The star stood amongst the small children and sang ‘Kamnna’. At the part where the song asks "what do you dream of?", he handed the mike to a little girl to continue the verse. Thinking that she was being asked what she dreamt of, she answered literally: " I dream of getting well". The eyes of all those present filled with tears, because they knew that these kids did not have much longer to live.
This was part of an event held especially for children suffering in the last wretched stages of cancer, a condition which must be fought from its earliest beginnings to provide any chance of recovery. Intensive care is required from the first stages of cancer to prevent it deteriorating into an irredeemably terminal state. These children could not be saved, either because the disease was not diagnosed quickly enough or because there were not the facilities to treat them.
Every year in Egypt there are hundreds of such children whose lives end before they have scarcely begun. Instead of a joyful life of play they know little more than pain and suffering. Their innocence is like a wild flower choked by the tares of disease. They suffer from their first days to their last.
When entering the National Cancer Institute (NCI) it’s hard for anyone to hide their feelings of grief, sympathy and pity for these children. Although they receive excellent care from all the doctors and nurses, the cruelty of this disease is often far beyond the power to help. It is hard to believe that this institution is in Egypt, as it hardly differs from institutes in any developed country. It was founded through the efforts of Egyptian businessmen who funded everything from the basics, such as floor tiles and chairs, through to medical equipment costing millions of pounds.
In the reception I came across an eight year-old boy named Karim Ismail who is suffering from leukaemia. He was crying. He didn’t want to enter the treatment room. His parents lost their tempers and yelled at him. A psychiatric specialist intervened, hugged the child and persuaded him to enter the room and face the ordeal that awaited him there. Despite his tender years Karim knew that he was about to endure a lumbar puncture – an injection in his spinal column with a hollow needle almost as thick as a nail. This procedure is used either as a part of chemotherapy or to take a sample for testing. It was to be Karim’s third experience of this, so it was small wonder that he had resisted and cried.
Donations have enabled the Institute to acquire newly developed anaesthetization equipment which keeps the child unconscious for the couple of minutes required for this operation, before they wake up again without suffering side effects. Before they had this equipment lumbar punctures were performed without any anaesthetic, because the frequent – sometimes as often as once a week – use of regular anaesthetization techniques is harmful.
The Institute is filled with many individual cases suffering from various forms of cancer; names, colour and religion differ from one to the next but the pain and the determined hope to beat the disease is a common factor in them all.
One such case is a child called Mohamed El Bakry. He suffers from blood cancer and has been at the Institute for six years. It was thought that he had made a full recovery but after a brief remission the disease returned and attacked him even more severely. Though he has nearly reached his end he still fighting for life. The Institute can do nothing for him but provide medication to combat the pain of the final stages. The Institute supplies this medication because Mohamed’s father is a poor worker who could not afford to pay the cost of even one day’s injections.
Cancer of the blood is one of the more common forms of the disease amongst children, even the very youngest ones. Marwa was 11 months old when she attended one of the parties. She was too young to be able to move about freely and instead played with the drip-feed to which she was attached. The disease attacked her cruelly and she died a few days after the party, without living to see her first birthday.
Another child, Ahmed Atef, was not even two months old when he was diagnosed with cancer in his right kidney. He was transferred from the Abu Rish Children’s Hospital to the Institute so that he and his parents would not have to travel from Benisweif to receive chemotherapy everyday and dialysis three times a week.
Dr Sherif Abu El Nega, a tumour specialist at NCI, said that about 1,000 children come to the Institute annually. Although this is a shocking statistic, when it is taken into account that half of the Egyptian population is aged under 18, it is not disproportionate compared with international figures. Child cancer statistics are related to industrial development and its impact on the environment. For example, the percentage of children with cancer in England reached its ceiling in1920. The same occurred in the USA during the 1940’s and the same thing is happening now in Egypt.
In addition, early diagnosis and the availability of appropriate treatments have increased the number of admissions to the Institute. Before a patient might have died of cancer without anyone recognizing the cause of death. However, whereas once maybe half of those entering the Institute would have died, the development of new treatments has seen a decline in the side effects that can fatally exacerbate a patient’s condition.
Dr. Sherif adds that up to the end of the 1980’s there were no survivors from bone cancer, but today the survival rate is 66 per cent.
It is generally thought that cancer is caused by genetic dysfunction and / or the effects of environmental pollution. Statistics show that the majority of affected children come from poor areas. It is said that everybody is attacked by cancer everyday but that their immune systems fight back and, usually, win. But immune responses depend on proteins; consequently in cases of malnourishment, repeated illness, lack of medical care and health awareness, common factors amongst the poorer classes, the body’s defences are weakened and cancer is able to gain a hold.
"Treatments cost LE35 million per year," Dr Sherif explained, "most of these expenses are covered by donations. At first we thought that most donations would come from businessmen, but when we advertised on TV almost every section of society donated. In one instance a man from Shobra El Kheima, wearing very simple clothes, donated LE2.
"When the donated money was transported from the Institute to the bank it caused a traffic jam because of the huge amount of coins given by young students and poor people. To this day we get on average four cars a week carrying donations of money, toys and old clothes from students."
Because the children are cooped up at the Institute for so much of their time even the briefest chance to enjoy the beauties of nature is precious to them. Consequently some donors organize parties, picnics and Nile cruises, to give the children the opportunity to experience the pleasures of normal childhood things.
Tourism expert Mahmoud Rezq El Gamal organizes two parties each year, one in the spring and the other during the 6th of October festivals, at his restaurant in Maadi. At the last party happiness and joy mingled with sorrow and pain. Some of the children danced and sang with their drips still in their hands, while others were confined to wheelchairs, but they all enjoyed their time there.
Two of the boys at the party were Mahmoud & Michael. They danced together hand in hand and were so active and happy in spite of their critical condition that all the other people there made a circle around them and clapped for them. The two boys were oblivious of what fate had in store for them – they died just a few days later. Mahmoud and Michael were never separated; they lived through the pain together and they died together.
All the children at the party were in a terminal condition and the doctors who accompanied them didn’t wish to deprive them of their last chance to have fun. One little girl asked for a cup of coffee and although it would not usually be allowed the doctor gave his approval. Some removed the drips from their hands to dance freely, while the parents couldn’t hold back the tears as they watched their children dancing their last dance. The doctors observed that all the children ate their food even though they used to refuse their meals at the Institute. These occasions had become an incentive for them to accept their medication, because they knew that to do as they were asked would mean that they could go to the party or on the picnic.
Mahmoud Rezq El Gamal says that the idea of organizing the parties came from Dr. Osama El Qilini who worked at the Institute. He suggested organizing parties for more than 160 children from the free of charge section which is funded by businessmen.
Maastricht luxury hotels "My wife and I were enthusiastic and prepared our first party. There were many contributors; for example, a florist gave each kid a small bouquet. After the success of those parties we began to invite other businessmen."
"The entertainment that these children get through parties and picnics is very important," said Naira El Said, a specialist in child psychiatry at the Institute. "The psychological status of the patient reflects 90 per cent of the chance that the medication will work. One can never believe that the children dancing and singing are the same ones that lie on their beds inside the Institute.
"The child doesn’t suffer alone, it effects the whole family both financially and mentally, especially as most of these kids come from poor families. Just moving to Cairo to provide their kids with the appropriate care creates a burden. All this pressure sometimes causes the parents to lose their patience. A guest house has been provided near the Institute for families coming from different towns and from the Cairo suburbs, where they can stay free of charge while their children receive their treatment. It includes everything: food, kid’s clothes…because the Institute understands the needs of the families."
While these children may be different from others inasmuch as they pray for recovery and fight for their lives; and while the donations of blood and medical equipment is vital; the Institute is careful not to forget that these patients are children and, like all children, they should have the chance to dance and play and smile.
