Afghanistan: Few Options for Leukaemia Patients

Attached to a drip, 13-year-old Zabiullah looks pale and frustrated as he gazes around his hospital room in Kabul’s Jamhuriat hospital.

“ ((The doctors tell me that I have a low blood count, and sometimes talk to each other that I don’t knowas if I have no idea [what’s happening],” he said. “But I know that I’m involved to asuffering from a dangerous disease.))”

Zabiullah’s consultant, Walid Yousafzai, treatment Doctor said that the teenager had been admitted 20 days ago with early stage blood cancer. Currently, the doctor continued, the boy’s condition was treatable.

“We do treatment as much as possible in our countryall we can, and use everything that is available in this country. If this is more advanced, but if the illness gets worsen then we will will counsel with the patient’s relatives to take him out of the countryabroad for treatment,” Yousafzai concluded.

Leukaemia patients in Afghanistan face an uphill struggle to both gain a diagnosis and access effective treatment.

There are few resources available within the country; bone marrow transplants, for example, are not accessible in Afghanistan. Lack of access to healthcare and public education mean that people often only seek treatment when their cancer is advanced or even terminal.

Jamhuriat Hospital saw 146 cases of blood cancer last year, made up of 85 male and 61 female patients.  Ten per cent of the patients were children under the age of 18.

One nurse at Jamhuriat Hospital, who asked to remain anonymous, said,;“Aassaid, “As far as I see, there is no treatment at all. We just provide some first aid for the patients, and the hospital does not keep the patient more than 15 days in the hospital.”

He added that terminal cases and those who appeared close to death were simply discharged., most of the patients that they are no longer capable of help and treatment, that there is no chance of living for them, then the hospital will discharge them.

Yousafzai said that this was not true, adding that patients were treated in cycles and then released to make room for the next case.

“ He added, the The first stage of treatment is 15 days. The patient is given six months’ worth of medication, and six months laterand after that, they patient is askedneed to come back and we do afor a follow-up re-examination and we will recommend the patient with the necessary advicesconsultation,” Yousafzai said.

But he acknowledged that the hospital could only provide with blood transfusions and iron supplements. There were no facilities for anything more complex.

Other hospitals in the capital have a similarly low level of resources.

The Indira Gandhi pediatric hospital has 30 rooms dedicated to cancer patients. Asad Saadat, the hospital’s internal medicine specialist, said that; last year 183 children with leukemia were referred to the hospital, which out of whom 27 of them died.

Doctors at the hospital made clear that they also only had very basic facilities to treat leukemia patients, such as blood transfusions.

Farid Rafiee, another internal medicine specialist, said that childhood leukemia could be directly blamed on the ongoing conflict and high levels of poverty in Afghanistan, as well as associated high levels of environmental pollution.

"War torn countries are always in danger,” he said. “Afghanistan also experiences these awful consequences."

Patients’ relatives said that although the hospital provided patients with free beds and consultations, all medicines had to be purchased privately.

Shahnaz brought her nine-year-old daughter Mursal to the pediatric hospital a week ago. She says that although she was satisfied with the treatment her child had received so far, it was clear that there was little more the doctors could do.

“They give blood to patients here, and ; some medicines that are very expensive,” she said. “We are poor and we have no money left to even buy food for her. We simply don’t have the money to pay for more blood transfusions if she needs them.”

For others, the outlook is even more bleak.

Parvin’s one-year-old son is receiving treatment at the pediatric hospital, but she said they were resigning themselves to the inevitable.

“My child became ill three months ago,” she said. “He suddenly became weak and we went to see doctors who told us it was malnutrition, but after a lot of examinations it turned out that he had leukemia.”

She added sadly, “This disease is not curable in Afghanistan and we are not able to go abroad. We are just watching our child die.”