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Why do Iranians have to leave the country to get treatment for cancer?

 

Maria Afsharian
October 27, 2005
iranian.com

Are you a medical professional who was born in Iran? An, entreprenuer looking to make a difference?

Cancer is one of the leading causes of death in Iran. And Iranian cancer experts say more and more people there are dying of cancer at younger ages than ever before. Treatment is expensive if it is even available. Embargo's and limitations on investments in cancer facilities by Iranian natives or doctors living in the U.S. prohibits any advancements or relief for patients. Tragic -- considering cancer knows no color, race, religion, or political affiliations.

I first became interested in the subject of cancer treatments in Iran on a recent visit there to bury my father, who died of cancer after traveling to the U.S. from Iran for treatment.

Here's a little bit of my story. I was born in Shiraz, Iran to an Iranian father and a Texan mother. My parents divorced when I was ten years old and consequently moved back to my mothers home state, grew up and graduated from college there before moving to Washington DC for a career as a journalist with Dateline NBC.

Dad stayed in Iran, visiting my sister and I in the U.S. periodically. Suddenly last summer Dad became sick. Frantic calls to Iran discovered a man who at one time had such a strong voice, now weak and almost scared. "They say I have an infection" he said on the phone. Your aunt says I have to come to america for treatment. Now I know that this conversation was reflective of so many conversations Iranians have with their family members...they don't tell them they have cancer. They believe it will take their "omid" or hope away to fight it. I still struggle with this ideology, sometimes agreeing and other times not.

And so he frantically boarded a plane weak and sick, to come to the U.S. for treatment. No insurance, no leads, no true understanding of what ailed him. My cousin told him she was sure he had Brucella, an infection. It was devastating to hear him tell this to the doctor, he believed his own lies, maybe he was fooling himself.

Inevitably, we discovered that Dad was the fourth person in his family to develop a form of lymphoma in three years. His younger brother, Askar just died of non-hodgkins lymphoma, his younger sister died two years earlier of ALL a form of leukemia and we lost a nephew at 36 of non-hodgkins lymphoma, now Dad had Richters transformation of CLL with a very grim prognosis. These are the only causes of death in this family, all from lymphoma/leukemia. I have since learned that lymphoma is not usually hereditary. Which leads me to believe that there is something in Iran, perhaps oil in the water, bacteria in the food or pollution etc. causing my family members to get sick. And it wasn't just lymphoma they had in common, they all traveled outside of Iran to get treatment, one went to London, three went to America.

In the first uncertain days at a local university hospital, as I made my bed in the convertible "chair that makes into an uncomfortable bed" to stay the night in his hospital room, I asked him if he regretted coming to the US for treatment and leaving the family. He replied, "No, we don't have the medicine I need in Iran."

I realized without admitting it, that he knew he had cancer. I didn't say anything and braced myself for the worst. He only lasted two months, after that, he was already weak from his travels and simply couldn't tolerate the chemotherapy, stays in the hospital and numerous infections. It is horrific to hear a doctor say there is nothing more we can do for your father and just watch them die a slow death, or his organs fail. It's almost as if someone is drowning and you can't save them and you cant believe you are in a hospital and no one can do anything, you feel helpless and a shock of reality. You almost start thinking about advocating patient assisted suicide. But yes I know that would be wrong.

I was lucky though because I spent a lot of time with my dad, desperate to make him better, not be afraid. What does it feel like to face death? I would wake up in the middle of the night and see him staring at the wall, and wonder what was going through his mind. He said he missed Shiraz. All this for a man, my hero, who walked into the hospital so sick but wearing his best suit, never to leave except in a coffin. A man so proud, wise and strong. He died in my arms with dignity and all I could remember was one of the last things he told me in the fashion of any proud Iranian father, "Do not pity me but learn from me, as your father I am your example, be strong... " I promised him I would take him home... and that I did.

After 29 years I stepped off the plane in Tehran in a surreal state, not believing where I was. After all the landscape looked much like the video we saw from the Iraq war at work... scary. But here I was wondering if I should be scared, my aunt said no, I chose to believe her. Then I flew to my final destination of Shiraz and experienced his funeral. Again, I didn't know what to make of things but strangely things felt "like home". They say that your younger years are truly your formative years and my formative years were spent in Iran. But, at 39 I was like a baby, I couldn't drive a stick shift, I couldn't drive in the crazy traffic, I didn't know how much a toman would buy. After being such a die hard independent woman in the United States, I had to learn how to ask for help, which I now look upon as a gift.

After someone dies in Iran, there is a long mourning period, with the end at 40 days. So I stayed there even after the initial ceremonies. It was during that time that Dad's words came back to fill my thoughts, "Do not pity me, but learn from me". What did this mean? In my time there I discovered that Dad lived a secret life. He secretly and quietly gave to those less fortunate, brought sacks of rice to the needy, he supported orphans, he paid for poor people's children's college tuition, he mentored young lawyers, he gave more than is expected to beggars in the streets, he paid for health insurance for those who couldn't afford it... and didn't tell anyone. It was only at his funeral service in the mosque that I met the poor that he helped, they came out in droves and told me how he had changed their lives. Astonishingly, I never knew he did this and neither did my family.

It was then that I set out to make a difference. As his daughter I wanted to help too, I wanted to keep his name alive. Mainly I wanted to know why it was that there was a lack of chemotherapy medicine in Iran or Shiraz, for those who needed it. Why is there such a high incidence of cancer in Iran. Why do patients have to suffer so much and so many desperately seek ways to get to another country to get treatment. Why is it that regardless of politics that medical treatment should be compromised.

I found my answers through my Dad's neighbor in Shiraz who I met because of a water pipe that broke in Dad's apartment and leaked into her apartment below. Mrs. Hakimi, a former city leader in Shiraz and an amaziing woman, she even has a street named after her, introduced me to the President of Shiraz University and the head of the Shiraz Cancer Institute. They were prepared to give me a plot of land on Shiraz University's campus if I could help build a cancer research institute... because there isn't one.

There are private hospitals galore built solely for heart surgeries, MRI's, and eye treatments, but nothing for cancer. We worked through detail after detail, planned floors etc. identified vendors who could give second hand radiation equipment, and chemotherapy vendors. Then I found out the news... that I would not be able to invest in any ventures in Iran because I live in America. Please note, that I am proud to be an American, but realize this is the law and I have to respect that.

Now I have to get creative. I am hoping by writing this article that someone somewhere knows of a resource or funds that might be able to make this project happen. Even the littlest investment of knowledge could make a difference. I visited the cancer ward in Shiraz with the sick children under the care of tired but capabale Dr. Mehran Karimi. I saw them suffering from lymphoma with little hope because of the embargo's on medicine and minimal govt funding. Crying parents, overworked doctors and nurses trying to make the best out of what they could provide. Yes just another story about a country sadly considered a "third world".

But what does "third world" mean to cancer... nothing. Since I couldn't invest any money I rallied to commission the building of chairs that would convert into beds, much like what I slept on in the U.S., so that parents of sick children wouldn't have to sleep in the streets, literally. Paint the wards with cartoons so that the children would have some happiness in an otherwise gloomy atmosphere. Provide refrigerators so that poor families could bring in their own food while they looked after their children in the hospital. And have books and toys donated. This is all I could do.

But there is still work to be done. Why do Iranians have to travel around the world for cancer treatment? Because the medicine isn't available and there are no up to date facilities or machines to treat them. Leaving their families. Don't we have an abundance of medical professionals or entrepreneurs around the world who were born in Shiraz who might want to give back. These people don't have a choice on whether or not they get cancer. And most aren't able to travel much less afford to go to other countries to get treatment. Isn't there valuable data that medical professionals can collect from the Pars region if only there were a structured system of collecting data were in place. Don't these people deserve better treatment?

Dr. Abbas Ali Ghaderi of the Shiraz Institute for Cancer Research, a two room facility, has put together a plan. A new cancer research institute 5 story building with a pharmacy, outpatient treatment room, organic research, biomedical research etc. If only an investor can make it happen he would be glad to put their name on the building. A place where university students can study, collect data, share information with the cancer community world wide and treat patients rich and poor. The cost, $600,000.

And there is Mrs. Saadat who lost her only child to cancer at age 21 who has spent her life building a hospital facility on her land, still unfinished, to house cancer ridden patients and is looking for guidance and ways to fill the rooms with medicine, doctors and investors. She begged me for names in "America" that could help her make her dream come true to provide a location for people to be treated for cancer in the Pars region without having to leave the country like her son had to.

I look around Shiraz and see private hospitals focusing on heart patients, MRI's, eye care but see nothing that has to do with cancer. I ask myself how is it possible that such a remarkable region of Iran has yet to have someone develop a comprehensive cancer center.

I ask you, in the spirit of my father and so many others who had to leave their families to go to other countries for treatment... if anyone has any politically correct solutions I welcome the opportunity to pass them along...for the future of millions... and an opportunity to make a difference.

About
Maria Afsharian is President of Summer Day Communications, Inc.

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