Dr. Nadeem M. Naji, Head of the Oncology Department at Aljumhuri Hospital to YT: “An increasing number of patients are dying from cancer due to consumption of Qat is increasing day by day” [Archives:2000/30/Health]

July 24 2000

Dr. Nadeem Md. Said Naji, born in Hardamaut, completed his Board in Internal Medicine and did doctorate in Oncology. He has been an Assistant. Prof. in Sana’a university and a Doc. in Aljumhuri Hospital since Feb 1998. Now he is head of the Oncology department.
In an interview with Yemen Times he shared many facts about his specialization and department :

“Until now, we only have an external clinic which is specialized in treating Cancer Patients, and we are trying our best to arrange for patients to be treated and cured.. we are trying to achieve what is called registration for cancer patients and we are on our way to that because in the next 3 months with aid from the ministry and the minister of health this department. affiliated to Aljumhuri Hospital will open. But actually we do not have an independent unit specific for this field” he said.
About specialized doctors he said that there are no specialized doctors in this field till now other than himself.. but there are a few Hematolgists who are good, and we are expecting around 4 Yemeni cancer doctors to arrive in a short period of time graduating from Pakistan.
Dr. Nadeem, told us that cancer diseases are quite common in Yemen. If we compare these 10 years with the previous ten years we could say that there is about a hundred percent increase in tendency in cancer in Yemen. Hospitals have become more advanced and patients awareness has become greater towards any kind of swell. It is true that there is an increasing number of cancer patients coming to us; In a single day we receive between 30-45 patients diagnosed with cancer with histopathology report. The general age comes between 30 to 50 years! And it is very sad that many of the cancer patients actually die because they either come late as advanced cases, like we receive many bilateral lymph node metastatic cervical regions which is a very advance case and sometimes gets only paralytic treatment. Or because the diagnosis is not accurate and the Doctor himself does not realize that this is cancer until a period of time.. many lymphoma cases could be mistaken for TB because they share many common symptoms, like sweat and loss of weight and the swelling on the neck. It could have been some other infectious diseases as well. The thing is that if we take a simple biopsy diagnosis. But unfortunately we don’t have any specialized or advanced laboratories for Immunhistochemesty in Yemen. Sophisticated examination is not there. So the patient is forced to go for advanced investigation out side Yemen. This could be because such kind of analysis is very expensive compared to the normal one, so the patient would rather get a cheaper test and might be treated thinking he has TB for months before it is discovered that it was a cancer tumor all the time and he then is sent to us as an advanced case of cancer.
“It is well known” Dr. Nadeem said that the leading cancer in the world according to world survey is lungs cancer , but I have made a retrospective study for one year in one of the hospitals and found that gastrointestinal tract cancer is more common in Yemen than other cancers. We could say that our environment, our food, using the water pipe (madaa’), al shama (Tubbaco put under the lip) plays a very critical role in getting oral cavity diseases. The other important kind is Lymphoma in general. Many Yemenis suffer from Hodgkin and Non Hodgkin Lymphoma and this disease does not differentiate between children and grownups. Lymphoma is widely spread in Yemen . A very strong observation here is that many of our patients come from the suburbs, where those people are naturally more related to nature and are far away from the city and the chemicals in it. Their diet is also known to be healthier. Still many of them suffer from Nasopharynx Cancer or Head and Neck cancer. I relate this to their wrong use of chemicals in protection of the plants and crops from insects or diseases that they pluck the plants before giving the needed gap after spraying these chemicals. This is especially true about Qat, as it plays a very strong role in Gum cancer, throat cancer and gastrointestinal cancer. An increasing number of patients are dying from cancer due to consumption of Qat is increasing day by day. About whether cancer is a disease carried by hereditary he said; practically science could not prove whether it is actually hereditary, but it is a well-known fact that chromosomes abnormalities(i.e. Genetic factors) make a person more susceptible to become a cancer patient in the future.”
About his ambitions and the obstacles he faces Dr. Nadeem emphasized again on the importance of having a specialized center for cancer treatment. He said that we only need one or two such centers in Yemen. because we could get sample from many places in Yemen and if they are kept in Formaline they could last for years. The government could support such a center and the difficult cases which could not be diagnosed easily could be referred to this center. With nominal payment from the patient he or she could be treated right and saved.
“We already have a building which is well equipped and just needs some final touches for the project to see the light 4-day. But unfortunately because of bureaucracy and routine it’s taken a long procedure and more than 7 months to do something which could be done in two weeks. If this center is complete, we could have, what is called, cancer registration and patients could be treated after being diagnosed. Also since this would be an authorized establishment, we could be a formal entity and could be provided with aid for many aspects including setting drugs from many sources. Another obstacle is the lack of specialized staff. We still need more doctors in this field. Also Dr. Nadeem said that the Oncology department. needs to be complete with its own specialized laboratory and its own radiotherapy department. Radiotherapy is much cheaper in curing patients than chemotherapy.
Dr. Nadeem continued, “all we need is to speed up the procedures and get rid of the long routine in our projects. This way we could save our peoples’ lives and money as well as keep the huge amounts of hard currency spent outside the country.”
“Another point is that we should not think that the cancer patient is a hopeless case. Many of the patients and their families even members of the staff think upon coming across a cancer patient that he or she should be left to die.. No, in spite of our limited facilities we still can save lives. We have many breast cancer patients, of women who are sent to us after the tumor was removed by surgery and then they are referred to us for chemotherapy follow-up. Many other cancer patients are cured completely.” Dr. Nadeem also stressed on the point that Yemeni Doctors ought to be appreciated more. “There are many qualified doctors in Yemen who could make a difference if only they were given the credit they deserve. If such a thing happens this will drive them to give more to their society and people in stead of fleeing away to other countries leaving Yemen in dire need for them.”In a final word.. Dr. hoped that serious steps are taken in improving health in Yemen especially cancer, because a cancer patient should be given high priority anywhere in the world. He also hoped that the ministry of health continues its support and that other charity associations should lend a hand as well. “There is a charitable fund for cancer patients which was established 9 months ago and through it, the aids could be given and would reach where they are urgently needed” he concluded.