US Imposed Syria Sanctions Hit Children’s Cancer Treatment at Damascus Children’s Hospital
Six years of conflict have brought the Syrian health service, once one of the best in the Middle East, close to collapse
Local and World Health Organisation (WHO) officials also blame
Western sanctions for severely restricting pharmaceutical imports, even
though medical supplies are largely exempt from measures imposed by the
United States and European Union.
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Six years of conflict have brought the Syrian health service, once
one of the best in the Middle East, close to collapse. Fewer than half
of the country’s hospitals are fully functioning and numbers of doctors
have dived.
The result is tumbling life expectancy — even after accounting for
the hundreds of thousands directly killed in the fighting — and soaring
deaths in pregnancy and childbirth.
On top of this, cuts in health spending by the government that is
fighting a hugely expensive war, a drastic fall in the Syrian currency
and indirect effects of the sanctions are all deepening the misery of
patients who need foreign-made drugs.
Children suffering from cancer at Damascus Children’s Hospital. Image credit: Reuters
For families with sick children, the situation is dire.
At the children’s hospital in government-held Damascus, the waiting
room outside the cancer ward was crowded with relatives, many of whom
had brought clothes, mattresses and blankets in case they had to spend
long periods far from their homes outside the city.
One of them was Naim Der Moussa, 55, who has been living in Damascus
for a year to secure regular treatment for his 10-year-old daughter
Wa’ad. They left his wife and six other children behind in the eastern
city of Deir Al Zor, where government forces are besieged by Daesh.
“My daughter was first diagnosed with kidney cancer and treated,” he said. “Now cancer has been found also in her lungs.”
Before the conflict, Syria produced 90 per cent of the medicines it
needed but anti-cancer drugs were among those where it traditionally
relied on imports.
Elizabeth Hoff, the WHO representative in Syria,
said medicine imports have been hit by significant cuts in the
government’s health budget since the war began in 2011 plus a 90 per
cent drop in the value of the Syrian pound, which has made some
pharmaceuticals prohibitively expensive.
However, a lack of cash is not the only reason why supplies of cancer drugs are falling far short of increasing demand.
“The impact of economic sanctions imposed on Syria heavily affected the procurement of some specific medicine including anti-cancer medicines,” said Hoff. The sanctions were preventing many international pharmaceutical companies from dealing with the Syrian authorities as well as hindering foreign banks in handling payments for imported drugs, she added.
The United States and EU have imposed a range of measures targeted
both at the government and some of the many armed groups operating in
the country.
Washington has banned the export or sale of goods and services to Syria from the United States or by US citizens.
The EU has imposed travel bans, asset freezes and an arms embargo,
with sanctions also targeting financial ties with Syrian institutions,
buying oil and gas from the country or investing in its energy industry.
President Bashar Al Assad has partly blamed the sanctions for turning many Syrians into refugees, often heading to Europe.
Both the US and EU regimes include exemptions for medicines and other
humanitarian supplies. However, by clamping down on financial
transactions and barring much business with the Syrian government, the
sanctions are indirectly affecting trade in pharmaceuticals.
Many drugs companies have erred on the side of caution, avoiding any
business with Syria for fear of inadvertently falling foul of the
sanctions.
The US State Department said the Treasury had authorised services in
support of humanitarian activities in Syria, adding that there were
legal ways to bring medicine into the country.
The EU also rejected criticism of its sanctions.
“Such measures are not aimed at the civilian population,” an EU spokeswoman said. “EU sanctions do not apply to key sectors of the Syrian economy such as food and medicine.”She acknowledged firms had increasingly pulled out of business with Syria but said this was also due to other reasons, including “security, reputation, commercial motivation, anti-money laundering measures” and the presence of militant groups.
The WHO brings essential medicines and medical supplies into Syria,
procuring generic drugs from approved sources in Europe, North Africa
and Asia. Branded US products cannot be imported due to the sanctions
situation, Hoff said.
With funds from Kuwait, the WHO has delivered life-saving medicine to more than 16,000 cancer patients, of whom thousands are children with leukaemia.
With funds from Kuwait, the WHO has delivered life-saving medicine to more than 16,000 cancer patients, of whom thousands are children with leukaemia.
Syrian girl Rahma sits on a bed as she receives treatment for cancer at Damascus Children’s Hospital. Image Credit:Reuters
But this does not meet demand. Besides cancer medication, there are
critical shortages of insulin, anaesthetics, specific antibiotics needed
for intensive care, serums, intravenous fluids and other blood products
and vaccines, Hoff said.
The overall collapse in Syrian health care has contributed to a drop
in life expectancy to 60 years for men and 70 for women in 2014, from 72
and 75 respectively in 2009. Only 44 per cent of hospitals are now
fully functioning and more than a quarter aren’t working at all, the WHO
said.
By 2014, the number of doctors in Syria had dropped to 1.3 per 1,000
people, less than half the level in neighbouring Jordan and Lebanon.
Against this deterioration, Damascus Children’s Hospital has also
come under increasing pressure. Cancer units in the provincial cities of
Aleppo and Latakia were both put out of service in fighting earlier in
the war.
Now about 200 children visit the Damascus hospital every week, with
more than 70 per cent from outside the capital, according to its head,
Maher Haddad.
The weight of demand has delayed treatment for dozens of sick
children by 15-20 days, affecting their prospects, overall health and
response to medication, he added.
Haddad also singled out the sanctions. Pharmex, the state-owned
company that buys drugs for government-funded hospitals across Syria,
was able to provide only 5-10 per cent of the cancer medication that is
required, he told Reuters.
“Most of the cancer medicines are imported. Pharmex used to import the stock of medicines that public hospitals need. But it has not been able to do so largely because of the economic sanctions, I believe,” he said.
His hospital has only 36 free beds, with 17 of those allocated to children with cancer.
In the waiting room, a woman who identified herself only by her first
name Nawal, said she travels from the Qalamoun area north of Damascus
every fortnight with her 14-year-old daughter who requires chemotherapy
treatment for leukaemia.
“We don’t have hospitals or charities in Qalamoun. Free treatment is offered only at the Children’s Hospital in Damascus,” Nawal said.
One private charity, Basma, is trying to help out by funding cancer
drugs for poor families. The proportion of patients who need assistance
has risen from about 30 per cent to nearly 80 per cent since the war
began, executive manager Rima Salem said.
Salem finds the delays in treatment worrying.
“A child with cancer might die waiting for his turn to get treatment,” she said.
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