Costly odyssey for cancer care in war-torn Sudan

Costly odyssey for cancer care in war-torn Sudan
The fighting in Sudan broke out in April 2023 between the regular army, headed by Sudan’s de facto leader Abdel Fattah Al-Burhan, and the paramilitary Rapid Support Forces (RSF) led by his former deputy Mohamed Hamdan Dagalo. (AFP)
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Updated 26 June 2024
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Costly odyssey for cancer care in war-torn Sudan

Costly odyssey for cancer care in war-torn Sudan
  • Fewer than 30 percent of hospitals remain functional
  • Its two main oncology centers — in the capital Khartoum and just south in Wad Madani — have closed

Gedaref: Doctors in eastern Sudan say Mohammed Al-Juneid’s wife, displaced and diagnosed with cancer, needs treatment elsewhere in the war-torn country. But the road is long and dangerous, and the journey expensive.
“Even if we make it to Meroe in the north, who knows how long we’ll have to wait until it’s her turn,” the 65-year-old told AFP in Gedaref, where he and his wife have sought safety from the country’s raging war.
Since April 2023, fighting between the army and the paramilitary Rapid Support Forces has shattered Sudan’s already fragile health care system.
Fewer than 30 percent of hospitals remain functional, “and even so at a minimal level,” according to the World Health Organization (WHO).
For tens of thousands of patients with chronic illnesses, that has meant embarking on long, dangerous odysseys across front lines, often just to reach an overwhelmed and under-equipped health care facility.
Many have flocked to Gedaref in the east, where more than half a million people fled to escape the fighting.
In its single oncology facility — one of the country’s last — women draped in colorful traditional veils lie on beds, chemotherapy needles in their arms.
Among them is Juneid’s wife, who used to undergo radiation therapy at Wad Madani hospital in central Sudan before “it closed because of the war,” her husband said.
“Now the doctors say she needs radiation again, which is only available at Meroe hospital” — a 900-kilometer (560-mile) drive that is actually far longer if you want to avoid the fighters on the way.
The couple found a driver who agreed to take them on the bumpy, checkpoint-marked road. He would do it for $4,000 — a small fortune that Juneid cannot afford.
Lying on a nearby bed, schoolteacher Fatheya Mohammed said her cancer had become more aggressive “since the war began.”
“They give me chemo injections here,” she told AFP. But at bare minimum, she needs CT scans that are “only available in Kassala,” 200 kilometers (125 miles) to the northeast.
That might as well be half a world away. Over the past year, Mohammed has received only three months of her government salary, and can’t afford to go anywhere.
Sudan, one of the world’s poorest countries even before the war, already had an under-funded and overwhelmed health care system before the war dealt the final blow.
Its two main oncology centers — in the capital Khartoum and just south in Wad Madani — have closed.
Smaller facilities, like the 27-bed East Oncology Hospital in Gedaref, have been overwhelmed by the influx.
In 2023 “we took in around 900 new patients,” the center’s director Motassem Mursi told AFP — up from their annual patient load of “around 300 to 400.”
In the first three months of 2024 alone “we’ve taken in 366 patients,” he said.
Of Sudan’s 15 oncology centers, only the one in Meroe still offers radiation therapy, an October article published in the online medical journal ecancermedicalscience confirmed.
The costs associated with treatment, transportation and accommodation are out of reach for many, “forcing them to confront their impending death without proper care,” wrote the authors, four doctors in Sudanese and Canadian hospitals.
“The limited access to oncology services during the current war endangers the lives of more than 40,000 Sudanese cancer patients,” they concluded.
Even if terminal patients were to accept their fate — at the hands of both disease and the war’s devastation — there is no respite from their daily physical agony.
Dire shortages of medicines, including painkillers, mean patients must “endure excruciating pain without recourse,” the authors wrote.
According to the WHO, “about 65 percent of the Sudanese population lack access to health care” entirely, in a country where upwards of 10 million people have been forced to flee their homes.
Shuttered hospitals and dire shortages place a “significant strain on and risks overwhelming the remaining facilities due to the influx of people seeking care,” the WHO has warned.
In Meroe, the last hope for patients in need of radiation treatment, the nightmare has come true.
“We have two radiation machines that work 24 hours a day,” a doctor at the Eldaman Oncology Center told AFP over the phone, requesting anonymity because he was not authorized to speak to the media.
“If one of them goes down, even just for maintenance, it causes an even bigger backlog of patients,” he said, exhaustion clear in his voice.


Syrian Kurdish groups on the back foot as power balance shifts

Syrian Kurdish groups on the back foot as power balance shifts
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Syrian Kurdish groups on the back foot as power balance shifts

Syrian Kurdish groups on the back foot as power balance shifts
  • Syrian Kurds established autonomy early in civil war, Turkiye views their main group as national security threat
  • Syrian Kurdish leader asks Trump to prevent Turkish incursion
QAMISHLI: With hostile Turkish-backed groups mobilizing against them in Syria’s north, and Damascus ruled by a group friendly to Ankara, Syria’s main Kurdish factions are on the back foot as they seek to preserve political gains carved out during 13 years of war.
Part of a stateless ethnic group straddling Iraq, Iran, Turkiye, Armenia and Syria, Kurds have so far been among the few winners of the Syrian conflict, controlling nearly a quarter of the country and leading a powerful armed group that is a key US ally in countering Islamic State.
But the power balance has tilted against them since the Islamist group Hayat Tahrir Al-Sham (HTS) swept into Damascus this month, toppling President Bashar Assad, two analysts and a senior Western diplomat told Reuters.
The seismic change in Syria is expected to yield deeper Turkish sway just as a change of US administration is raising questions over how long Washington will keep backing the country’s Kurdish-led forces.
For Turkiye, the Kurdish factions represent a national security threat. Ankara views them as an extension of the Kurdistan Workers Party (PKK), which has been waging an insurgency against the Turkish state since 1984 and is deemed a terrorist group by Turkiye, the United States and other powers.
The Syrian Kurdish groups “are in deep, deep trouble,” said Aron Lund, a fellow at Century International, a US-based think tank.
“The balance has shifted fundamentally in Syria to the advantage of Turkiye-backed or Turkiye-aligned factions, and Turkiye seems determined to exploit this to the fullest.”
The shift has been reflected in renewed fighting for control of the north, where Turkiye-backed armed groups known as the Syrian National Army (SNA) have made military advances against the Kurdish-led Syrian Democratic Forces (SDF).
Fanar Al-Kait, a senior official in the Kurdish-led regional administration, told Reuters that the ouster of Assad, whose Arab nationalist Baath Party oppressed Kurds for decades, presented a chance to stitch the fragmented country back together.
He said the administration is ready for dialogue with Turkiye, but the conflict in the north showed Ankara had “very bad intentions.”
“This will certainly push the region toward ... a new conflict,” he added.
Turkish President Tayyip Erdogan said on Friday he expected foreign states would withdraw support for Kurdish fighters following Assad’s toppling, as Ankara seeks to isolate the People’s Protection Units (YPG), the Kurdish militia that spearheaded the SDF alliance.
Responding to questions from Reuters, a Turkish official said the root cause of the conflict is “not Turkiye’s view toward the region; it is that the PKK/YPG is a terrorist organization.”
“The PKK/YPG elements must lay down their arms and leave Syria,” the official said.
SDF commander Mazloum Abdi, in a Reuters interview on Thursday, acknowledged the presence of PKK fighters in Syria for the first time, saying they had helped battle Islamic State and would return home in the event a total ceasefire was agreed with Turkiye. He denied any organizational ties with the PKK.
Feminism and Islamism
Meanwhile, in Damascus, the new leadership is showing warmth toward Ankara and indicating it wants to bring all Syria back under central authority — a potential challenge to the decentralization Kurds favor.
While Turkiye provides direct backing to the SNA, it along with other states deems HTS a terrorist group because of its Al-Qaeda past.
Despite this, Ankara is believed to have significant sway over the group. A senior Western diplomat said: “The Turks can clearly influence them more than anyone else.”
HTS leader Ahmed Al-Sharaa told a Turkish newspaper that Assad’s ouster was “not only the victory of the Syrian people, but also the Turkish people.”
The Turkish official said HTS was not and never had been under Ankara’s control, calling it a structure “we were communicating with due to circumstances” and adding many Western states were also doing so.
Syrian Kurdish groups led by the Democratic Union Party (PYD) and the affiliated YPG militia took control of much of the north after the uprising against Assad began in 2011. They established their own administration, while insisting their aim was autonomy, not independence.
Their politics, emphasising socialism and feminism, differ starkly from HTS’ Islamism.
Their area grew as US-led forces partnered with the SDF in the campaign against Islamic State, capturing Arab-majority areas.
The Turkiye-backed SNA groups stepped up their campaign against the SDF as Assad was being toppled, seizing the city of Manbij on Dec. 9
Washington brokered a ceasefire, but the SDF has said Turkiye and its allies have not abided by it, and a Turkish defense ministry official said there was no such deal.
US support for the SDF has been a point of tension with its NATO ally, Turkiye. Washington views the SDF as a key partner in countering Islamic State, which Secretary of State Antony Blinken has warned will try to use this period to re-establish capabilities in Syria. The SDF is still guarding tens of thousands of detainees linked to the militant group.
Turkish Defense Minister Yasar Guler said last weekend that Turkiye saw no sign of a Daesh resurgence in Syria. On Friday, Turkiye’s foreign minister, Hakan Fidan, told his German counterpart during talks in Ankara that alternatives needed to be found for the management of camps and prisons where the detainees are being held.
Separately, US Assistant Secretary of State for Near Eastern Affairs Barbara Leaf said on Friday that Washington was working with Ankara and the SDF to find “a managed transition in terms of SDF’s role in that part of the country.”
President Joe Biden’s administration has said that US troops will stay on in Syria, but President-elect Donald Trump could remove them when he takes office on Jan. 20.
Letter to Trump
During his first administration, Trump attempted to pull out of Syria but faced pressure at home and from US allies.
In a Dec. 17 letter to Trump, reviewed by Reuters, top Syrian Kurdish official Ilham Ahmed said Turkiye was preparing to invade the northeast before he takes office.
Turkiye’s plan “threatens to undo years of progress in securing stability and fighting terrorism,” she wrote. “We believe you have the power to prevent this catastrophe.”
Asked for comment, Trump-Vance transition spokesman Brian Hughes said: “We continue to monitor the situation in Syria. President Trump is committed to diminishing threats to peace and stability in the Middle East and to protecting Americans here at home.”
Trump said on Dec. 16 that Turkiye will “hold the key” to what happens in Syria but has not announced his plans for US forces stationed there.
“The Kurds are in an unenviable position,” said Joshua Landis, a Syria expert at the University of Oklahoma. “Once Damascus consolidates its power, it will move on the region. The US can’t remain there forever.”
HTS leader Sharaa told British broadcaster the BBC that Kurds were “part of our people” and “there should be no division of Syria,” adding arms should be entirely in the state’s hands.
Sharaa acknowledged one of Turkiye’s main concerns — the presence of non-Syrian Kurdish fighters in Syria — and said: “We do not accept that Syrian lands threaten and destabilize Turkiye or other places.”
He pledged to work through dialogue and negotiations to find “a peaceful formula to solve the problem,” saying he believed initial contacts had been established “between the Kurds in northeastern Syria or the SDF organization.”
Kait, the Kurdish official, said his administration wanted “a democratic Syria, a decentralized Syria, a Syria that represents all Syrians of all sects, religions and ethnicities,” describing these as red lines. The SDF would be “a nucleus of the coming Syrian army,” he added.
SDF commander Abdi, in his Reuters interview, confirmed that contact had been established with HTS to avoid clashes between their forces but said Ankara would try to drive a wedge between Damascus and the Kurdish-led administration.
Still, he said there was strong support from international parties, including the US-led coalition, for the SDF joining “the new political phase” in Damascus, calling it “a great opportunity.”
“We are preparing, after a total ceasefire between us and between Turkiye and the affiliated factions, to join this phase,” he said.

Winter is hitting Gaza and many Palestinians have little protection from the cold

Winter is hitting Gaza and many Palestinians have little protection from the cold
Updated 22 December 2024
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Winter is hitting Gaza and many Palestinians have little protection from the cold

Winter is hitting Gaza and many Palestinians have little protection from the cold
  • Nearly 2 million Palestinians displaced by the devastating 14-month Israeli offensive
  • The UN warns of people living in precarious makeshift shelters that might not survive the winter

KHAN YOUNIS, Gaza Strip: Winter is hitting the Gaza Strip and many of the nearly 2 million Palestinians displaced by the devastating 14-month war with Israel are struggling to protect themselves from the wind, cold and rain.
There is a shortage of blankets and warm clothing, little wood for fires, and the tents and patched-together tarps families are living in have grown increasingly threadbare after months of heavy use, according to aid workers and residents.
Shadia Aiyada, who was displaced from the southern city of Rafah to the coastal area of Muwasi, has only one blanket and a hot water bottle to keep her eight children from shivering inside their fragile tent.
“We get scared every time we learn from the weather forecast that rainy and windy days are coming up because our tents are lifted with the wind. We fear that strong windy weather would knock out our tents one day while we’re inside,” she said.
With nighttime temperatures that can drop into the 40s (the mid-to-high single digits Celsius), Aiyada fears that her kids will get sick without warm clothing.
When they fled their home, her children only had their summer clothes, she said. They have been forced to borrow some from relatives and friends to keep warm.
The United Nations warns of people living in precarious makeshift shelters that might not survive the winter. At least 945,000 people need winterization supplies, which have become prohibitively expensive in Gaza, the UN said in an update Tuesday. The UN also fears infectious disease, which spiked last winter, will climb again amid rising malnutrition.
The UN Agency for Palestinian Refugees, known as UNRWA, has been planning all year for winter in Gaza, but the aid it was able to get into the territory is “not even close to being enough for people,” said Louise Wateridge, an agency spokeswoman.
UNRWA distributed 6,000 tents over the past four weeks in northern Gaza but was unable to get them to other parts of the Strip, including areas where there has been fighting. About 22,000 tents have been stuck in Jordan and 600,000 blankets and 33 truckloads of mattresses have been sitting in Egypt since the summer because the agency doesn’t have Israeli approval or a safe route to bring them into Gaza and because it had to prioritize desperately needed food aid, Wateridge said.
Many of the mattresses and blankets have since been looted or destroyed by the weather and rodents, she said.
The International Rescue Committee is struggling to bring in children’s winter clothing because there “are a lot of approvals to get from relevant authorities,” said Dionne Wong, the organization’s deputy director of programs for the occupied Palestinian territories.
“The ability for Palestinians to prepare for winter is essentially very limited,” Wong said.
The Israeli government agency responsible for coordinating aid shipments into Gaza said in a statement that Israel has worked for months with international organizations to prepare Gaza for the winter, including facilitating the shipment of heaters, warm clothing, tents and blankets into the territory.
More than 45,000 Palestinians have been killed in the war in Gaza, according to the Gaza Health Ministry. The ministry’s count doesn’t distinguish between civilians and combatants, but it has said more than half of the fatalities are women and children. The Israeli military says it has killed more than 17,000 militants, without providing evidence.
The war was sparked by Hamas’ October 2023 attack on southern Israel, where the militant group killed 1,200 people and took 250 hostages in Gaza.
Negotiators say Israel and Hamas are inching toward a ceasefire deal, which would include a surge in aid into the territory.
For now, the winter clothing for sale in Gaza’s markets is far too expensive for most people to afford, residents and aid workers said.
Reda Abu Zarada, 50, who was displaced from northern Gaza with her family, said the adults sleep with the children in their arms to keep them warm inside their tent.
“Rats walk on us at night because we don’t have doors and tents are torn. The blankets don’t keep us warm. We feel frost coming out from the ground. We wake up freezing in the morning,” she said. “I’m scared of waking up one day to find one of the children frozen to death.”
On Thursday night, she fought through knee pain exacerbated by cold weather to fry zucchini over a fire made of paper and cardboard scraps outside their tent. She hoped the small meal would warm the children before bed.
Omar Shabet, who is displaced from Gaza City and staying with his three children, feared that lighting a fire outside his tent would make his family a target for Israeli warplanes.
“We go inside our tents after sunset and don’t go out because it is very cold and it gets colder by midnight,” he said. “My 7-year-old daughter almost cries at night because of how cold she is.”


American pilots in ‘friendly fire’ incident as US military hits Houthi targets in Sanaa

American pilots in ‘friendly fire’ incident as US military hits Houthi targets in Sanaa
Updated 22 December 2024
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American pilots in ‘friendly fire’ incident as US military hits Houthi targets in Sanaa

American pilots in ‘friendly fire’ incident as US military hits Houthi targets in Sanaa
  • Houthis have targeted international shipping in Red Sea to impose Israel’s naval blockade
  • The group that controls large parts of Yemen hit Tel Aviv with a missile strike, injuring 16 people

DUBAI: Two US Navy pilots were shot down over the Red Sea in an apparent “friendly fire” incident, the US military said Sunday. Both pilots were recovered alive, with one suffering minor injuries in the incident.

The incident came as the US military conducted airstrikes targeting Yemen’s Houthi rebels, though the US military’s Central Command did not elaborate on what their mission was at the time.

“The guided missile cruiser USS Gettysburg, which is part of the USS Harry S. Truman Carrier Strike Group, mistakenly fired on and hit the F/A-18, which was flying off the USS Harry S. Truman,” Central Command said in a statement.

The command said on X, shortly after midnight local time: “CENTCOM forces conducted the deliberate strikes to disrupt and degrade Houthi operations, such as attacks against U.S. Navy warships and merchant vessels in the Southern Red Sea, Bab al-Mandeb, and Gulf of Aden,”

The video released by the US military showed a jet taking off from a carrier.

“During the operation, CENTCOM forces also shot down multiple Houthi one way attack uncrewed aerial vehicles (OWA UAV) and an anti-ship cruise missile (ASCM) over the Red Sea.”

Videos on social media showed people fleeing large explosions in the capital, but Arab News could not immediately verify the authenticity of the footage.

The command said that US air and naval assets were used in the operation, including F/A-18s, adding the “strike reflects CENTCOM's ongoing commitment to protect U.S. and coalition personnel, regional partners, and international shipping.”

The Houthis, who control large parts of Yemen, seized the capital in 2014 and have  been conducting drone and missile attacks on international shipping in the Red Sea in an effort to impose a naval blockade on Israel, who, for more than a year, has been carrying out a devastating war against Hamas in Gaza.

Earlier on Saturday, a Houthi missile hit Tel Aviv, injuring 16 people.


Syrian soldiers distance themselves from Assad in return for promised amnesty

Syrian soldiers distance themselves from Assad in return for promised amnesty
Updated 22 December 2024
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Syrian soldiers distance themselves from Assad in return for promised amnesty

Syrian soldiers distance themselves from Assad in return for promised amnesty
  • Lt. Col. Walid Abd Rabbo, who works with the new Interior Ministry, said the army has been dissolved and the interim government has not decided yet on whether those “whose hands are not tainted in blood” can apply to join the military again

DAMASCUS, Syria: Hundreds of former Syrian soldiers on Saturday reported to the country’s new rulers for the first time since Bashar Assad was ousted to answer questions about whether they may have been involved in crimes against civilians in exchange for a promised amnesty and return to civilian life.
The former soldiers trooped to what used to be the head office in Damascus of Assad’s Baath party that had ruled Syria for six decades. They were met with interrogators, former insurgents who stormed Damascus on Dec. 8, and given a list of questions and a registration number. They were free to leave.
Some members of the defunct military and security services waiting outside the building told The Associated Press that they had joined Assad’s forces because it meant a stable monthly income and free medical care.
The fall of Assad took many by surprise as tens of thousands of soldiers and members of security services failed to stop the advancing insurgents. Now in control of the country, and Assad in exile in Russia, the new authorities are investigating atrocities by Assad’s forces, mass graves and an array of prisons run by the military, intelligence and security agencies notorious for systematic torture, mass executions and brutal conditions.
Lt. Col. Walid Abd Rabbo, who works with the new Interior Ministry, said the army has been dissolved and the interim government has not decided yet on whether those “whose hands are not tainted in blood” can apply to join the military again. The new leaders have vowed to punish those responsible for crimes against Syrians under Assad.
Several locations for the interrogation and registration of former soldiers were opened in other parts of Syria in recent days.
“Today I am coming for the reconciliation and don’t know what will happen next,” said Abdul-Rahman Ali, 43, who last served in the northern city of Aleppo until it was captured by insurgents in early December.
“We received orders to leave everything and withdraw,” he said. “I dropped my weapon and put on civilian clothes,” he said, adding that he walked 14 hours until he reached the central town of Salamiyeh, from where he took a bus to Damascus.
Ali, who was making 700,000 pounds ($45) a month in Assad’s army, said he would serve his country again.
Inside the building, men stood in short lines in front of four rooms where interrogators asked each a list of questions on a paper.
“I see regret in their eyes,” an interrogator told AP as he questioned a soldier who now works at a shawarma restaurant in the Damascus suburb of Harasta. He spoke on condition of anonymity because he was not allowed to talk to media.
The interrogator asked the soldier where his rifle is and the man responded that he left it at the base where he served. He then asked for and was handed the soldier’s military ID.
“He has become a civilian,” the interrogator said, adding that the authorities will carry out their own investigation before questioning the same soldier again within weeks to make sure there are no changes in the answers that he gave on Saturday.
The interrogator said after nearly two hours that he had quizzed 20 soldiers and the numbers are expected to increase in the coming days.
 

 


Israel accuses Pope of ‘double standards’, after Gaza criticism

Israel accuses Pope of ‘double standards’, after Gaza criticism
Updated 22 December 2024
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Israel accuses Pope of ‘double standards’, after Gaza criticism

Israel accuses Pope of ‘double standards’, after Gaza criticism

JERUSALEM: Israel accused Pope Francis of “double standards” Saturday after he condemned the bombing of children in Gaza as “cruelty” following an air strike that killed seven children from one family.
“The Pope’s remarks are particularly disappointing as they are disconnected from the true and factual context of Israel’s fight against jihadist terrorism — a multi-front war that was forced upon it starting on October 7,” an Israeli foreign ministry statement said.
“Enough with the double standards and the singling out of the Jewish state and its people.”
Gaza’s civil defense rescue agency had reported that an Israeli air strike killed 10 members of a family on Friday in the northern part of the Palestinian territory, including seven children.
“Yesterday they did not allow the Patriarch (of Jerusalem) into Gaza as promised. Yesterday children were bombed. This is cruelty, this is not war,” he told members of the government of the Holy See.
“I want to say it because it touches my heart.”
The Israeli statement said: “Cruelty is terrorists hiding behind children while trying to murder Israeli children; cruelty is holding 100 hostages for 442 days, including a baby and children, by terrorists and abusing them,” a reference to the Palestinian Hamas militants who attacked Israel and took hostages on October 7, 2023, triggering the Gaza war.
“Unfortunately, the Pope has chosen to ignore all of this,” the Israeli ministry said.