Cancer, quarantine and loss: a tale of two brothers

Yasser (L) and Haisam Zogheib (Photo: Nesrin Saab) 

It’s just over two months since Yasser and Haisam Zogheib returned to Sydney after spending almost a month at a private oncology clinic in Dornstetten, Germany.

Yasser, a father of three, had been receiving treatment there for the stage four prostate cancer that had metastasised to his bones, liver and lungs. Haisam was his physical and emotional support.

In extraordinary circumstances that should have received extraordinary consideration, both brothers – my uncles – soon found themselves face-to-face with the rigidity of NSW Health’s quarantine criteria. Despite repeatedly applying for exemptions so they could isolate together at home, they were instead separated.

This meant Yasser was forced to spend most of his final weeks alive, alone.

GERMANY

The stakes were already high when Yasser Zogheib sought personalised treatment at Hallwang Clinic in Germany, applying twice to the Department of Home Affairs before finally being permitted to travel.

Accompanying him for moral support was his younger brother Haisam, whose fourth child had been born just a week before their departure.

Before he left for Germany, Yasser’s oncologist estimated his prognosis was just two to three months.

“In Australia there are a lot of restrictions on who can access these treatments,” explained Yasser, the owner of Cincotta Chemist in Auburn. In fact, the well-reviewed therapy was unavailable in Australia.

Instead, he’d been on carboplatin chemotherapy, but it was proving ineffective on his metastatic cancer.

Yasser’s oncologist Dr Carole Harris, estimated his prognosis was just two to three months. In a letter to NSW Health, she said that upon his return the plan would be to continue with chemotherapy, with or without immunotherapy, as long as he was well enough.

Completely aware of the risks attached, particularly in his vulnerable state, Yasser hoped the clinic’s treatments might help save his life. But the stay in Germany was a challenge in every way, which extended to a terrifying drop in white blood cell count and the eventual development of a bacterial infection.

Yasser and Haisam at a cafe in Germany (Photo: Haisam Zogheib)

“After [the doctors] saw my blood tests, I started on four different courses of antibiotics and had an operation to remove my catheter, which was being used to inject me with treatments,” Yasser said. “The doctor was afraid that it was getting infected.”

With a white blood cell count of 0.7 and reported high levels of C-reactive protein (CRP) and procalcitonin – both indicators of infection – Yasser felt growing concern that he would become fatally septic.

Back in Australia, his wife Linda contacted local MP Stephen Kamper about getting Yasser to a hospital for testing upon his arrival in Sydney – ahead of what they hoped would be isolation at their Bexley home. In Germany, Yasser and Haisam had also applied online for exemptions, citing how they would isolate together at Yasser’s granny flat.

QUARANTINE

Since late March, the NSW Government has been enforcing compulsory quarantine for arriving travellers. Online commentary has subsequently ranged from the “terrible conditions” of hotel isolation to distaste for anyone opposing the policy.

“… celebrities like Nicole Kidman and Dannii Minogue had been allowed to isolate at home – but not, it seemed, terminally ill Australians like Yasser.”

On its website, NSW Health pledges that having “strong medical, health or compassionate grounds” is all that is required to qualify for an exemption.

It was widely reported that celebrities like Nicole Kidman and Dannii Minogue had been allowed to isolate at home but not, it seemed, terminally ill Australians like Yasser. Instead, the brothers lost count of their communications with NSW Health before and during Yasser’s time in St George Hospital and Haisam’s quarantine at The Sheraton hotel.

Yasser’s immune system initially recovered after his return, but little else went according to plan.

He recalls being in the emergency room with Haisam after being told by staff that they would be quarantined together. Then, “four police officers came to the emergency room to pick up Haisam. People in the emergency ward started looking as if a big criminal was being arrested, which made me very distressed.”

Haisam was taken to The Sheraton for his quarantine, while Yasser remained in St George Hospital, amid concern for his frail health.

A CATCH-22

“If you choose home quarantine, you have to be there for 14 days, and [then] apply for another exemption to go to the hospital,” Yasser said. “The problem is, every facility you go to will ask you if you’ve been overseas and if your answer is yes, they ask you to leave.”

Three days after his arrival, Yasser was informed that his improving condition meant he’d be transferred to a hotel to complete his quarantine. Despite numerous applications stating the unsuitability of hotel quarantine for someone in his condition, it was only another blow to his health – his eye swelling from the cancer – that stopped him from being moved.

Yasser’s proposal to isolate in his granny flat was ultimately ignored.

Instead, he stayed isolated in his hospital room, with one designated visitor permitted to speak to him through a glass door. “If someone like me in my condition can’t get an exemption, then who is qualifying for these exemptions? Obviously no one,” he said.

*Yasser Zogheib

THE SHERATON

At The Sheraton, Haisam met similar resistance from NSW Health. Unable to support his wife, who now had the added responsibility of their newborn son, and still dealing with the guilt and stress from Yasser’s treatment, he described the cycle of trying to get an exemption.

“I understand the need for us to be cautious, but it must be done without taking my humanity away.”

“I would address their concerns and just get a rejection with no explanation,” he said. “I really expected our government would look favourably upon my circumstances, since they were so unusual. I understand the need for us to be cautious, but it must be done without taking my humanity away.”

The inability to choose meal times, leave his room, speak to anyone, get fresh air, or get his room cleaned, were just a few of the issues he named. Haisam also revealed that before this experience, he too was critical of those who complained of the conditions. But now, he says: “You get treated worse than a prisoner here.”

He recalled that one evening he had woken up hungry and opened his door to see if food had been delivered while he was asleep. “Immediately a security guard started screaming loudly at me to get back inside the room. The government knows this is bad and that’s why they have psychologists on call. They know it’s hard to cope with.”

Haisam was assessed by a psychologist at the hotel, and found to be experiencing “severe psychological distress” and “high levels of anxiety” from the difficult experiences in Germany. Despite his mental health state, he was still required to remain at the hotel and was declined an exemption to home isolate.

His experience with NSW Health confirmed the fears that Dr Paul Finlay had after screening arriving travellers at Sydney Airport. At the beginning of the quarantine policy, he shared his concerns that the travellers he flagged as being vulnerable, were never exempted to home isolate – despite being told by NSW Health that they had been.

FAMILY

While in quarantine, both brothers stayed in regular contact with their families via video calls and a group chat on WhatsApp.

“The whole family had a Zoom call almost every day with [Yasser and Haisam],” their sister Angela recalls. “When [part of] your family is detached from the rest, being able to support them is the most important thing.”

DR NOLTING

From June 6th to July 19th – a total of 43 days – Yasser was unable to see his Sydney oncologist. He was refused all oncological treatments, despite his rapidly spreading cancer requiring urgent attention. This included Avastin infusions, a commonly used medication, which had proven extremely effective during his treatment in Germany.

His doctor at the Hallwang Clinic, Dr Nolting, kept in regular contact with the family via phone calls, and was made aware that treatment had been stopped.

“You have an aggressive form of cancer that needs consistent care,” he would tell Yasser on the phone – referring to his cancer scoring a nine out of 10 on the Gleason grading system for aggressiveness of prostate cancers.

Dr Nolting warned that without treatment, Yasser’s cancer was doubling in size every day. “They’re killing you,” he’d say. “You’re walking to your deathbed.”

Yasser consistently requested for his treatment to resume, but to no avail.

It was only on Friday, July 19th, that he was permitted to resume his immunotherapy, but he was still denied the Avastin infusions that had seen his health improve in Germany.

YASSER

Unfortunately it was too little too late, and late last month, Yasser’s condition gradually worsened as he developed disseminated intravascular coagulation (DIC), causing issues with excess blood clotting and a fatally low platelet count.

He was eventually released from hospital, as there were few treatments left that could be safely administered in his frail state.

Yasser passed away in his home in the early hours of Friday August 7, surrounded by his family.

Yasser with (from L to R) son Mohamad, daughters Alyssar and Amal and his wife Linda.

When contacted for comment, a media advisor for NSW Health replied only in the context of this story about my uncles being for a university assignment.

They wrote: “Unfortunately due to the volume of media requests we are receiving, we are unable to accommodate student enquiries.”

— Farah Elrifai  @felrifai