ABSTRACT
BACKGROUND: Over half the countries in the World Health Organization (WHO) Eastern Mediterranean Region (EMR) are experiencing conflict or are socially fragile, compromising cancer care. Nonetheless, throughout the EMR, competent nurses are major players in the cancer care team. The aim of this paper is to portray the challenges and opportunities for oncology nursing in the EMR. METHODS: This paper draws upon the relevant literature on oncology nursing across EMR with a focus on Afghanistan, Lebanon, Somaliland, and Iran. To enhance the scant nursing literature and obtain real-life experiences, short interviews were undertaken with nine nurses and two doctors, personal contacts of the authors, working in cancer care in those countries. RESULTS: Against the general background of vast economic constraints in health services, the lack of recognition of oncology nursing as a speciality and high rates of nurse migration, many oncology nurses in EMR are fighting for professional recognition and some are working under unsafe conditions. Undeterred by these circumstances, nurses are making every effort to care compassionately for people with cancer. CONCLUSIONS: The perspectives of the cancer workforce in EMR both foster an appreciation of cultural diversity and provide the evidence and motivation for oncology nurses worldwide to further collaborate via global nursing organisations to strive for country-specific recognition and change in nursing practice.
ABSTRACT
Somaliland is an autonomous region in the northern part of Somalia that declared its independence in 1991. It is a low-income country (LIC) with a population size of 5.7 million with a gross domestic product per capita of $775. Health services are delivered by public, private and non-governmental organisations. The public health care system in Somaliland is facing huge challenges. Seven percent of the population suffers from non-communicable diseases, but data on cancer incidence and mortality are not available. Much of the emphasis in public health has been placed on primary care and maternal and child health. There is still a large gap in cancer prevention, early detection and screening in the country. Additionally, there is no cancer registry or published data on cancer. Currently, there are a few private hospitals that provide chemotherapy services in Somaliland of which Needle Hospital is one. Services provided in this hospital include medical oncology for all solid tumours, palliative care, follow-up and cancer health education. The hospital provides services for patients from Somaliland and neighbouring countries including Djibouti, Somalia and Ethiopia. As a new oncology clinic in an LIC, the clinic is facing many challenges, like the absence of a multidisciplinary tumour board, presentation of patients at the advanced stage of tumours and poor cancer awareness in the general population.