COVID-19 shutdown stalls treatments for Family Island cancer patients

NASSAU, BAHAMAS — The COVID-19 pandemic has significantly disrupted lives across the country, but in some cases, the resulting travel restrictions have severed access to critical medical treatment.

Grand Bahama native Portia Ebrahim has taken a flight into New Providence to undergo treatment at least once a month for nearly a year since she was diagnosed with stage two breast cancer.

Up to yesterday, Ebrahim said there was still no resolution to the challenge the complete border shutdown poses for her and scores of other cancer patients scattered throughout the Family Islands.

She also expressed concern for patients who have private insurance and do not rely on the public healthcare system, but can no longer access therapy in the United States or elsewhere.

“It is so worrisome; the stress of COVID-19, the everyday stress of being a person with immunocompromised system is taxing on you regardless,” she told Eyewitness News.

“Now, here it is you have the COVID-19 situation that we are in and it is immensely stressful. Something as simple as going to the food store some people take for granted, but in this instance it’s even worse.”

Portia Ebrahim

“It’s a real issue especially for cancer patients,” Ebrahim continued.

“We’re stuck between a rock and two hard places. We don’t know how long this station is going to be, and while all of this is happening your system is being depleted so to speak.”

Ebrahim had a bilateral mastectomy in May last year, and completed her last round of chemotherapy on January 21.

Before COVID-19, she traveled to New Providence every three weeks to receive the antibody treatment, Herceptin.

It’s a common treatment for HER2-positive patients like Ebrahim, whose cells have a protein that promotes the growth of cancer cells.

“The antibody treatment is to help build up the immune system, the white blood cells, so they can attack the cancer” said Ebrahim in a bid to explain her treatment in layman’s terms.

“It’s worrisome because you can’t afford to miss one week, one treatment builds the antibodies that I need to continue with the fight of the cancer. My worry is that we have so many cancer patients here (Grand Bahama) and there isn’t a way to get any type of cancer treatment.”

Ebrahim noted there were designated shopping times for the disabled and senior citizens, who have a higher risk of becoming seriously ill; however, there are no provisions for immunocompromised individuals.

“There is no kinda plan and it’s really frustrating,” Ebrahim said.

“Meanwhile, back at the ranch, we have no treatment and your [immune] system is already shot to hell.”

Ebrahim has already missed one antibody treatment, and her next scheduled treatment would be next week Tuesday.

She said she was contacted on Friday by an official from the Oncology department in New Providence, who informed her arrangements were being made to reach out to cancer patients in Grand Bahama, Abaco and Eleuthera, who would normally travel to the capital for treatment.

Ebrahim continued: “On Friday, I was told the plan was to gather us up and bring us into Nassau. Your system is already compromised and they want to take you to Nassau COVID-city.”

“Then the flight comes to Nassau, but it doesn’t come back the same day or even the next day. I was told we’d have to be in Nassau for a couple days.

“I don’t have family over there to stay with and when I do have to stay overnight for a test, I normally spend one night in the hotel. They asked me if I have money to stay in the hotel, where will I get that from? Things I could normally do to go out and earn some money, I can’t do because it’s all shutdown.”

Ebrahim said: “Then I was told someone else would be in contact in reference to logistics, and that they are trying to have the treatments done in Freeport. I went (Monday) and did the blood work. But yesterday got a call and was told the drugs for treatment are supposedly in Freeport, but under the national drug plan program for NIB.”

When Eyewitness News reached out to Minister of Health Dr Duane Sands for comment last week, he noted the circumstances demanded officials get creative to solve emerging challenges.

“We’re going to have to be creative to solve a number of problems in this COVID era,” he said.

“It’s just a matter of making a determination as to how things will get solved. I wish I had a simple answer, but we don’t.”

Ebrahim during her last treatment session at the Oncology Department at the Princess Margaret Hospital on March 27.

Sands said officials were addressing needs on a case-by-case basis.

Ebrahim said she believes the pandemic has exposed not only deep gaps in the access to healthcare for Family Islanders, but the shortsightedness of the current National Health Insurance (NHI) framework, and the need to decentralize the capacity for specialized treatment in the public health system.

Ebrahim said patients have long advocated for the establishment of a cancer treatment facility to service the island, and reduce financial burden and stress — most recently during public consultation for NHI.

“We have a private clinic here that one of the oncologists comes down to regularly in Freeport, but there is a cost of seeing him at a private facility,” she said.

“And it was asked during one of those NHI sessions in Freeport if the drugs could be brought over for patients to be seen there.

“If you don’t have the $465 to be seen privately, then you’re in a mess, you’re really in a mess. There is only so much you could do here. The seriousness of the matter is if you don’t have the ways and means by which to do that it can be stressful and taxing on your pocket.

She added: “I am a civil servant, so I can go ahead and have flights down with assistance from the cancer society. But if there was a situation like an NHI with the public and private hospitals included in a program, you would have been able to be seen at a private facility in this type of situation.”