Amanda Tawk was diagnosed with cancer in December. Photo / Diego Ibarra Sanchez, The New York Times
Many children undergoing chemotherapy in Lebanon now have nowhere to turn for treatment after an explosion destroyed hospitals and wiped out medicine stockpiles.
The children being treated at Beirut's St. George Hospital built an extended family with each other, painting and dancing together when they had the energy and rubbing each other's backs when they vomited after chemotherapy sessions.
Now these cancer-stricken children are struggling to keep up with their treatment and preserve the bonds they developed with each other over sometimes years of treatment, after a powerful blast ripped through Beirut last week and took their hospital — their home away from home — with it.
The blast destroyed four hospitals in Beirut, including St. George, one of the largest in the country, leaving many dozens of Lebanon's youngest cancer patients with nowhere to go for care.
Adding to their trauma, many children were at St. George when the blast struck, causing widespread injuries and killing at least one of their parents.
For Peter Noun, head of St. George's paediatric haematology and oncology department, only one of the three hospitals he practices in is now operational.
"It's hard to know that we have a deadly but treatable disease and we cannot do anything for these kids because everything is destroyed," Noun said.
Children respond well to chemotherapy, he explained, as long as they follow a strict schedule and do not miss any sessions.
Since the blast, Noun's days are spent crisscrossing Lebanon, checking on the sick children in their homes and visiting hospitals to see if they have space to admit his 110 patients in dire need of care.
But any hospital left in Beirut is over capacity, tending to the 6,000 Lebanese injured in the blast.
A further complication: Lebanon's coronavirus numbers are surging, and Noun worries the children he treats — already immunocompromised because of their chemotherapy — could catch the virus and die.
Noun was able to secure a handful of spots at one hospital outside Beirut for his most critical patients. He hopes that field hospitals being built by foreign governments will be ready fast enough to care for his remaining patients.
But time is running out, and he worries some children may relapse.
Marita Reaidy has lived most of her seven years in and out of St. George from the time she was born, a fragile premature baby.
When Marita received her second cancer diagnosis last year, she returned to St. George and began rebuilding her hospital family, choosing her favorite nurses and picking her friends from among the other sick children.
"My home is now destroyed," Marita said in an interview. "This was my hospital. It's gone. I don't want to see my hospital die like this."
All the children interviewed for this article, and their parents, gave permission for their stories to be told and for their names to be published.
Marita and her mother, Amal Reaidy, woke up on Tuesday last week, excited they would be returning home to see Marita's father and sister after a weeklong chemotherapy session.
The patient said goodbye to all the nurses and bid farewell to Yuri Abou Mrad, who had become one of her closest friends. Yuri, 7, was diagnosed with Ewing's sarcoma last year.
St. George had become the only place where Yuri and Marita felt like normal children. No one gave them pitiful looks or stared at their bald heads.
Later that Tuesday evening, Yuri's father, Omar Abou Mrad, saw a fire raging at the port from a window at the hospital, perched on a hill overlooking the Mediterranean.
His son walked over to get a look, wheeling the metal contraption that carried his chemotherapy treatment.
The smoke turned black, and Yuri's father started to worry. He knew from his childhood during Lebanon's civil war that giant windows could become lethal, splintering into deadly shards after an explosion.
Seconds later, the blast came, its shock wave rippling across Beirut, destroying buildings in its path. At St. George, windows shattered while parts of the ceiling collapsed on hospital beds, pinning patients down.
When Abou Mrad came to, Yuri was crying and both were bleeding, lying atop shattered glass and twisted metal.
"It was waterfalls of blood," Abou Mrad recounted. "I was too afraid to look down, as I wasn't sure if my body was still intact. I looked only at Yuri's face and kept saying, 'Don't worry. Everything will be OK.'"
An audio recording of the minutes after the blast, taken by Abou Mrad, captures the sheer terror of the moment, the screaming and wailing.
"Yuri, do not be scared. I am here with you," Abou Mrad said in the recording.
"But maybe it will explode again!" Yuri cried.
Abou Mrad called for help, unable to move. The tubes that fed the chemotherapy into Yuri's chest were tangled up in the debris.
Eventually, a nurse helped free them.
Despite a broken hand and fractured rib, Abou Mrad grabbed Yuri and placed him in an emergency exit stairwell. He then joined others trying to help the wounded.
One father, whose daughter had just been diagnosed with cancer, was so badly injured he died days later.
"The trauma of having cancer so young and then to see your father, blood coming from his head, blood everywhere," Noun said. "All she can say now is, 'Baba will now see me from above. He will help me from heaven.'"
The parents who survived the blast are now exhausted. Life was difficult before. Now it is hell, they say.
In the months before the blast — the result, according to Lebanese officials, of 2,750 tons of ammonium nitrate catching fire at the Beirut port — the country was already on the brink of collapse.
An economic crisis had devastated many of the middle-class families who go to St. George for affordable, quality care. As Lebanon's currency shed its value, the families struggled to afford the medicine and treatment their children needed.
But Noun always found a way to help them, they said. Now there is little he can do.
The blast badly damaged the government-run warehouse that stored imported medicine. The medicine stockpile at St. George was also destroyed.
The parents are now left to wonder: How can they save their children in a country that cannot save itself? In a country that would allow the ammonium nitrate to be stored at the port since 2014 despite repeated warnings to Lebanese officials about the dangers it posed?
Yuri's father said the family is considering leaving Lebanon for good.
"If it's too late for us, for my generation, I don't want it to be too late for my kids," Abou Mrad said. "I don't want them to grow up and turn 18 and only know this destruction and sadness."
Gobran Pierre Tawk, the father of another young St. George patient, moved back to Beirut from Australia in 2017 so his daughter, Amanda, 3, could be born in Lebanon. He opened a small business, and everything was going well. But it all started to fall apart last October, when the economy went into a tailspin and protests over government corruption and incompetence wracked the country.
Amanda was diagnosed with cancer in December, and she and her parents had been living in St. George since.
Like many other Lebanese, the blast left Tawk determined to emigrate, threatening to deprive Lebanon of the people it needs to rebuild.
On Monday, Amanda's Australian visa arrived, expedited by the country's embassy after the attack.
"I believe in Lebanon, but I am also a father," Tawk said. "My priority is to make sure Amanda is safe and happy. You have someone who is dying from cancer, and it's her right to get treatment.
"I love my country," Tawk added. "But I should not have to worry about whether my children live or die here."
Written by: Maria Abi-Habib
Photographs by: Diego Ibarra Sanchez
© 2020 THE NEW YORK TIMES
Twenty-seven locations in Kyiv were hit, including residential buildings.