Ukraine’s first cancer hospice opened on September 5. Few in this country, it appears, know what the word oncology means, but such institutions are well-known in the West, because growing cancer incidence is a problem common to all countries. Doctors say that oncology mirrors the population’s health standard. In Ukraine, the yearly cancer death toll is 160,000, and some 700,000 are under constant medical oversight. This statistic is nothing out of the ordinary. Of late, cancer morbidity in Europe has climbed steadily upward; man is paying for technological progress and increasing transport. Ukraine is no exception, even though its production has been going down over the past decade. And we are actually the world’s leader in cancer deaths. Statistically, 40% of the patients with malignant tumors die every year. Zoya Fedorenko, Candidate of Science in medicine and head of oncological relief and cancer epidemiology at the Oncology and Radiology Research Institute, attributes this primarily to the low standards of public health. People are not accustomed to watching their health and are in no hurry to undergo medical checkups, while in the West everyone is examined practically semiannually. True, it is now fashionable to discuss and write about a healthy lifestyle in Ukraine; there are lots of books and booklets dedicated to the subject on every newsstand and at every bookstore, yet one can seldom find works by physicians and professional researchers. Instead, there is a flood of publications highlighting “miraculous” self-treatment methods for cancer (such as baked onions, shark cartilage, and much-advertised food additives alleged to resolve malignant tumors). Those trying such methods end up incurable. The fact remains that cancer can be cured at an early stage, despite the widespread belief that it is a plague of the twentieth century, like AIDS. The population’s medical ignorance is such that people, on learning the terrifying diagnosis, do not even try do anything about it. They do not sign into oncological clinics, while medical treatment using adequate equipment and trained personnel lower the cancer death rate 2-3 times compared to patients with other diseases.
People’s unwillingness to visit doctors is explained not only by ignorance, but also by harsh realities such as the lack of qualified medical assistance and people’s inherent fear. Moreover, every visit to the doctor means additional expense on medications. Yet the advantage is still there and even more apparent; it is better to part with 150-200 hryvnias a year to have the tests than 15-20,000 on cancer treatment. Needless to say, what we have in Ukraine in terms of health care — visits to the doctor at twenty minutes per patient — does not make possible proper therapeutic examination, while 85% of malignant tumors can be diagnosed during a routine medical checkup. The lack of funds for Ukrainian medicine deals a painful blow to the nation’s health. Lack of modern diagnostic equipment at times prevents doctors from spotting cancer at an early stage, so that even the skill of our physicians leaves such patients practically no chance of survival.
Strangely, given the situation, a national cancer program was worked out only recently, much like those to combat AIDS and tuberculosis. It covers a period of five years and the initial draft required UAH 2 billion from the health care budget. Naturally, this could not be implemented, considering that the budget came to a total of UAH 3 billion. Thus it was cut to UAH 600 million. Basically, the program includes allocations for modern equipment and chemotherapy drugs which are not produced in Ukraine due to the lack of funds and powerful basis. Meanwhile, despite keen awareness of the problem, there are no clauses relating to a public campaign of information and prevention. At least a hospice is open, meaning that the ice has been broken. Everything at the hospice is done in keeping with international standards and paid for by the state, including spacious one-patient rooms with video equipment and shower booths, cozy visiting rooms, and polite personnel (50% more than other oncological institutions). The hospice is based on a ward of the city oncological center. The authors of the project claim that people on staff know from their own experience what losing those near and dear to cancer is all about; that the hospice is not a house of death but one where people can live decently until the end. The district oncological hospital sends it patients with a non-arrested pain syndrome, solitary people with cancer, and those with “complicated living conditions.” Oleksiy Kalachov, acting head of the ward, says that a patient can spend only three weeks at the hospice, because there is no treatment as such, it just seeks to make their lives easier.
Of course, an institution like this means that we are turning our face away from the problems of cancer; it also means, however, that one hospice with just ten beds cannot solve any of these problems in Ukraine. On the contrary, it once again draws public attention to the fact that our health care is a far cry from what people living elsewhere in Europe have.
