Why expats battling breast cancer choose to stay abroad

Sharon did not want to go home for treatment for breast cancer and become a burden on her children. (Issa Alkindy)
Updated 31 October 2018

Why expats battling breast cancer choose to stay abroad

  • Workers from the Philippines choose to stay in the UAE, despite being far from family, because the treatment is better and they can continue to earn a living
  • One Abu Dhabi doctor said 98 percent of his expat patients who have breast cancer choose to stay

DUBAI: Dazed and completely daunted, Sharon listened to the muffled words of the doctor informing her that she had Stage 3 breast cancer. “Why only now?” the doctor asked repeatedly, as images of her two young boys flashed before her.
It did not seem possible. With no family history of breast cancer or habits that would place her at risk of developing the disease, she had believed her health was fine. Then one afternoon, while she was in the cafeteria at the university where she worked, a pain shot from her armpit to her breast. Terrified, Sharon booked into a clinic for a consultation.
During the 10-day wait for the results of her tests to come back, the pain got worse by the day. Then came the diagnosis: Advanced stage breast cancer that might have already invaded lymph nodes and muscles beyond the tumor site.
Sharon, a single mother from the Philippines, had moved to the UAE in 2006 to teach at a university in Sharjah, leaving her children to be cared for by others who could provide them with a better life, in common with many others from her country who have chosen to support their families through working abroad.
Yet the strain of being away from family becomes even more intense for those with a chronic illnesses who face hospital appointments alone, sitting in waiting rooms without a familiar hand to squeeze.
Even so, when faced with the difficult choice of staying in the Gulf or returning home for treatment, many expats choose to stay. Sharon was no exception.
Breast cancer, which has four stages, is one of the world’s most common cancers, and causes 15 percent of cancer-related deaths among women — the greatest number, with 627,000 deaths worldwide in 2018 alone. In the Middle East, through fear and embarrassment, doctors fear women are discovering they have cancer when it is at an advanced stage when risks are higher.
“Breast cancer is the number one form of cancer in the Middle East among women, and there’s been a stable increase of reported incidents in the region,” Dr. Mohanad Diab, head of oncology at NMC Hospital in Abu Dhabi, told Arab News.
A significant number of his breast cancer patients are expats, he added. More than 98 percent of them stay in the country for treatment.
Often these women stay because they think of themselves as the “breadwinners” with families depending on their earnings. For them, going home would mean the loss of a major source of household income.
Sharon said that she “didn’t want to be a burden” to her kids by returning to the Philippines with an illness that would costs thousands of dollars to treat: After all, her young children were relying on her income for a comfortable life and good education.
Another factor is the “generous” medical insurance available in the UAE, which Sharon was able to use for most of her treatment — from initial tests to a mastectomy.
Alma Linggay, a 39-year-old expat who discovered she had cancer last October, faced a similar predicament to Sharon. She was also working in the UAE and receiving treatment away from family in the Philippines. “I can’t stop working. I have a lovely daughter I need to provide for. I have to be strong for her.”
Linggay said that it was a “blessing” to be able to receive treatment in the UAE, adding that her insurance has covered most of her chemotherapy sessions. “I only pay Dh10 ($2.72) per session for my chemo,” Linggay said, adding she might have had to pay for treatment elsewhere.
So highly regarded is the UAE’s breast cancer treatment that doctors even recommend staying in the country to benefit from this.
“In the UAE, we have the most advanced technology in radiotherapy, and all kinds of chemotherapy around the world are available in this country,” Dr. Diab said.
In the majority of cases, breast cancer patients are encouraged to continue with their daily routine, he said. “Breast cancer treatment usually takes a long time, so we advise them to stay here to continue working,” Dr. Diab said, explaining that not working can add to emotional and mental pressures patients face.
“We always tell them how they can still work as usual, with only 20 to 25 percent of daily power compromised. Nonetheless, patients with breast cancer will still be able to fulfill all commitments in their jobs,” he said.
But not everyone can face going through treatment without having easy access to the support of their family and home.
Sharon recounts the stories of some who returned to their home countries, either immediately after diagnosis or after being cleared of cancer, only to end up with more complications.
“I know around four to five people who died after going back to the Philippines,” Sharon said, her eyes downcast.
Despite being miles away from her family, she did not feel totally cut off while she being treated in the UAE.
“My doctors and nurses are very supportive, as well as my employer, who was also among those who convinced me to stay in the UAE,” she said, adjusting her bright pink turban.
“It’s extremely important for breast cancer patients to have a support system throughout their treatments,” said Dr. Nazura Siddiqi, a specialist in obstetrics and gynecology at Bareen International Hospital, adding that besides the physical challenges of the disease, it is “mentally draining.”
Yet Sharon has reported rarely feeling alone as she struggled with the disease. Once, she found more than 50 envelopes, scattered across the floor of her university office — all filled with anonymous messages from her students keen to cheer her up and promising to support her.
University staff would club together to help out every time she found herself unable to pay some additional medical expenses.
Now Sharon has become an advocate of breast cancer awareness, conducting informative talks in schools to share her experience in dealing with cancer and encouraging women to have themselves tested as early as possible.
She also meets with people who have the same condition in social gatherings, usually hosted by the UAE-based cancer support group, Blessed.
On the day she was diagnosed with cancer it felt like a death sentence, Sharon said. Now she wants to share how the experience turned out.
“I’ve successfully beat cancer now,” she said. “I’m glad I stayed.”


New Saudi rules on hookah leave businesses, consumers confused

Arab News visited different restaurants in the town and found a few serving hookahs. (AP/File)
Updated 22 min 18 sec ago

New Saudi rules on hookah leave businesses, consumers confused

  • Manal Jafar: Everywhere in our city is polluted with smoke, you can hardly find a restaurant where you can safely take your kids

RIYADH: The Saudi Ministry of Rural and Municipal Affairs has imposed new regulations on restaurants and cafes serving hookah. Although many were disappointed following the announcement to allow hookah inside cities, businesses were shocked to know about the fees imposed on them. Nonsmokers have also raised their concerns after they realized that bills will rise by 100 percent if they visit a restaurant that serves hookah.
Arab News visited different restaurants in the town and found a few serving hookahs. Some said that they will still serve it, but will not charge customers any extra fees.
Meanwhile, a trending hashtag in Saudi Arabia addressed the issue of fees on tobacco, with some customers sharing their bills online.
Michel Abou Assaly, director of operations at Shababik Restaurant in Jeddah, said that when they first found out about the new law they were surprised: “We were obliged to stop serving hookah and we had to send all our employees at the shisha department on a short leave until things became clearer.” He added they did not want their customers to pay double the price for the same product. He anticipates a 40 percent drop in sales.
“Thousands of restaurants and cafes will close down and at least 100,000 families will be affected,” Assaly said. He added that investors should ask the ministry to reconsider this law.
Halima Muthaffar, a writer, said that although she hates the smell of tobacco, she still sees this as an unfair decision. She added that it is not the right time, especially as Saudi Arabia is opening up for tourists.

FASTFACT

• The use of tobacco is expected to cost the Saudi economy SR480 billion ($128 billion) for the period 2018-2030.

• Authorities hope to reduce tobacco consumption in the Kingdom to 5 percent by 2030.

• The annual fee for the license to serve tobacco ranges from SR5,000 to SR100,000.

• Fees for licensing tobacco during events range from SR600 to SR3,000.

• 100 percent of fees are imposed on all bills of restaurants and cafes serving tobacco.

Columnist Gassan Badkook said that the authorities will reconsider the way these fees are being calculated. He said that three groups will be negatively affected: Nonsmokers, who will have to pay fees for a product they do not use, investors who might close their businesses and employees who might lose their jobs.
Manal Jafar said she agrees with the fees: “A restaurant should serve food only. Everywhere in our city is polluted with smoke, you can hardly find a restaurant where you can safely take your kids.”
Mohammad bin Hamad said he rarely goes to a restaurant with his family, but they never ask for hookah. “Why should I pay 100 percent fees on top of my bill? We should wait for a few months, many restaurants will stop offering hookah because they will lose so many customers.”