Kyrgyz Cancer Treatment Fears

Stanislav Redko receives treatment at Kyrgyzstan’s only hospice for those with terminal cancer.

He also has no medical insurance. And since neither he nor the hospice has the money to pay for his care, for now the doctors there cover the costs themselves.

But even this unsatisfactory arrangement could soon come to an end, with reports in the Kyrgyz media suggesting that the facility, based at the National Centre of Oncology and Radiology, NCOR, in Bishkek, is due to shut down within the month.

Deputy director of the NCOR Tynchybek Borbashev denies this rumour. “There is no order to close the hospice, so it is too early to talk about this,” he told IWPR. “There are normal conditions in this facility, just like in all the other departments at the NCOR, so there is no need to shut it down.”

But when IWPR visited the hospice, staff and patients told a different story.

At the moment the department cares for 25 patients, with a total of 300 passing through each year. Four iron beds and a dirty basin are all that fill each depressing, shabby ward.

“We don’t have anaesthetics, our patients are climbing up the walls in pain and we can’t help them,” said Roza Jyrgalbekova, who runs the hospice. Funding has dried up, she explained, “We can’t afford expensive medicine – our department is in a state of emergency.”

The hospice was founded in 1998 on the initiative of Indira Kudaibergenova – the then director of NCOR – with the support of the Meerim foundation, a charitable body set up by Mairam Akaeva, wife of president Askar Akaev.

“I had the idea to found the hospice after an outrageous incident when a terminal cancer patient from Karakol was taken to hospital, but because he lacked money he couldn’t return home to his relatives and he died on a bench next to the department,” said Kudaibergenova, who is now head of oncology, radiodiagnostics and radiology at the Kyrgyz State Medical Academy.

The hospice has since existed on “modest grants from international organisations”, explained Jyrgalbekova.

“[But] recently [we have] stopped receiving any aid at all,” she said. “No one needs us. Even the management of the NCOR do not support our department. They say our patients don’t need anything anymore. But in fact they need anaesthetics and good care to lessen their suffering.”

Appeals to the heads of the NCOR, the minister for social welfare, the health ministry and international organisations have come to nothing, she said.

And whilst Bakyt Shaimbetov, deputy director for research at the NCOR, insisted to IWPR that conditions at the facility are quite acceptable, staff say they struggle to care for their patients with the limited resources available to them.

“People come here hoping for good-quality care and are quickly disappointed because we can’t provide them with elementary things,” said Murkaras Asylbekova, a senior nurse there. “We try to relieve their last days with kindness. We do all we can – we feed them, we clothe them, we change their bedding and sometimes buy the necessary medicine at our own expense. But that is not what patients expect from our hospice.”

Asylbekova said the hospice is short of even basic medical equipment like thermometers, manganese solution, bandages and cotton wool.

The facility, said Kudaibergenova, also suffers from a lack of staff, “Seriously ill patients need care, attention and people simply to talk to them. The hospice does not just need medicine and equipment, it needs medical personnel, psychologists and even social workers.”

Jyrgalbekova explained that this, too, comes down to a lack of funding, “We have virtually no medical staff. Who would work for 400 som [10 US dollars] a month? And the work really is difficult, both morally and physically.”

But for now, the main worry for patients is what will happen to them if the department closes completely.

Kubanychbek Ryskulov was brought to Bishkek from Talas with cancer of the stomach and liver.

“Our children don’t even want to hear about their father’s illness… it was very difficult for me to look after my husband on my own,” his wife Bakyt Talaigul-kyzy, who helps to care for him, told IWPR with tears in her eyes. “I was very scared when he started having attacks, so my nephew and I gathered all the money we had left and brought him here. If the hospice is closed, I can’t even imagine who will help us and where we will go.”

Nearby, Tolgonai, whose neighbour Boris has cancer of the brain and is unable to move from his bed, laments the poor conditions in the department, “We are already used to sharing a toilet, but it is unbearable to lie in bed alone for days on end. We don’t even have a radio, let alone a television. There isn’t a single telephone in the whole hospice.”

But she too fears the alternative.

“If the hospice is closed and we are deprived even of this, then I will just have to die on the street because I have nowhere to go,” she told IWPR. “I have no home or relatives to look after me in the last moments of my life.”

Gulnura Toralieva is an IWPR correspondent and Marina Bashmanova is an IWPR trainee in Bishkek. IWPR trainee Irina Yugai also contributed to this article.