When light is lethal: Moroccans struggle with skin disorder

When light is lethal: Moroccans struggle with skin disorder

Determined for her 7-year-old son to attend school despite a life-threatening sensitivity to sunlight, Nadia El Rami struck a deal with the school director: Mustapha would be allowed in the classroom, but only if he studies inside a cardboard box.

Mustapha Redouane happily accepted the arrangement. He knew his mother’s idea would silence the school’s worries about his condition, a rare genetic disorder called xeroderma pigmentosum, or XP, which can make sun rays and other sources of ultraviolet light extremely damaging to the skin and eyes _ and is more common in North Africa than much of the world.

“I hate the sun anyways. It gives me blisters,” he said, sitting on his mother’s lap, his face covered with dark brown freckles that the school director considered a distraction to other students.

Now 8, Mustapha has already had 11 operations to remove cancerous growths on his skin.

A nurse performs skin checkups for 8-year-old Mustapha, who is affected by a rare disorder called xeroderma pigmentosum, or XP, inside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

His family is among thousands around the world struggling with XP, and increasingly sharing advice and seeking new treatments. In Morocco, families are also fighting for recognition, government help _ and the simple right to go to school.

The disorder affects about 1 in 10,000 people in North Africa _ more than 10 times the rate in Europe and about 100 times the rate in the United States, according to Dr. Kenneth Kraemer, who researches XP at the U.S. National Institutes of Health.

Because the disorder is inherited, XP is more common in populations where marriage between relatives is high, Kraemer said. Affected children inherit two copies of a mutated gene, one from each parent. A 2016 Moroccan government study estimates about 15 percent of marriages are between family members.

Living in a country where the sun shines year-round makes them more susceptible to skin cancers that can be caused by the disorder, said Fatima El Fatouikai, pediatric dermatology specialist at the Ibn Rochd University Hospital in Casablanca.

Without protection, few XP patients in Morocco live beyond their teenage years, El Fatouikai said. It is particularly challenging in developing countries where awareness and treatments are scarce, and in poor, rural communities where people spend more time outside.

Families wait alongside their children affected by a rare disorder called xeroderma pigmentosum, or XP, inside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Habib El Ghazaoui, a father who runs the Association for Solidarity with Children of the Moon, plays with 8-year-old Mustapha who is affected by a rare genetic disorder called xeroderma pigmentosum, or XP, inside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Outside of El Fatoikai’s office, families coming from all around Morocco, sit in a waiting room eager for their names to be called in. There is a rumor about a new XP treatment.

The truth is, she says, “We only have prevention as a possible treatment. These children ... have to avoid even minimum sun exposure.” The main prevention measures: avoiding the sun, and wearing protective clothing, face shields and sunscreen.

Fatimazehra Belloucy, 25, has dealt with skin cancer and other problems because of XP.

“If only people made it easier. Their words hurt. I feel entirely alienated,” she said, describing scared looks and hateful comments as she passes by. Her family limits interactions with her, fearful that the disease is contagious.

“No one would take care of me, so I had to do it myself,” said Belloucy, who received her high school diploma and is now enrolled in university and hopes to land work helping with the disease.

Fatimazehra Belloucy, 25, a woman affected by a rare disorder called xeroderma pigmentosum, or XP, poses for a portrait by the corniche in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Fatimazehra Belloucy, 25, a woman affected by a rare disorder called xeroderma pigmentosum, or XP, poses for a portrait in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Most Moroccan children with XP don't continue their education. While U.S. schools install window filters for XP pupils and otherwise adapt to their needs, such accommodation is rare in Morocco.

“It hurts me that I have to see little kids suffer because of lack of awareness,” says Habib El Ghazaoui, who quit his veterinary job and made it his life's mission to raise awareness and help children with XP after learning his daughter Fatimazehra had the disorder.

His daughter, now a young adult raising awareness on social media, has had 50 operations for cancerous growths on her tongue, eyelids and elsewhere. She stays indoors and mostly sleeps during the day but, as the sun sets, she goes to parks and cafes, determined to lead a normal life.

Ghazaoui leads the Association for Solidarity with Children of the Moon from his house in the town of Mohammedia. He juggles his time between visiting families, distributing donations of creams and masks, providing the Casablanca hospital with data and pressuring the government to take action.

Romaisae, 6, who is affected by a rare disorder called xeroderma pigmentosum, or XP, poses for a portrait in her home in the town of Sale, near Rabat, Morocco, July 23, 2019. (AP Photo/Mosa'ab Elshamy)

Said El Mohamadi shares a moment with his 6 year old daughter Romaisae who is affected by a rare disorder called xeroderma pigmentosum, or XP, in their home in the town of Sale, near Rabat, Morocco, July 23, 2019. (AP Photo/Mosa'ab Elshamy)

XP support groups are increasingly sharing advice online, and held an exceptional meeting in London last year to share “hundreds of practical hints” about hoods, window protections or meters to measure light _ and even a French-designed face shield with a fan in it, said NIH researcher Deborah Tamura.

The donations from Ghazaoui’s group reach families like those of Said El Mohamadi, a tailor in the city of Salé, whose 6-year-old daughter has the condition.

“She’s sad, but I can’t risk taking her to school where there isn’t any kind of protection,” he said.

“But she needs an education,” her mother Maria El Maroufi pleads.

Fatimazehra El Ghazaoui, 27, a woman affected by a rare disorder called xeroderma pigmentosum, or XP, poses for a portrait inside her home in Mohammedia, near Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

A father applies a cream on the arms and neck of his child who is affected by a rare disorder called xeroderma pigmentosum, or XP, as they wait for a medical consultation in a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Rabiaa Waraqa, left, and Salaheddine Elkalshi, center, apply a cream to their 6 year old daughter Yasmin, who is affected by a rare disorder called xeroderma pigmentosum, or XP, in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Dermatologists gather information on children affected by a rare disorder called xeroderma pigmentosum, or XP, inside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

A nurse takes off a protective mask as she performs skin checkups for 6 year old Yasmin, who is affected by a rare disorder called xeroderma pigmentosum, or XP, inside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

A girl affected by a rare disorder called xeroderma pigmentosum, or XP, waits for a skin checkup with her family at a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Nadia El Rami walks with her 8 year old son, Mustapha, who is affected by a rare genetic disorder called xeroderma pigmentosum, or XP, outside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Fatimazehra El Ghazaoui, 27, a woman affected by a rare disorder called xeroderma pigmentosum, or XP, poses for a portrait wearing a protective mask she wears outside on sunny days, in her home in Mohammedia, near Casablanca, Morocco, July 16, 2019. (AP Photo/Mosa'ab Elshamy)

Habib El Ghazaoui, a father who runs the Association for Solidarity with Children of the Moon, speaks with parents of children affected by a rare disorder called xeroderma pigmentosum, or XP, inside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Habib El Ghazaoui, right, a father who runs the Association for Solidarity with Children of the Moon, distributes topical cream to parents of children affected by a rare disorder called xeroderma pigmentosum, or XP, inside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Maria El Maroufi, holds her 6 year old daughter Romaisae who is affected by a rare disorder called xeroderma pigmentosum, or XP, in their home in the town of Sale, near Rabat, Morocco, July 23, 2019. (AP Photo/Mosa'ab Elshamy)

Fatimazehra El Ghazaoui, 27, a woman affected by a rare disorder called xeroderma pigmentosum, or XP, poses for a portrait inside her home in Mohammedia, near Casablanca, Morocco, July 16, 2019. (AP Photo/Mosa'ab Elshamy)

Habib El Ghazaoui, a father who runs the Association for Solidarity with Children of the Moon, embraces a young girl affected by a rare genetic disorder called xeroderma pigmentosum, or XP, outside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Mohammad, 6, who is affected by a rare disorder called xeroderma pigmentosum, or XP, waits with his mother inside a hospital in Casablanca, Morocco, July 24, 2019. (AP Photo/Mosa'ab Elshamy)

Fatimazehra El Ghazaoui, 27, a woman affected by a rare disorder called xeroderma pigmentosum, or XP, is seen through the window of her home, near Casablanca, Morocco, July 16, 2019. (AP Photo/Mosa'ab Elshamy)


Text from AP News story When light is lethal: Moroccans struggle with skin disorder by Amira El-Masaiti.

Nadine Achoui-Lesage and Mosa’ab Elshamy in Casablanca and Mohammedia contributed.

Photos by Mosa’ab Elshamy