Meet the UAE’s first female surgeon, breaking down the breast cancer taboo
Dr Houriya Kazim is the United Arab Emirates’ (UAE) first female surgeon, and the first medical professional to openly talk about breast cancer in the region. A historically taboo topic despite being the most common form of cancer in the UAE, Houriya has pioneered efforts to raise awareness of the illness and encourage early detection and treatment, which has led to a dramatic decrease in the number of advanced cases she sees nowadays.
Born into a family of doctors, Houriya trained in Ireland, going on to receive a double fellowship from the Royal College of Surgeons as well as a Master’s of Public Health in Epidemiology from the University of Texas School of Public Health. It was while studying that she first encountered the stigma around the word “cancer”.
“For the first couple of years you’re in the classroom or the lab,” she says. “Then when you finally start working in hospitals you are given rules around communication and courtesy, and one of the things that we were not allowed to say in front of the patient was the “C-word”. We had other words for cancer, so if we were discussing a patient in front of the patient, we would use the Latin word “neoplasia”, which means “new growth”.”
The stigma of breast cancer
When Houriya returned to the UAE after finishing her studies, she found an additional difficulty – there were few female consultants, and female patients were reluctant to show certain parts of their body to male doctors. “I joined a government hospital in Dubai as an intern, and I was one of the only women on the surgical team. I noticed that there was a need for a female surgeon, not necessarily just for breast cancer as there were other parts of the body that women didn’t want to show a male surgeon, for example for things like haemorrhoids. They preferred me, the most junior doctor, to examine them rather than the male consultants, so I would be with the patient behind the curtain describing what I found by examination to the consultant on the other side.”
Unfortunately this meant that a lot of cancers were going undetected until they were very advanced. “I had never seen these kinds of breast cancer patients before. Cancers are cells that are dividing out of control and if you don’t do anything about them they keep growing. These were really advanced cases, and it shocked me that women would know that something was there and leave it until it got to that point.”
“There wasn’t screening or awareness, along with a lack of knowledge, fear of the disease and not wanting to see a male surgeon. And of course if you leave a cancer to reach an advanced stage, then you will most likely succumb to that cancer. That tells the rest of the community that cancer equals death, so the fear continues,” she says.
Raising awareness of cancer treatment
Houriya realised she needed to educate people about breast cancer, and highlight that if treated early it is possible to go on to lead a normal, healthy life. “In order to do that, we first have to detect cancers early, then patients must receive the correct treatment. Lastly, they need to be vocal about it. We used to have a road show where I would take nurses and patients to the hinterlands of the UAE, and survivors gave talks and the nurses would examine women. The most powerful tool was to hear from a local lady who was working, who had kids, who had received cancer treatment and who was to all intents and purposes just leading a normal life.”
In 2006 Houriya founded the Well Woman Clinic in Dubai, a health centre for women that provides advice, screening and treatments for a variety of health conditions. A year previously she had established Brest Friends, a charity running Dubai’s first breast cancer support group where women can share their experiences of living with cancer and receiving treatment. It has since expanded to include women who have any type of cancer. “It was a difficult thing to set up,” she explains. “In this region people are not very open about things that are close to them. We don’t have an Oprah Winfrey kind of society where people give out their deepest, darkest secrets. It was hard to try and get women from the Middle East to come to these meetings, because it is so overwhelming. But to go into a room full of people who’ve had chemo, who’ve had surgery, and for whom their hair has grown back and they look back to normal is very powerful.”
Through the group women can access support with nutrition, exercise and mindfulness, and there is also a closed Facebook group for women to ask questions and talk about their progress. ” Breast cancer is a very emotive subject compared to, say, thyroid or colon cancer,” Houriya says. “It is a shock when women find out that they have cancer, and there is a bereavement process. You go through different stages of anger, denial, bargaining and depression. Finally at the end is acceptance, and as the different therapies keep patients so busy sometimes this happens when a patient has finished their treatment and they think, “what did I just go through?””
The need for regional cancer research
Brest Friends is supported by Al Jalila Foundation, a non-governmental organisation that promotes early detection and funds breast cancer research in the UAE. A current area of focus is genetics and how this may link to the incidence of breast cancer. “In Europe, the US and Australia, it’s a disease of postmenopausal women and the median age in these countries is somewhere around 62,” Houriya says. “In the whole of the Middle East, North Africa and Indian subcontinent our median age is around 45-47, so it’s a completely different disease. There must be something related to genetics going on.”
To date most of the available data on breast cancer comes from outside the Middle East, so Houriya is working with the Al Jalila Foundation to expand the pool of research, specifically around genetics. “We know for example that Ashkenazi Jews have their own mutation that increases their risk of breast cancer, so it will be interesting to see what we find,” she says.
Over the course of her 30-year career, Houriya has seen huge change – from cancer rarely being mentioned in the public sphere to a much more open approach and the awareness that prevention is crucial for it to be curable. “Between the internet, the work we’ve been doing on awareness, and screening centres that have now been set up, we don’t see so many advanced cases of breast cancer anymore,” she explains.
Research is the next step for her, along with teaching. “I’m at the age where it’s time to give back,” she says. “I try to encourage women to become surgeons. It’s true I was the first female surgeon in the UAE, but I wasn’t the first one who tried. It’s a difficult field anywhere in the world, but here we have other sociocultural issues and a lot of pressure to get married and have children. Truthfully, I couldn’t have done this if I hadn’t postponed having kids.”
“When I was thinking about becoming a surgeon, I didn’t have anybody to look up to, faces that looked like me, a woman and a woman of colour,” she adds. “That’s an important message to pass on.”
This is an edited version of a podcast hosted by Unlimited. NADJA Media is a partner of Unlimited, a multimedia podcast platform that gives a voice to female entrepreneurs in the UAE. To listen to the full podcast visit Anchor FM.