We invited Dr. Nagham Ibrahem to tell us about her work for and with gynecological cancer patients in Iraq. It was so interesting to hear about her activities for the 2024 World Gynecologic Oncology Day, which combined education with a henna party! Read an excerpt of the conversation below (edited for length and clarity) or watch the full interview on our Instagram Reels.

 

 

World Gynecologic Oncology Day

Could you tell us a little bit about yourself and about where you work?

Dr Nagham Ibrahem 

Hi everybody. I'm Nagham Ibrahem from Baghdad, Iraq. I'm a gyn oncologist in Baghdad Medical Teaching Hospital. I'm an OBGYN consultant and I'm a trainer in a fellowship of gynae oncology. Nice to meet you all.

World Gynecologic Oncology Day 

This is the third or fourth year that you've been involved with World Gynecologic Oncology Day, right?

Dr Nagham Ibrahem 

You're right!

World Gynecologic Oncology Day 

Can you tell what you have planned?

Dr Nagham Ibrahem 

This year we are going to have four events, inshallah. On different dates. We start in Baghdad Teaching Hospital with our colleagues, our trainers, our other medical oncologist radiologists, all the supportive group in the hospital. The second, we will walk in University of Baghdad with our group team and the medical students. The third one, at the colposcopy clinic. We invite patients and their families. And we make some Arabic touch, which is henna. The fourth event is by the Iraq society, gyn oncology committee, annual Congress. There will be lectures regarding HPV vaccination, endometrial cancer. And we will share awareness for all our colleagues.

This is teamwork, oncology teamwork.

World Gynecologic Oncology Day 

So this year's campaign for World Gynecologic Oncology Day is stigma. What is some stigma that your patients face?

Dr Nagham Ibrahem 

They don’t have a stigma because they have a gynecological cancer, but cancer patients in general face some stigma and some challenges, sometimes from families. Some divorce, some have financial problems. As a medical staff, a paramedical staff, we will all make support for them in their treatments line, and we always give messages for their families. Sometimes their families are afraid of the cancer patients or being infected by them or contagious from them. Or if you take chemotherapy or radiotherapy, you may affect the adult family.

We make it clear that this is not right, there is nothing to afraid of. We all support them against stigma.

World Gynecologic Oncology Day 

So you're saying that the patients who come to you, are a bit superstitious, or afraid of their cancer more than the type of cancer?

Dr Nagham Ibrahem 

Yes, that's it.

World Gynecologic Oncology Day 

That very interesting. Every country has had a different answer to this question. It's so interesting. In some other countries, for example, there is a bit of stigma around vaccines, and I know that you're doing a lot of work on cervical cancer prevention. Is there any sort of hesitancy about the HPV vaccine?

Dr Nagham Ibrahem 

Let me talk about screening and vaccine in combination. Okay, we have a protocol for screening and Ministry of Health in Iraq. It is also well established from 2020. But it is not applicable everywhere according to the availability of the equipment, the staff who can perform. So we make screening in an opportunistic way. So when the patient comes to us, she may not know about this screening. We try to make awareness—we advise them to bring her daughters, her relatives, talk to her friends.

And sometimes we advise them for vaccination, vaccine. It is available in the private sector only. It is not established in the vaccination program yet, but many efforts and much education have been pushed towards it being available soon, inshallah.

World Gynecologic Oncology Day 

I noticed that on your Instagram you are doing a lot of awareness to tell patients what to expect when they come to your clinic and about HPV.

Dr Nagham Ibrahem 

There are some who come with an HPV test. They are so worried—oh, she thinks she had to perform hysterectomy.

No, HPV is not a cancer. We just have some steps to do, and everything will be fine, okay?

World Gynecologic Oncology Day 

We have a question from (ENGAGe Co-Chair) Kim Hulscher. What about your patient advocacy groups in Iraq?

Dr Nagham Ibrahem 

We try to collect them right now, together. They sometimes meet in our oncology clinic in the hospital, sometimes they meet in our private clinics. Sometimes they meet when they come and take, for example, chemotherapy or their daily treatment, and they have their mobile and number, each one will be a dynamic, a supported group.

World Gynecologic Oncology Day 

What is some advice to a patient who is maybe struggling with stigma or feeling alone?

Dr Nagham Ibrahem 

We will finish with them. They'll fight against cancer until they succeed and have cancer elimination completely. We are with them. We support them.

In medical oncology, in radio and sometimes in the surgical department, they meet, the patient and everyone supports the other.

There is no stigma to being a gynecological cancer patient at all, and there is no stigma to being a cancer patient at all.

Cancer is just a disease, like any other disease. We would like to announce our patients to go for screening, not to be panicked. We want to be earlier. We have many pre-invasive diseases that can be treated.

Unfortunately, many of the vulval cancer patients, they are shy, especially elderly women. They are shy to attend the clinic or to say that she has vulval symptoms. Okay? So unfortunately they come late.

World Gynecologic Oncology Day 

Yes, and that's one of the things that you're doing with your awareness activity. You're making it less difficult for someone who is shy to come forward, right?

Dr Nagham Ibrahem 

Yes, yes, true.

For the patient, number one, we should celebrate you. Number two, make support for their families.