Cancer cases up but treatment limited

Since being diagnosed with cancer of the stomach, Azamat Baike, a 45-year-old man from Naryn in central Kyrgyzstan, frequently comes to the Kyrgyz capital Bishkek to receive medical treatment. He receives only rudimentary care as the money collected by his family is barely enough to cover the travel costs from his remote region; one session of chemotherapy costs about US $35 in a country where the average monthly wage is around $50. His doctor has told him he needs a course of at least 15 sessions to have any chance of being cured. “I cannot pay for the full therapy course because it is very expensive, my relatives help me a bit with the money so I come when I can, but I am not optimistic I will rid my body of the cancer,” he said. Such cases are not unusual in this mountainous former Soviet republic, where some 40 percent of the country’s 5.1 million inhabitants live below the national poverty line, according to the World Bank. That’s bad news for many in Kyrgyzstan, where according to health specialists the number of cancer cases is on the rise, while access to proper treatment is not widely available, particularly in rural areas. The health ministry says that each year there are more than 4,000 newly registered cases of cancer, with over 3,000 people dying annually from the disease – mainly lung, stomach and bowel cancer. Unofficial sources say the number of people suffering from cancer is much higher due to shortcomings in the registration process. The rise in most types of cancers is due to poverty, lack of awareness about how to reduce risks, and unhealthy lifestyles, including heavy smoking and drinking, the health ministry has said. Part of the problem is a lack of places where proper testing for cancer can be carried out. “People are not able to get treatment or to be diagnosed for cancer except in Bishkek, Tokmok or Osh,” said Indira Kudaibergenova, Chair of the Oncology Department of the Kyrgyz State Medical Academy in Bishkek. Late or poor diagnosis leads to more deaths from cancer, health officials maintain. Today, the majority of people come with complications from their cancer, which increases the mortality rates,” said Kudaibergenova. The high cost of treatment is also driving up mortality rates from cancer. “The treatment is available but half of the treatment fee, which averages around $1,000, has to be paid by the patient, according to government decrees on medical subsidies, but people do not have enough money even to get themselves to the country’s three cancer centres,” Rahima Jumabaeva, a doctor from the oncology centre in Bishkek, said. “I do not have money to get treatment as my husband already has huge debts. What should I do?” said Irina, a 37-year-old mother of two who has been diagnosed with cervical cancer. Mobile cancer diagnosis units used to operate in rural parts of Kyrgyzstan, running tests every month or so in remote areas. Today there are only resources to run the programme once every six months – meaning many more people go undiagnosed. “Some of our people with cancer usually go to Bishkek, but many do not have money to pay for the trip, and here we cannot help them because they need special treatment,” said Nuria Dotalieva, a family doctor in Orlovka village, 100 km east of the capital, where there are 108 registered cancer cases out of a population of 8,000. According to the World Health Organization (WHO), more than 11 million people are diagnosed with cancer every year. It is estimated that there will be 16 million new cases every year by 2020. Cancer remains a big killer globally, causing 7 million deaths every year - or 12.5 percent of deaths due to disease worldwide. “I really want our government to pay attention to the cancer situation and the cancer service in the country. We have very skilled specialists, but we do not have enough equipment and medicine. If the government helps us, many people will get a chance to live,” Kudaibergenova said.