Kyrgyzstan: Cancer Treatment Crisis

The use of outdated radiotherapy equipment to treat Kyrgyz cancer patients significantly reduces their chances of survival and puts doctors' health at risk, say staff at the country's only specialist oncology unit.

The National Oncology Centre's equipment, left over from the Soviet period, has long passed its expiry date - but cost, lack of parts and a dearth of qualified technicians all mean it can't be replaced or repaired.

The number of patients with malignant tumours has increased drastically in Kyrgyzstan recently, with 4,248 cases registered in 2002 alone. Most require radiotherapy and the 60 per cent mortality rate among them is largely a result of inadequate medical care, doctors at the centre say.

Head of the radiology unit Rakhat Arylbaev told IWPR that outdated equipment puts both patients' and doctors' health at risk, "We cannot provide good quality treatment using equipment

that is outdated and dangerous for medical personnel. At any moment, the equipment may break down and we will be exposed to radiation."

The unit's radiotherapy machines were acquired in 1980, when Kyrgyzstan was part of the Soviet Union. At the time, they were inspected twice a year and radiology cartridges - necessary to make the equipment work - were regularly replaced to ensure that the machines operated effectively.

Now, though, it is extremely difficult to buy spare parts for the equipment, which went out of production ten years ago, and the prohibitive costs of radiology cartridges means they are never

replaced.

Furthermore, Kyrgyzstan has very few specialists capable of servicing the machinery. Doctors told IWPR that the only specialist available to them is retired now. He works part-time, and says he's tired of trying to make the superannuated equipment work.

The centre has repeatedly lobbied the health ministry with their concerns but, with new machines costing around 6 million US dollars each, the government simply doesn't have the funds to

help.

"The ministry has already sent a series of project proposals to improve the oncology service to all international donors," deputy health minister Guljigit Aliev told IWPR. "We included the

purchase of equipment and the cost of changing their parts in the projects. The equipment is very expensive, changing some parts might cost 400,000 dollars."

There have been no positive responses yet but the health ministry hopes to receive them soon, he said.

Doctor Arylbaev is less optimistic. "We realise the state is not able to help us. So we have appealed to international organisations for help many times," he said. "But unfortunately they only give a sigh when they see the conditions in which we have to treat out patients. There has not been any real help yet."

Many cancer patients pin their last hopes on radiology treatment.

"I know I won't last long without radiology... If I am deprived of it there's not much hope for me, " Miraida Satarova, mother of three children, told IWPR. "I can't afford to undergo treatment in another country where there are conditions for treating cancer patients."

Primary school teacher Evgenia Bashmakova is similarly fearful. "I knew about my illness a long time ago," she said. "I have already undergone surgical treatment and chemotherapy. Our doctors advise all three methods of treatment for effectiveness. I now have to undergo radiotherapy. So I pray to God for the equipment to be repaired - my life depends on it."

A doctor who works at the unit, but who wished to remain anonymous, told IWPR that there would soon be no-one left at the centre prepared to risk their health to treat people using the

outdated equipment.

"It's simply dangerous," he said. "We have been accustomed to sacrificing ourselves since Soviet times. But who will take care of us now? I don't just feel sorry for the patients, I also feel sorry for the doctors who risk being exposed to radiation every day. This problem needs to be solved urgently."

Gulnura Toralieva is an independent journalist in Kyrgyzstan.