QAB ELIAS, Lebanon: Maha al-Ali buries her dark, auburn locks in her grandmother’s embrace, her full red cheeks glowing with a shy smile.
Just a few months ago, she was on the verge of death.
Maha looks almost unrecognizable in old photos her mother still keeps on her phone, head nearly bald, face pale, lips bearing a shadow of the same smile.
The 4-year-old girl from the Aleppo countryside fled her home when she contracted what her family would later find out was cancer of the lymph nodes, her access to health care severed by the brutal war that swept the city.
She is now free of the cancer after months of expensive chemotherapy and treatment funded by aid organizations. But her case highlights the challenges facing budget-strapped NGOs who struggle to provide food for refugees, let alone advanced, costly health care.
Maha’s family first discovered a lump in her stomach two years ago, and she was operated on by doctors near Aleppo, who excised part of the growth that they found. She still bears the scars of the wound, but later her stomach became bloated once again.
The family fled Syria to Lebanon seeking treatment, giving up much of what they owned to do so, in December 2012.
“If you want to take your family [to Lebanon], if you are a woman or a girl, you remove whatever is adorning your hands and you give it to the driver,” said Maha’s aunt, who raised the girl as her daughter, and whose name is also Maha.
She was eventually admitted into the Rafik Hariri Hospital.
“She was gone,” Maha’s grandmother said. “No food, no drinking. If she drank water or ate anything, she would throw it up.”
The girl’s grandmother requested a meeting with then-Health Minister Ali Hasan Khalil, who gave her a dispensation that instructed the Higher Relief Committee to pay part of her medical costs.
The HRC ended up paying 15 million Lebanese pounds, the cost of the initial part of her stay at the Rafik Hariri Hospital. Expenses since then have been covered by BASSMA, a Lebanese NGO.
Refugees have to rely on special programs by aid agencies because the U.N. High Commissioner for Refugees is underfunded and tries to target the neediest refugees with food through its aid programs as a result. The UNHCR also cannot provide long-term expensive health treatments.
There are now over 1 million Syrian refugees registered with the UNHCR in Lebanon.
Maha immediately began treatment at the hospital with chemotherapy that lasted about six months, during which time she lost all her hair three times.
After that, she had to return to Beirut once every 15 days for supplementary injections, and she now takes additional medicine to augment her devastated immune system.
But last month, doctors told the family that all traces of the cancer had disappeared. Maha was free of the illness, but had to remain under monitoring in case of relapse.
Living in the refugee tent settlement in Qab Elias, a suburb of Zahle, is also a challenge for the young, weakened girl and her family.
“The land is a little polluted here,” said Azra al-Mohammad, the grandmother, who sprinkles her retelling of the child’s story with prayers for everyone who helped her recover.
Near the tent, which is partly covered with straw mats and thin mattresses, is a sewage tunnel. The tent is crowded – it houses three families made up of 17 individuals. The rent is due this week, and Maha’s father can only manage odd jobs for about 10 days a month.
She gets LL40,000 a month of food assistance from the UNHCR, but because of her weak immunity, she can only eat certain fresh foods. Eating canned food could immediately make her sick.
The family cleans the house, Maha’s pillow and her clothes every day. She isn’t allowed to play in the mud with her friends or to eat with the rest of the family, a feeling of isolation that is hard to shake off, her aunt said.
“She wants to eat the way the children do, she wants to play in the mud,” the aunt added. “But all that is forbidden.”
She also has to worry about medicine and new tests to ensure the cancer has not returned.
Still, the elder Maha barely held back tears as she described the moment she found out the cancer had subsided.
“It’s indescribable,” she said. “When you see it happen in front of you, you wish that you had the illness, not your child. You don’t mind losing everything just so you can get them medicine.”
“If I were to describe it, I would weep, and I don’t want to weep,” she said. “We’ve seen so many tears, we want to laugh a little.”