Whether in besieged East Ghouta, or regime-controlled Damascus, cancer patients in Syria are struggling to obtain treatment.
Abu Ghassan is still trying to find a cure for the cancer his wife suffers with in the besieged area of East Ghouta.
Dar el-Rahma centre is the last cancer surgery remaining, and doctors here estimate there are around 600 cancer patients who need to be evacuated out of the area for immediate treatment.
Abu Ghassan told The New Arab that the condition of his wife had rapidly deteriorated as the treatment centre could no longer provide enough supplies due the siege and lack of medication.
Only hospitals in the nearby Syrian capital of Damascus provide radiotherapy, and they are out of reach for the besieged residents of East Ghouta.
Aid workers and hospitals in the area have warned of a humanitarian catastrophe if the siege continues, further threatening the lives of patients.
In the first few months of the siege, 20 cancer patients died at the Rahma centre, because they could not be provided with sufficient medicine.
Around 400,000 people are believed to be trapped in the besieged area, with the UN having previously appealed for the Assad regime to allow the evacuation of around 500 priority patients.
From the list of 500 urgent cases announced last November at least 16 have already died for lack of medical assistance.
Meanwhile in Damascus, crowds of patients wait in front of al-Bayrouni hospital for treatment. Some are local residents, while many have journeyed from other Syrian governorates.
Among those waiting is Ahmed al-Sheikh from the city of Homs in central Syria. He has cancer. He says every time he arrives at the hospital his “treatment is delayed, or the schedule changed”, and he waits hours in the hope of receiving medicine.
He fears that he will no longer be able to afford the cost of travel between Homs and Damascus, and the expenses of accommodation.
“Most patients are in the same position,” he said.
Cancer drugs imported from the US and Europe were previously offered at the hospital for free, but the imposition of sanctions lead to imports being slashed in half.
Both the US and EU include exemptions for medicines and other humanitarian supplies. However, reports suggest that the sanctions are indirectly affecting trade in pharmaceuticals due to the risk of doing business with Syria.
Less effective medicine has therefore been imported from countries such as India and Iran. Alternatively, patients buy US-imported medicine from the Lebanese capital, Beirut, at their own expense.
Among those is Mowafiq, a cancer patient living in Beirut, who says his medicine is $250 per dose. Yet his salary from his IT job is nowhere near enough to cover the expense, and he has sold his belongings and borrowed money from relatives to pay for his life-saving medication.
According to pharmacist Mohammed Rawas, most pharmacies in Syria still manage to import some cancer drugs, but they are extremely expensive compared with the deteriorating Syrian currency and low incomes.
Elizabeth Hoff, the WHO representative in Syria, told Reuters last year that medicine imports have been hit by significant cuts in the government’s health budget since the war began in 2011 – plus a 90 percent drop in the value of the Syrian pound, which has made some pharmaceuticals prohibitively expensive.
However, a few have profited: there have even been investigations into staff at cancer hospitals who have been accused of selling cancer drugs for personal gain.