Murjan’s days usually start at 5 am. She is a senior nurse with the mobile clinic that offers free mammography screening to women in the remote areas of the West Bank in the occupied Palestinian territory (oPt). A minibus leaves from Augusta Victoria Hospital – one of the main Palestinian cancer treatment centres – in East Jerusalem at 7 in the morning to take Murjan and her colleagues to one of the villages. It’s often a few hours’ drive – and not just because of the remoteness. Over a hundred fixed and over two thousand “flying” Israeli checkpoints hamper Palestinian free movement within the West Bank, including for ambulances and mobile health clinics. For Murjan, this is one of the biggest obstacles in her daily work. “Sometimes, a two-hour drive becomes five. Or, what’s worse, a checkpoint might be closed without any prior notice and we have no other option but to come back.”
During the visits, the mobile clinic team provides breast screening, raises awareness about breast cancer and its prevention, shows women how to do a self-examination and explains the importance of regular check-ups.
In Filamiya village, near Tulkarem, seven women are waiting for Murjan and her colleagues at the municipality building. Nurses distribute information leaflets and answer the questions women might have about mammography or breast cancer. Then, after a one-on-one consultation, women go to a mammography van for screening.
Khaula came for a breast screening for the first time in her life: “Until today, all I knew about cancer was that people die from it. Thanks to information from the medical team, now I know that if you have cancer chances for successful treatment are high. Also, we can do our part to prevent this disease.”
In many Palestinian communities, people are not aware of cancer and the disease still carries a stigma. “Every village, every community is different,” says Murjan, “We need to be sensitive to cultural norms and traditions”. The mobile team may need to make multiple home visits to convince a woman, and often it requires a conversation with her whole family, to come for mammography. “People have a lot of prejudices and fears, and we have to adjust and find a way to address them. 7 years of experience helped me to gain needed skills”, says Murjan. As nothing speaks better than personal experience, women who survived cancer join for the visits from time to time to help spread the knowledge and share their own stories.
Breast cancer is the most common cancer occurring in Palestinian women and is responsible for 10% of all death in the oPt. Mobile mammography clinics run by Augusta Victoria Hospital helped to reduce the number of cases referred for treatment at palliative stage significantly. They provide follow-up support to women who were diagnosed with cancer to ensure they can get needed treatment.
“In spite of all the difficulties we face daily in our job, I do not despair,” Murjan says. “I am a firm believer in what we do, and every time we successfully reach one more village to explain the importance of breast check-ups to women and provide our services, I know it is worth the effort.”