR Exceptional Care Committee from refugees in Jordan and Syria whose cancer costs were likely to exceed $2,000 per year.

He says the findings show that cancer is an important problem in refugee settings. They also highlight the immense costs that “national health systems and humanitarian organisations face when overwhelmed by massive influxes of refugees”.

Between 2010 and 2012, the ECC assessed 1,989 applications for treatment, about 25 per cent of which were cancer related (breast and colorectal cancer being the most common).

Around half (48%) of these cases were approved and funded. The main reasons for denied funding were a poor prognosis (43% of cases in 2011 and 31% in 2012) or that the treatment was too costly (25% in 2011).

The average amount requested from the ECC for cancer treatment was $11,540 in 2011 and $5,151 in 2012, However, the amounts approved were substantially lower—$4,626 and $3,501 respectively.

“The countries in the Middle East have welcomed millions of refugees, first from Iraq and then Syria. This massive influx has strained health systems at all levels,” explains Dr Spiegel.

“Despite help from international organisations and donors to expand health facilities and pay for additional personnel and drugs, it has been insufficient. The burden has fallen disproportionately on the host countries to absorb the costs.”

The problem is very different to other humanitarian crises seen in sub-Saharan Africa in past decades. There, infectious diseases and malnutrition were the priority.

“In the 21st century, refugee situations are substantially longer and increasingly occur in middle-income countries where the levels of chronic diseases, including cancer, are higher,” continues Dr Spiegel.

“Cancer diagnosis and care in humanitarian emergencies typifies a growing trend towards more costly chronic disease care, something that seems to have been overlooked, but is of increasing importance because the number of refugees is growing.”

Since the Syrian conflict began over three years ago, about nine million people have fled their homes. About 2.5 million of them are in the country’s immediate neighbouring countries – Turkey, Lebanon, Jordan and Iraq.

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