World Cancer Day 2019
Each year the UICC marks World Cancer Day on February 4th with a global awareness raising campaign. They highlight key issues, facts and publish preventative measures on cancer control around the world. To participate this year Krebsallianz wants to focus on two key issues presented by UICC namely the financial burden of cancer control and inequity of cancer services.
Over the past twelve years Krebsallianz has played witness to the financial burden of cancer on patients and their families. Across the globe costly cancer treatment bankrupt patients owing to the high costs of chemotherapy, radiotherapy and other treatments. In our partner countries we help patients and families who have to cover the entire cost of treatment themselves. Another expense for many patients is that services aren’t always available in less densely populated non-urban areas resulting in patients having to travel far for treatment. Those with little to no access travel to neighbouring countries to seek solutions which adds extra costs. That’s why we support initiatives that aim to make access to cancer services equal to all and support the view that access should be needs based and not on the ability to pay.
Considering that 70% of cancer deaths occur in low- and middle-income countries we aim to play a part in cancer control where it is most needed. Considering that “Less than 30% of low-income countries have cancer treatment services available” Krebsallianz continues its aid programs in low-income countries to bridge the gap in care.
The financial burden of treatment in Moldova
Cristina and Nicolai live in the capital city, Chisinau. Their son, Daniel, has been battling leukaemia since 2015. Moldovan health insurance only guarantees patients a bed in a hospital. All expenses have to be covered by the patient and their family, this includes food, bedding, and most importantly, medicines. Nicolai works for the state bakery on a modest wage. Before Daniel’s diagnosis Cristina worked as a children’s entertainer but she had to quit to take care of Daniel. After Daniel’s diagnosis many other parents on the ward helped them out by giving them chemotherapy that they no longer needed. Once his first eight rounds of therapy were over Daniel’s doctors prescribed him medication to maintain a state of remission. Cristina was in despair because she saw no way that she could afford the medication so she just had to hope that the chemotherapy had worked.
Now two years on and Daniel has just finished another round of eight chemotherapy treatments. In the meantime, Cristina’s mother passed away and left the family with 9,000 € worth of debt for 20 years’ worth of unpaid utility bills. On top of Daniel’s treatment, the family must pay back their mother’s debts soon because the landlord is trying to evict the family from their Chisinau apartment for late rent payments. Cristina tells us she cannot imagine anything worse than having to care for Daniel when they have nowhere to live. Cristina and Nicolai’s situation is critical. Their monthly income is around 600€ which goes towards their debts and food for the family. Krebsallianz and our local partners in Moldova, Coram Deo, stepped in to help pay for Daniel’s treatment. We continue to support the family and work with Coram Deo to help others in similar dire situations.
Equity in access to cancer services
Life-saving cancer diagnosis and treatment should be equal for all – no matter who you are, your level of education, level of income or where you live in the world. Oftentimes, there exists an unequal allocation of cancer services which tend to concentrate in urban areas which can result in reduced access to specialist services and healthcare professionals as you move away from the larger cities. No matter where patients live, cancer treatments should equally accessible. In spite of education and income levels treatment should be accessible to all.
One of our partners who has observed disparities in care over the past decade in Nepal is Dirghajeevi Voluntary Group (DVG). Samir Shrestha, the founder of the group, began volunteering over 10 years ago at the Chitwan Cancer Hospital before moving to Kathmandu to study social work. From a small group of social worker volunteers, DVG has grown in its operations and in 2018 opened a day care centre in Lolitpur, Kathmandu. On top of psycho-social care, Samir and his team provide families and their children suffering from cancer with awareness raising campaigns, trips and awareness raising events e.g. a mother’s evening. The DVG aims to provide childhood cancer patients and their families with quality psycho-social care and a tight-knit community.
The community that DVG is building provides support for many underprivileged families in the wider Kathmandu area. Because Kathmandu is home to one of the two public cancer hospitals in Nepal many parents come from far when their child is diagnosed with cancer. This means parents must leave their home and often their source of income and settle in Kathmandu. The DVG group aim to raise funds this year for a bus service to and from their day care centre so that parents still have the chance to work while their child is attending day care.
This world cancer day Krebsallianz supports the UICC WCD message that “Where you live shouldn’t define if you live.”
Geography places a crucial role in accessibility of treatment in Nepal. With only one public cancer hospital in Chitwan and a children’s cancer ward in Kanti Hospital in Kathmandu, there is a lack of treatment which cannot cover the needs of all cancer patients across the country. What’s more, at the public hospitals, facilities are stretched to their limits. Family members have to be there with their child 24 hours a day and provide food for their children. Many parents sleep in the hallways of the hospital because they have nowhere else to stay.
The DVG group aims to set up further day care centres and hopes to fund outhouses for families who cannot afford accommodation while caring for their child in a hospital. In March of this year Samir intends to do a 1,000km cycle ride to spread the vision of the DVG and fundraise for their future projects.
In support of World Cancer Day 2019 Krebsallianz will continue to support initiatives that relieve the financial burden of cancer treatment as well as organisations who aim to reduce the equity gap in cancer care.