Hanging onto the Edge of Life…

Cancer Patients Can’t Afford Medical Treatment

Nana Pazhava, Zugdidi

As a result of amendments to the healthcare system, so-called reforms, those suffering sick cancer are facing death. The formerly existing system of medical assistance for such patients envisaged that the government would offset 70% of the cost of treatment, which has now been canceled. Only several concrete programs will be funded by the state after the amendments planned in the Ministry of Healthcare. Co-financing program will still work for the patients over 60; as for younger people, they will not be able to involve this category and they will have to pay their treatment. According to official statistics, the number of such patients is just over one in three, 35 % of all Georgians.

Irma Ghurtskaia suffers from cancer and lives in the village of Rukhi in the Zugdidi district. Doctors diagnosed that she had breast cancer back in 2005 and she was operated on in the same year. However, in spite of the operation, the ill woman was only able to afford to take part of the program of chemotherapy, which was the prescribed program that that would have allowed for her full recovery. In 2008 tomography examination showed that Irma Ghurtskaia has multiple metastases in her brain.

The young woman is not sure that she will not be cured. However, she now complaints that expensive medicine cannot help her, as it may be too late.

Irma Ghurtskaia: “I felt bad following chemotherapy and on top of that my health conditions worsened because I fell on the stairs… since then I could not get up and I am now bed ridden. The medicines injured my stomach and now I have started having epileptic attacks. I have terrible pains; I cannot calm down until I am not injected “Diazepam”. I will not be able to take chemotherapy treatments anymore. However, neither of these medicines has helped me.”

Doctor Nato Mosia states that her patient is in poorest conditions. However, the patient does not agree to have a laser operation, be treated with chemical or undergo hormone therapy as yet.

Nato Mosia: “Cancer on her left breast, metastases in her brain, second clinical classification -this is the diagnose of the patient. However, Irma Ghurtskaia has not visited my clinic for a long time. She has not taken the proper medical treatment. She is just treating the symptoms and not the disease itself. She is currently be treated by a doctor who is a specialist of neuropathology.

The family of Irma Ghurtskaia is rather concerned about her health conditions as well as neuro –pathologists. However, Irma’s parents cannot afford to buy the necessary medicines. In addition, problems are further complicated since the Ghurtskaia family is neither registered as socially excluded nor it has access to any medical insurance. Their plight is a result of the reforms in the health care system. Now she is unable to receive any kind of assistance from the government. Her family is left to somehow find a way to buy expensive medicine on their own.

Irma Ghurtskaia, patient: “My parents paid 715 GEL for my medical surgery. Another part was paid by the government. I paid for chemotherapy. I was told in the Oncology Center that if I presented documentation I would return the money I paid for my surgery. However, the local government does not help me. My parents have to pay 30 GEL for one visit to a neuro-pathologist, and there too are all the problems in being able to afford medicines.”

Cancer specialists say that very few patients who suffer from cancer will be able to continue treatment and that there are approximately 2,500 registered patients who suffer from this disease in the Samegrelo-Zemo Svaneti region. Insurance companies bought out the state program that provided their treatment. Now insurance companies are suppose to be providing for those suffering from cancer. However, most such patients are uninsured and insurance companies don’t sell health policies to sick people as a rule.

Nona Pipia, director of Oncology Center Regional Branch is concerned with the fact that insurance companies even refuse to fund the cost diagnosing those who have cancer as out-patients.

Nona Pipia, Oncologist: “Diagnosing out patients is funded from Primary Healthcare Program. The problem is that it is impossible to diagnose cancer by a test made in outpatient clinic. Moreover, the diagnosing cancer is not funded from the Primary Healthcare Program, as this program only covers primary healthcare expenses. How is it possible for me as a breast doctor to operate on a patient when I do not have access to cytological test results?! They are called socially excluded because they can not pay money and that is why cytological analysis must also be funded by the state.”

The director of Oncology Center Regional Branch speaks about the restrictions the insurance companies have imposed on funding chemotherapy.

Nona Pipia, oncologist: “One socially excluded patient from Poti had a mammary gland in the demolition phase. We treated her with chemotherapy and used expensive medicines as part of the process. The treatment itself cost 1,500 GEL and as result her health condition improved greatly. The next chemotherapy was conducted under limited budget of 500 GEL, as the insurance company did not allocate more coverage for this patient. We gave her cheaper medicines that could be afforded with the mere 500 GEL. I hope the patient’s conditions will not deteriorate. Otherwise, I will simply have to tell her family that they must find money for her treatment.”

Oncologists of Samegrelo-Zemo Svaneti Region face yet another problem. The Oncology Center Regional Branch does not have its own office. The Branch is temporarily placed in a former maternity hospital owned by Zugdidi Central Hospital. It is a 4-storied building and houses the Public Healthcare Department, Emergency Unit. Now IDPs are settled in building too. There is no mammography apparatus in Samegrelo- Zemo Svaneti Region. Such an apparatus is essential in order to properly examine mammary gland cancers, which has been demonstrated to be the most common disease faced in this region. The Ministry of Healthcare of Georgia has promised local doctors that problems associated with cancer treatment will be resolved in 2009.