Delivering childhood cancer care in fragile and conflict settings: best practices from the occupied Palestine territory

"I remember talking to a mother, whose child had cancer, who told me that after many months she was finally able to sleep through the night because her child was now receiving morphine at the hospital and had stopped screaming in pain,” recalls Dr Salwa Massad, a Research Manager for the WHO Palestinian National Institute of Public Health – occupied Palestine territory.

Salwa touches upon the dire shortage of cancer and palliative medicines, for children with cancer living in the Gaza Strip. Years of conflict and the ongoing siege of the Gaza Strip since 2012 has exacerbated gaps in childhood cancer service delivery, created shortages in cancer medicines, and delayed access to life-saving services such as radiotherapy for children living with cancer.

In 2021–2022, Salwa, Khalid Abu Saman and the team conducted an assessment of structural barriers to paediatric cancer services in Gaza in partnership with the Ministry of Health (MoH) and WHO. A key early strategy was to involve the MoH closely in the design and roll-out of the survey so as to secure Government buy-in for suggested interventions thereafter. Another strategy was to involve multiple stakeholders in the qualitative study including parents of children with cancer, oncologists, nurses, social workers in oncology hospitals in Gaza and in referral hospitals in the West Bank, MoH focal points, and pharmacists – to gain a better understanding of the scope of the problem and design long-term solutions.