ERBIL, Kurdistan Region – “’Is your husband still with you?’ Kurdish women ask me,” says Goli Abdurahman. “They know that many men take a second wife when their spouse gets breast cancer. My husband understands and supports me. I am lucky.”

Since being chosen as the Amsterdam citizen of the year in 2011 for her work on educating migrant women in the Netherlands about breast cancer, Abdurahman is now doing the same in her native Kurdistan.

“I use my own case to get attention for the fact that cancer still is a taboo, and it is increasing in Kurdistan,” says Abdurahman, who lost a breast to cancer in 2007, and through her Pena Center supports cancer patients in Iraqi Kurdistan.

Her center offers information and support, organizing meetings across the Kurdistan Region and handing out brochures in Kurdish about cancer and its treatment for young and old. It receives some financing by the Erbil government, but mainly depends on volunteers.

“As I am a victim of cancer Kurdish people find me pitiful. They see a cancer patient as someone who will die and who is not equal to others,” she smiles, sporting a pink ribbon pinned to her blouse as a symbol of her cause.

The culture of shame in Kurdistan leads to people not talking about the illness. Mothers with daughters who get cancer worry about their prospects for marriage if their illness becomes known, says Abdurahman, 46.

This leads to denial. Very often cancer is only discovered in a late phase when treatment is no longer effective. In this way it becomes a self-fulfilling prophecy: Cancer is a taboo because it kills, and therefore people hide it so long that curing it becomes impossible.

Abdurahman is herself an example of successful treatment after early diagnosis.  Although she is doing well, she is planning to have her other breast removed as well, as a preventive measure. Her doctors in the Netherlands told her there is a 60 percent chance the cancer will come back. “I am not lucky with my health, so it’s better not to take chances.”

These preventive therapies are almost unknown in Kurdistan. The DNA-test, needed to find out if a person is genetically prone to cancer, is not available. Nor is the scan that shows if the cancer has spread. The waiting list for a bone scan to check on cancer cells is long. For bigger tumors operations are not possible. The right medicines are often not available.

“This is the big problem in Iraqi Kurdistan. Cancer is increasing, but there is no good treatment,” says Abdurahman.

Many people go for treatment abroad, but this again leads to hardship. “I know of a husband who wanted to sell his house to get his wife treated in Turkey. But she was postponing treatment because she wanted her daughter to get married first. Now, if he sells the house, no treatment can save her anymore. He will lose the house and his wife.”

Ignorance about cancer is widespread. Many people do not realize that it is a deadly disease if not treated early. People even go to the imam for honey and herbs to treat it, Abdurahman fumes. “There is so little I can do, I feel so powerless.”

She has heard many complaints about bad treatment of cancer patients at the hospitals, which she thinks is another consequence of the way cancer patients are regarded. “Yet, nobody wants to complain for fear of revenge. They are afraid of the power of the medical staff.”

There are no real statistics about the increase of cancer in Kurdistan. Because official figures are unavailable, Abdurahman asked doctors for figures and got some. But the numbers do not give a clear picture. The little research available shows an increase, showing women over 50 as the highest patient group.

As the problem is not acknowledged, neither is the need for breast prostheses, which are not available in Kurdistan. Abdurahman is the first to bring them in.  From her home, she supplies patients with prostheses that she brings from abroad, a gift from a cancer foundation in Holland. Kurdish hospitals send patients to her. “We need a specialist shop here, because many people now can afford to buy them,” she says.

She would like to work in a more professional manner, for instance as a social worker to help patients and their families. But her Dutch nursing certificates have been refused by the Kurdish commission which registers foreign diplomas. “People like me are seen as a threat,” Abdurahman thinks.

 “Everybody looks at his own interest first,” she laments. “For me, other peoples’ interests have always been my first concern.”

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For more information: www.penacenter.com