Today we have the three monthly meeting of the R4HC UK fund and this is really a research project looking at the relationship between health and conflict. I am the co-investigator for one of the streams which is looking at cancer and conflict, trying to understand the generation of data on cancer and cancer treatment within populations affected by prolonged and intense conflict.
Specifically what region are we talking about?
Our research project will be concentrating in Gaza to try to understand a case study which is breast cancer in Gaza and understand the political and social determinants of outcome in breast cancer for patients in the Gaza Strip.
What kind of methods are being used?
We are going to be using both statistical data to try to understand the generation of data. Our starting point is that the generation of data is impeded in conflict as much as the provision of healthcare and that has a knock-on effect on disempowering both health professionals and patients in these conflict areas because it’s a form of subjugating the information or the narrative of the treatment and the disease in a way that is detrimental to the patients and detrimental to the ability of the health system to provide for these patients. Therefore one of the starting points is to understand how data is collected and data is used in times of conflict so that you can understand what are the real determinants of outcome, in our case in breast cancer.
Tell us about who you collaborate with
Part of the R4HC consortium are universities in the region, so like ours, the American University in Beirut; there is the King Hussein Cancer Center, there’s Birzeit University in the West Bank and we’re also collaborating with affiliates like the World Health Organisation office in Gaza. Really the research is a conduit to identifying the impediments to research capacity therefore you conduct the research and that enables you to see where are the points in the system where the data is not being generated and what are the reasons why it’s not being generated. So in the capacity building phase you are able to better target those areas that are the reason why data, actionable data, on patients and on incidences and on treatment is not being generated.
What do you think about cancer care in the broader context of conflict?
Within the debate within global health unfortunately cancer and conflict is both recent and also it has always revolved around carcinogenic, cancer creating weapons. But what we are advocating is understanding the whole treatment pathway, from diagnosis to treatment to palliative care, and the dynamics through which conflict impedes that whole treatment pathway is a much more important and much more effective way of understanding and improving the lot of cancer patients in these areas. Rather than trying to figure out which weapons are carcinogenic, most of the destruction happens in the disruption of the treatment pathway from diagnosis to palliation or from diagnosis to cure.
What do you see as an end goal?
To impart the skills and create the culture and provide the resources by which health professionals working with breast cancer patients in the Gaza Strip are able to generate actionable data that starts with auditing their own work and then goes on to eventually publishable research that becomes actionable policy papers that is able to provide their voice in the debate and the voice of their patients in the debate. We believe that one of the impediments to that happening is the absence of data and the weakness of research capacity in that area.
