Morocco earthquake: mitigating the impact on patients with cancer.

The 6·8 magnitude earthquake that shook Morocco on Sept 8, 2023, left thousands dead or injured.1Marshall M Why was the Morocco earthquake so deadly?.Nature. 2023; (published online Sept 12.)https://doi.org/10.1038/d41586-023-02880-3Crossref Scopus (1) Google Scholar Morocco, like many other low-income and middle-income countries, was unprepared for such a disaster, especially in rural areas where the tremor epicentre was located. The earthquake has deeply impacted care facilities in the region and has presented unique challenges to local health-care systems. Vulnerable populations, such as older people and patients with cancer, have specific requirements and are largely neglected during disasters.2De Guzman R Malik M Global cancer burden and natural disasters: a focus on Asia's vulnerability, resilience building, and impact on cancer care.J Glob Oncol. 2019; 5: 1-8PubMed Google Scholar Redirecting efforts and resources to encompass patients with non-communicable diseases, such as cancer, is essential. Considering Africa's substantial cancer burden, countries with settings similar to Morocco could encounter these challenges in the future. During these urgent situations, careful planning and preparedness is required to ensure access to essential treatments for these populations in times of crisis.3Sahar L Nogueira LM Ashkenazi I Jemal A Yabroff KR Lichtenfeld JL When disaster strikes: the role of disaster planning and management in cancer care delivery.Cancer. 2020; 126: 3388-3392Crossref PubMed Scopus (8) Google Scholar Existing evidence suggests that disasters have a detrimental impact on cancer-related outcomes in older individuals, primarily because of interruptions in care and difficulty accessing timely treatments.4Lynch KA Merdjanoff AA Impact of disasters on older adult cancer outcomes: a scoping review.JCO Glob Oncol. 2023; 9e2200374PubMed Google Scholar Guidelines to enhance rapid and robust responses that specifically address the needs of patients with cancer are urgently needed. These guidelines should incorporate lessons learned from past events.5Porzio G Aielli F Verna L et al.Home care for cancer patients after an earthquake: the experience of the “L'Aquila per la Vita” home care unit.J Pain Symptom Manage. 2011; 42: e1-e4Summary Full Text Full Text PDF PubMed Scopus (11) Google Scholar For example, lessons learned from the COVID-19 pandemic, including the use of reliable communication systems to establish channels for disseminating crucial information to patients, their families, and their health-care providers. The identification of safe and accommodating evacuation routes is also fundamental. An unmet necessity is the preparation of caregivers through early and adequate training on the management of vulnerable patients during natural disasters. Comprehensive staff training on disaster-response protocols and the specific requirements of patients with cancer during emergencies is essential to deliver crucial care, even under challenging circumstances. Patients' medical records should be maintained and secured electronically in external servers to ensure access to their important data, including cancer treatment plans, when conventional infrastructures are compromised. The use of telemedicine solutions could support remote cancer care during emergencies and substantially enhance health-care resilience and response capabilities. Nonetheless, hospitals should hold stocks of essential cancer drugs, medical supplies, and equipment secured in spaces resistant to seismic events with regular monitoring. Hospitals also need to include plans for safe transport to other health-care facilities based on prearranged agreements with transportation providers. Importantly, the decentralisation of human resources and means—including task shifting—should also be recommended to meet the rising demand during conflicts6Hammad N Ahmed R Sudan: current conflict, cancer care, and ripple effects on the region.Lancet. 2023; 402: 179Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar and disasters. Despite the constraints in the oncology workforce in low-income and middle-income countries, service delivery through decentralisation might have a substantial positive impact during these circumstances. Collaborative networks between private and public hospitals could also facilitate resource allocation and expertise sharing during difficult circumstances. Patients with cancer during disasters and pandemics can also develop psychological stress. Psychological support services to aid emotional and mental challenges should be provided. Educating the public to empower rapid campaigns for proactive support of patients and their families should also be incorporated in these guidelines. We urgently call upon the oncology community and cancer organisations worldwide to provide guidelines for managing patients with cancer during natural disasters in low-resource settings and standardise emergency preparedness and responses.7Kundu S Sana H Dutta R Gerk A Pigeolet M Raykar NP Call for standardised emergency preparedness and response.Lancet. 2023; 401: 1924-1925Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar These recommendations will ensure the management of long-term effects and the provision of efficient health-care services in disaster-prone and vulnerable environments while also maintaining essential community health care. Research on the management of cancer in patients facing displacement due to war and natural disasters remains an unexplored and unmet area. We declare no competing interests.