Abigail Klein Leichman
August 21, 2023

Retinoblastoma (Rb), a potentially deadly eye cancer affecting children up to age five, is highly curable in high-income countries.

But in many other countries, barriers to healthcare cause survival rates to plummet below 50 percent.

Hoping to save the eyesight of children from Afghanistan, a country with no established treatment centers for Rb, physicians from Israel and Pakistan formed the Retinoblastoma Silk Road Project a little over a year ago.

Afghanistan, a low-income country in Central Asia under Taliban control since 2021, has nearly 100 new cases of Rb every year. Eye clinics operated by the Afghani International Assistance Mission (IAM) through the National Organization for Ophthalmic Rehabilitation (NOOR) aren’t equipped to deal with this disease, leaving the children’s parents no alternatives.

Ophthalmologists from Israel’s Sheba Medical Center, including ocular oncologist Prof. Ido Didi Fabian, teamed up with IAM/NOOR and Pakistani Rb Centers of Excellence to establish an official referral pathway for Afghan children with suspected Rb to receive specialized treatment in neighboring Pakistan.

“Through international collaboration, telemedicine consultation, geographic coordination and charitable contributions, the Retinoblastoma Silk Road Project aims to significantly reduce child mortality rates caused by this fatal cancer,” said Fabian.

According to a Sheba spokesman, several Afghan children have now received treatment in Lahore thanks to the project, which is supported financially and logistically by Sheba Global, the medical center’s international division.

Israeli, Pakistani MDs save eyesight of Afghan children
Girls in Helmand, Afghanistan. Photo by timsimages.uk via Shutterstock.com

Israel does not have diplomatic relations with either Afghanistan or Pakistan.

“At Sheba Global, we try to help patients across the world, also in Iran, Saudi Arabia and Syria,” said Fabian. “Since 2017, through a study group I initiated, I’m in touch with physicians who treat Rb across the world. Doctors from Afghanistan and Pakistan are part of this, and that’s how the project started.”

The partners engaged an Afghan coordinator who takes the referred children and a parent to the border, where a dedicated driver from the Pakistani side takes them to the eye center in Lahore. The families get free lodging at a nearby safe house.

The Israeli physicians help decide which children to refer to Pakistan, via consultations held over WhatsApp and Zoom where they can see the medical imaging. They are also available to the pediatric oncologists at the Pakistani Rb Centers of Excellence in Lahore and Karachi to consult on individual cases.

The joint endeavor, Fabian noted, aligns with the goals of the World Health Organization’s Global Initiative for Childhood Cancer, which recognizes Rb as one of the six cancers in which the initiative strives to achieve at least a 60% survival rate by 2030.

The Retinoblastoma Silk Road Project, said Fabian, “aims to become a model referral pathway for other countries, especially in underserved nations and communities.”

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