Keynote speech by HH Princess Dina Mired at UICC Congress

HRH Princess Dina Mired of Jordan shared on X:

“Sharing with you my talk at UICC congress ‘Gaza’s Cancer Patients: Navigating the Dual Struggle Between Illness and War’.”

Source: Princess Dina Mired/X

Keynote speech by HH Princess Dina Mired
“Gaza’s Cancer Patients: Navigating the Dual Struggle Between Illness and War”

Geneva
17 September 2024

Your Excellencies
Colleagues, Friends

“The last time I gave a keynote speech on the plight of cancer patients in conflict zones, was in Cambridge, England in 2022. At the time, the all-consuming global topic was the Ukraine war.

The Ukraine war was a seminal event for many of us in global health for many reasons. Of course, firstly, we were all very concerned to see a new war erupt in Europe, and naturally as fellow human beings, we were very sad and worried particularly for the ordinary citizens who often bear the brunt of such proxy wars.

However, as the war unfolded, we saw something else, a refreshing new way of unprecedented global solidarity. The security council, UN agencies, the EU, the Human rights and international law organizations all aligned as one calling for respect of the Geneva convention, the non-targeting of civilians, the respect of all international human rights laws. And vis a vis health in general and cancer in particular, we finally saw the beginning of the acknowledgement and institutionalizing of “Cancer” and cancer patients as part and parcel of the emergency relief during times of conflict. Humanitarian emergency relief had always concentrated only on emergency care leaving civilians with cancer and other non-communicable diseases completely ignored.

First ladies and hospitals in adjoining countries were collaborating beautifully to save cancer patients. I remember having conflicted feelings. Happy that finally, cancer patients are now actually taken into account during war . On the other hand, I also felt disappointed, sad and I must say envious…on why the same standards and solidarity that we saw in the Ukraine, did not apply to our people during conflicts in our region, we who suffer the exact same horrors as other civilians.

Little did I know then that a year and a half later in 2023, during the genocide on Gaza, I and many people around the world, would be gutted, devastated and shocked, when the whole humanitarian infrastructure, norms and laws not only were erased but literally razed to the ground in one blow. We were thrown back to the dark ages. Provision of food, water, shelter, hygiene which are the basic tenets of emergency care during conflicts, were/still are completely denied to a whole civilian population of 2 million people. Furthermore, health facilities, health personnel, ambulances, pharmacies, medical stores, medical storage facilities, whether owned by Gazan’s or the UN’s supposedly protected facilities were all targeted as collateral damage. Even the Red cross and Red Crescent did not escape the onslaught. The Geneva Convention was dead and buried under the rubble as the whole of Gaza.

The landscape of cancer care for the 1000+ current cancer patients in Gaza pre-October the seventh was very challenging to say the least. After all, Gaza’s hospitals have suffered from the Israeli blockade for 17 years prior. This blockade severely restricted the movements of goods and people in and out of the Gaza strip. This meant that cancer patients had to navigate unique and insurmountable obstacles over and above what an average cancer patient must go through. To start with, one of the most important treatment modalities for cancer care was never allowed and denied for Gazan cancer patients– That of radiotherapy…

There is no radiotherapy treatment in Gaza! imagine that. Coupled with serious shortages of oncology drugs, equipment, specialized oncology care personnel and with 40-50 percent unable to leave for treatment abroad due to severe restrictions and the requirement of a complicated web of special exit permits to leaving the strip led many to die from avoidable deaths.

The opening of the only specialised cancer hospital with 180 beds in late 2018- The Turkish-Palestinian Friendship Hospital- which became the only resort for cancer patiets certainly helped alleviate some of the burden. In 2019 The Palestinian Chlidren Relief Fund (PCRF) opened the first and only Dr. Musa and Suhaila Nasir Pediatric Cancer Department. Both of these investments signalled the start of an organised emerging cancer care at minimum.

So, Post Oct 7th, instead of calling for replicating and building on the positive steps taken for cancer patients in the Ukraine War, we were now calling for the basic tenets of survival: food, water, fuel for hospitals and even for waiting medical and food trucks to enter!!! Calling for a ceasefire just to tend to the wounded!!! We were reduced to calling for the availability of anesthesia and medical alcohol so that surgeons did not have to disinfect patients with vinegar nor to amputate children’s limbs without anesthesia! Yes, the humanitarian system was reduced to calling for basic compassion for wounded children and civilians…and astoundingly the calls fell on deaf ears.

Palestinian cancer patients in Gaza now did not have any clear and safe navigation routes. If you were an adult cancer patient, you knew that you would have lost your last resort for cancer care- as the Turkish cancer hospital was de-commissioned early November due to destruction and fuel shortages. If you were a pediatric cancer patient, you were traumatized by the bombardment of the only pediatric cancer department that of PCRF. One successful attempt to transfer out of Gaza 7 pediatric cancer patients from the cancer department to KHCC took such a long time even though WHO, St Jude and other weighty partners negotiated for months on end to get the 7 out…another attempt to get 14 new cancer patients to KHCC failed because many either died during the wait or were simply not found.

If you were one of the lucky few cancer patients sitting on a hospital bed, you knew deep down in your heart that the IV inserted into your veins did not deliver anymore chemo drugs, nor pain killers. You only had to look at the empathetic glances from your care givers to know that. You also did not know whether your expert oncologist would come in the next day, whether arrested, kidnapped or killed, or whether your favorite nurse would still be alive, let alone whether your family survived yesterday’s indiscriminate bombings. And for most cancer patients the dreaded news was when being asked to be displaced from one place to another knowing now full well that are no safe places in Gaza.

And of course, we are not talking here about early detection services and new cancer diagnosis, why because these services completely ceased. With hospitals being destroyed and the ones standing turning into make-shift shelters to thousands of people whether injured or not, meant that cancer the disease , had a field day, with no opponent in sight. This bodes very badly for the explosion of advanced cancer cases in years to come reducing the chances of successful treatment.

As a cancer patient in such circumstances, the mental stress is beyond description…you did not only fear the external war but also feared the internal war ravaging your body by cancer itself, the latter of which is also a non-believer of ceasefires.

So, having not many options, countless cancer patients decided to take the only navigation route available to them …that is to join their extended families (if they still existed) and surrendered to dying slowly and in extreme pain at least amongst the last vestige of support system. Many would have died by now, probably more from starvation, communicable diseases, shock and stress than from cancer at this point.

Forgive me for being very pessimistic and despondent, but it is extremely hard to cling on to any shred of optimism right now, when we see that even the UN, WHO, UNICEF, save the children, Doctors Without Borders, human rights and other respected organizations have also been relegated to begging the UN Security Council for the application of the Geneva Convention and for the protection of health during times of war. And…wait for it, for the UN Security Council to veto such non-political purely humanitarian and legal request several times! The lawful rulings of the mighty International Criminal Court have also been ignored!

I and Professor Richard Sullivan penned an open letter at the start of the Gaza Genocide, to all the cancer organizations in the world, to weigh in and speak up for the implementation of the Geneva convention, protection of the safety and health of civilians. I was stunned to see many organizations struggling and scrambling to write a coherent authoritative non-political statement in support of protecting the lives of civilian population including cancer patients in times of conflict, let alone a genocide unfolding live before us. We did not ask anyone to weigh in on the politics of the conflict, no one would be qualified to do so anyways.

We just wanted all so called self-professed global health advocates and medical associations, who continuously call for equity and access to care for all human beings regardless of race, religion or geography….to simply be slightly outraged at the unprecedented humanitarian catastrophe and actually weigh in on the humanitarian norms that should be followed during times of conflict, at minimum protesting for the safety of frontline health care workers who were killed just for doing their job.

We wanted the global medical and cancer organizations all over the world to add their weighty independent voices to support the Geneva Convention and to support the UN organizations and global multilateral humanitarian legal system which were being weakened and enfeebled day by day in the eyes of the whole world. Instead, we saw weak and feeble statements. To add insult to injury, we heard about doctors and medical personnel censured by their affiliate medical organizations for supposedly being Pro-Palestinian! Asking for the respect of the Geneva Convention , International law and for the protection of children and civilian lives is not being Pro-Palestinian but rather being Pro Human!

What is at stake here, is not just the global failing of protecting Palestinian civilians, it is far more serious than that and with grave repercussions that will reverberate for all humanity long in the future.

The fact that the protection of health for civilians during conflict has been shown to be no longer a given sacred right as sanctioned by international laws, means that in other future conflicts warlords will now take note, that they can now weaponize health in times of conflict as they have seen that they will neither be stopped, nor held accountable. Taking us all back literally back to the barbaric ages.

And the problem is that no one now has the right to moralize anything to anybody anymore, as we have seen the “tale of two cities” unfold right before our very eyes. The Ukraine war was one hopeful example of solidarity and respect of international laws, and the Gaza Genocide was the extreme other, replete with double standards, hopelessness, and disregard for human lives.

We, as the global community, cannot let that happen for all civilians caught in war. Not for the Ukranians, Russians, Israelis, Palestinians, Armenians, Yemenis , Sudanese, Syrians and any other nations affected by war. Not even for the devil incarnate! That is the whole point of the Geneva Convention after all.

This meeting is called “Gaza’s Cancer Patients: Navigating the Dual Struggle Between Illness and War”
It should be called “Breaking the cancer of silence, – the urgent call for Solidarity Solidarity Solidarity…” We ask you all to be the first to state that you abhor not only the intentional breaking down of international humanitarian infrastructure during wars, but also reject the interference of power politics polluting and weakening that framework that was established exactly for such purposes.

We need you all to collectively call for real solidarity in order to influence global policy, so that we can all start to rebuild the whole echo health system in Gaza. This should be in trandem with the solid commitment afforded to the rebuilding of Japan after the 2nd world war. The commitment for Japan included not only a blue print for rebuilding the infrastructure and the economy but came with billions of dollars to make that a reality. We know what needs to be done, we need the foundational framework of serious global solidarity to implement what we know quickly and urgently. I hope that today will usher the start of healing and solidarity.

Collectively, we simply cannot let the Gaza genocide become the model for defining future humanitarian care and rescue. Equity and access to health should not be selective nor compromised.

What happened and still happening in Gaza Genocide should NEVER happen again, never to anyone.”

Her Royal Highness Princess Dina Mired of Jordan is a humanitarian, passionate global advocate for Cancer Control and Non-Communicable Diseases (NCDs) and mother of a cancer survivor. She is the Patron of the International Society of Pediatric Oncology (SIOP), Honorary President of the EORTC Research Fund, and Honorary Ambassador of Harvard Global Health Win-Win Initiative. Her Royal Highness is the Past – President of the Union for International Cancer Control (UICC), and former Director-General of the King Hussein Cancer Foundation.