Millions of Egyptians living in slum areas are unable to afford medical treatment. Photo: Ben Hubbard/IRIN
CAIRO, 15 July 2010 (IRIN) - Hanging around a hospital lobby has become a daily pastime for 50-year-old labourer Ahmed Ismail. Every morning for the past few weeks the liver cancer sufferer has been going to al-Demerdash Hospital in Cairo in the hope of having his malignant hepatic tumour surgically removed.
“The hospital administrators asked me to get ready for the operation a long time ago. But each time I come, they tell me that my turn hasn’t come yet,” he told IRIN.
Ismail is one of hundreds of thousands of poor liver cancer patients contributing to ever-growing waiting lists for operations in hospitals around the country.
Egypt has one of the highest incidences of hepatitis C, one of the main causes of liver cancer, in the world, according to the World Health Organization (WHO).
“Infection with hepatitis C virus (HCV) is a major global health care problem. WHO estimates that up to 3 percent of the world’s population has been infected with the virus. The infection rate ranges from as low as 0.1 percent in Canada to the extremely high rate of 18.1 percent in Egypt,” said a WHO study published in April 2010.
Lack of funds
While the government’s allocation of 650 million Egyptian pounds (US$114 million) to liver diseases makes up 40 percent of the 1.5 billion pounds ($263 million) of health subsidies it provides, it is simply not enough specialists say.
Ashraf Omar, president of Egypt’s Liver Cancer Association, last week said the number of deaths resulting from liver cancer in the country had risen from 4 percent in 1993 to 11 percent in 2009.
“Hepatitis C is just one main reason for liver cancer,” Mohamed Fathi, a liver specialist from Ain Shams University, said. “The terrible thing is that the disease is on the increase. Studies say liver cancer will hit even more Egyptians 10 years from now.”
Fathi said between 500,000 and a million Egyptians would die in the coming few years because they could not pay for treatment. Other specialists said the figure would be even higher as many poor people die of liver cancer without ever knowing what condition they had.
In labourer Ismail’s case, he said it all started with a “terrible and immobilizing” pain in his side. “It took my breath away and made me collapse onto the floor. My wife advised me to go to a clinic to get treatment, thinking it would be a temporary pain.”
His local clinic referred him to a hospital in Cairo where doctors discovered after a series of scans that he had a liver tumour. “I almost fell to the ground from shock,” Ismail said. “I didn’t expect it to be so serious.”
Food contamination
A study by Amal Samy Ibrahim, a professor of epidemiology at Egypt’s National Cancer Institute, said food contamination, which is a major cause of liver cancer, is rampant in Egypt.
The study said grain storage methods were not controlled and there was a lack of awareness of the dangers of improper storage.
The enormity of liver cancer as a health hazard in Egypt is even clearer when compared with other countries. Ibrahim said that in her study statistics provided by the Middle East Cancer Consortium (MECC) showed that the liver was not a common organ for cancer, except in Egypt.
“Liver cancer’s relative frequency was below 2.0 percent in the other MECC countries,” said the study. “In Egypt, however, liver cancer accounted for 12.7 percent of male cancers, 3.4 percent of female cancers, and 8.1 percent of both sexes together.”
The study said a male predisposition to liver cancer was more marked in Egyptians, with a 3.8:1 male-to-female ratio. Cypriots were second with a 3.1:1 ratio, followed by Israeli Arabs, Jordanians and Israeli Jews with respective ratios of 3:1, 1.6:1 and 1.4:1.
Ismail hopes and prays he does not become another statistic: “I know that waiting means that the tumour can spread to other areas in my body,” he said. “But I must wait because I don’t have other options.”
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