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.