Annual Report of the Department of Health 2010 - Unrwa

The highest incidence rate was reported from Gaza Field (333.4/100,000) which may explained by poor water quantity and quality in
addition to the frequent technical problems with water stations and power cuts due to the prolonged closure of borders and lack of fuel
and replacements. West Bank reported 168.7/100,000 and Jordan, 124.9/100,000. The lowest rates were seen in Lebanon and Syria with
56.5/100,000 and 57/100,000 respectively.
CERVICAL AND BREAST CANCER SCREENING
In order to provide secondary prevention aimed at early detection and management of cervical and breast cancer at an early curable stage,
and to promote primary prevention activities, UNRWA implemented a screening programme for breast and cervical cancer which started
in 2006. The level of implementation varied between the Fields according to the availability of funds and operational difficulties. In 2010,
this service was outsourced through contracts for the provision of mammography and cytology screening tests in two Fields: Syria and
Lebanon.
The low detection rates of cervical cancer, has led the Agency to opt for the discontinuation of this screening activity in 2010. Conversely
the utility of breast cancer screening has been confirmed. It is unfortunate that technical and budgetary limitations are preventing the
implementation of breast cancer screening in other Fields and that funds are not expected to be secured for the on-going activities in Syria
and Lebanon.
IN LEBANON
During 2010, a total of 1,810 women of the target population (>50 years and other specific categories at higher risk) were screened for
breast cancer by mammography and breast ultrasonography if indicated. 365 (20.2%) had abnormal findings, 27 (1.5%) were diagnosed
with breast cancer and 16 cases are considered as precancerous condition, after breast biopsy. The detection rate for breast cancer was
1.5% in 2010 compared to 2% in 2009 and with 1% in 2008. Findings indicate that this screening program is cost-effective and should not
only be maintained, but expanded to other Fields. All precancerous and cancer cases were referred to hospital for further treatment.
A total of 680 women from different age categories were screened for cancer of the cervix by using a Pap smear. Only one case was
diagnosed with cervical cancer which corresponds to a detection rate of 0.15%.
Table 31 - Cancer screening in Lebanon Field
Breast cancer
Cervical cancer
Total Screened Breast Ca. Detec on rate Total Screened Cervical Ca. Detec on rate
1810 27 1.5% 680 1 0.15%
IN SYRIA
904 women were screened for breast cancer, out of them 153 (17%) were with abnormal mammography results and 18 cases (2.0%) were
ultimately diagnosed with the disease and they were referred for surgery and further treatment.
MEDICAL SUPPLIES
In 2010, the total value of medical supplies and equipment from all funds (General Fund - GF, in-kind contributions and emergency appeals)
was approximately USD 21.19 million, an increase of 25% compared with 2009. The increase in total expenditure (USD 4.28) is mainly due
to an increase of the Gaza Field expenditure. In 2010, the total expenditure in the Gaza Strip was USD 8.34 million, while in 2009 it was only
USD 5.1 million. This USD 3.24 difference is mainly the result of carrying 2009 budget residues into 2010, as in 2009 a high proportion of the
Gaza Strip expenditure was covered by donations received after the war. In addition, the savings made in 2010 from the GF budget of
Jordan Field (about USD 0.5 million) were utilized to procure essential laboratory and dental equipment.
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