Imane, Morocco

Imane Labiad studying in a cafe in Fes, Morocco.

Imane Labiad, 25, did not start school until she was 10, yet she is already in the final year of studying for a Bachelor’s Degree at Sidi Mohammed Ben Abdellah University in Fez. Her ambition is to study for a Masters and a PhD and return to the university as a Professor. Sadly, this ambition is currently unattainable because the cut-off age for students with MS qualifying for free medication through the CNOPS programme is 30 and starting school late means she will miss that deadline.

I am ambitious. I want to fulfil my own dreams but also the dreams of my family too. I had a hard life as child. I started primary school very late, at the age of nine and a half years. I am from Taounate, a rural area where it is very common that boys can go to school but girls should not. I was helping around the house, tending sheep and bringing firewood from the forest. In 2007, my father decided to move the entire family to Fez and that’s when I started school.

When I went to school I had a strong passion and enthusiasm to study, I had the ambition to fulfil great things and make my family proud. My ambition after obtaining my Bachelor’s degree was to enrol in a MA program then go for a PhD program and become a university professor at the very same faculty where I am pursuing my studies.

When I learnt about my MS, my ambition had to change. If I want to get a PhD, I would be 30 years of age by then but if I exceed the age of 30 during my studies I will not be able to benefit from CNOPS (Caisse Nationale Des Organismes De Prevoyance Sociale is the government health insurance for students). CNOPS funds all my fingolimod MS treatment.

I now believe that I had my first relapse in 2019 but I was not diagnosed until 2022. In my first relapse in 2019 I felt my legs were heavy for two weeks but I was fine again after that. Then, during Covid-19, I started to get serious heavy feelings in my legs. I went to see a general practitioner and he gave me a two-month supply of a drug that is used to treat blood vessel disorders. I did not feel any better after that so he referred me to a neurologist, who asked me to do an MRI scan. When the neurologist saw the results of my MRI scan he confirmed that I had inflammation but recommended that I start treatment at a public hospital where I would be able to access CNOPS.

In December 2021, I met Dr. Siham Bouchal at Hassan II University Hospital in Fez, who told me that they cannot make a final judgment using only that MRI. In addition to MRI, I had to do many other tests, including blood tests and a spinal tap procedure. They collected a sample of the cerebrospinal fluid for testing and sent it to France. In March 2022, I was told I must be hospitalised for additional tests. The tests were sent to Casablanca because there are only two laboratories in Morocco that can process them. I then was required to do additional MRI scans.

In total, I paid almost 20,000 MAD ($1,800)) but because I have CNOPS I will be reimbursed.  A tiny bit of that fee was covered by my family but the rest was paid for by a local association I do not know the name of, as it is a group of people who prefer to give donations and remain anonymous.

At the start, when I first learnt that this is a chronic disease and that I had to take a very expensive drug for the rest of my life, I was shocked. But thanks to my religious background, I was able to be patient and I ended up being the one who was calming down my parents, who were still in shock. I told them that this is a test and I am strong enough to go through it. I found myself motivating them instead of the other way around.

Now I am mainly concerned about my health insurance and whether I will continue to have it. I will be getting my Bachelor’s degree next year. To access health insurance, you must either be a student and benefit from CNOPS or be working and benefit from CNSS (Caisse Nationale de Securite Sociale, the national health insurance scheme). If I am not admitted to a MA degree program I will no longer be eligible for CNOPS. The other option would be to get married to someone who has CNOPS as the spouse of a person enrolled in CNOPS can benefit too.

If I don’t have insurance I could register for RAMED but fingolimod is 15,000 MAD ($1,375) a month and the expensive drugs are often not covered by RAMED. For CNSS, the total amount reimbursed is very low, it varies between 50% and 70% maximum and the individual covers the rest. On CNOPS the cost is completely exonerated so I don’t pay anything.

The doctors say it is impossible for me to stop the medicine and that I must take it on a regular basis but I keep worrying: What if I was unable to get my treatment for a month or so? What will be the consequences?  If I can’t continue my studies, the best thing is to be an entrepreneur, but the issue for me here again is whether as an entrepreneur I will have a health insurance to help with treatment.

This is a huge worry for me, but I am good at coping with new things. School was a big dream for me. I was very happy I managed to fulfil it. I realised that it was an opportunity that was not granted for everyone and I made sure to be up to the challenge. With MS I found it very hard at the beginning but then I decided that life must go on. This is just another test in this life. I will pass it as the same way I pass my other exams at university.

Thank you to HANASEP for connecting us with Imane.

Imane Labiad (right) talking to Rabia Elbachtiri from HANASEP outside the university in Fes, Morocco.

Imane Labiad studying in a cafe in Fes, Morocco.

Imane Labiad is a student at university, Fes, Morocco.

Imane Labiad is a student at university, Fes, Morocco.