Morocco in need of better and cheaper treatment for breast cancer

02/11/2006

Breast cancer is a growing problem in Morocco due to a lack of awareness and early detection of the disease. The problem is compounded by insurance companies not wanting to pay for detection measures, limited public treatment facilities and the high cost of private care.

By Sarah Touahri for Magharebia in Rabat – 02/11/06

[File] Breast cancer patients undergoing chemotherapy at the National Oncology Institute

Nearly 10% of Moroccan women are afflicted with breast cancer, according to the National Oncology Institute (INO). Doctor Rajae Aghzadi, president of the Association Against Cancer, says 10,000 to 12,000 new cases are detected every year. The majority of those with the disease are aged 45 to 55, but patients are getting younger, Aghzadi told Magharebia.

Doctor Jalil Abdelouahed, head of the oncology surgery department at the INO, feels the social impact of breast cancer is enormous.

"The disease is growing in Morocco because of a lack of awareness," he told Magharebia. He says some people do not even know the disease exists.

Doctors say present infrastructure is no longer sufficient.

The only two public cancer centres in Morocco are the INO in Rabat and the Ibn Rochd oncology centre in Casablanca. Most Moroccans have little or no access to care. The INO staff in Rabat is inundated everyday with patients from all over Morocco. Hospital infrastructure is especially lacking in rural areas, where poor women find it difficult to receive care.

Because of high demand, three private oncology centres have opened over the past ten years. Patients are spared long waits for treatment, but pay a high price.

Doctor Abdellatif Benider says the average cost of breast cancer treatment in Morocco ranges from 40,000 dirhams to 50,000 dirhams, an amount beyond the means of many patients.

Housewife Hayat Boufaracha learned of her breast cancer six months ago.

"I was stunned at the news. How could I go to Rabat for chemotherapy when I live in Taza? You have to wait a long time to be treated in the public hospital and at private hospitals, I was being asked for 45,000 dirhams, which I do not have," she says. She has had to depend on the generosity of others for treatment.

Lack of funds cause many patients to only have one chemotherapy session per week instead of the prescribed two or three sessions. The practice is most common outside the Rabat-Casablanca corridor.

Insurance payouts are also a major problem. Benider states insurance companies require the disease to be present before paying.

"A 45-year-old woman having a mammogram as part of breast cancer detection must pay 800 dirhams. If she's lucky enough not to be ill, she will not be reimbursed," he points out.

Early breast cancer detection costs three times to four times less than late diagnoses. Treatment has a 100% success rate if the tumour is less than two centimetres, says Doctor Rajae Aghzadi, a breast cancer specialist.

"All you need to do is see a doctor immediately to avoid the catastrophe of advanced cancer. Moroccan women don't seem to be aware of the urgency of early detection or informed about current care options, even if they know how serious the disease is," she indicates.