 |
Jemma
Davtyan works in the cancer ward. |
"I don't want to run into memories,"
says the middle-aged woman, closing her honey-colored
eyes. "From now on the earth has started
spinning around in a different way."
It was a summer day about three years ago when
Marine Galstyan's disease was confirmed. And a
burden heavier than lead fell with the diagnosis
that changed her future.
Relatives with somber faces slowly and heavily
began visiting Galstyan's family for expressing
their unpersuasive words of encouragement.
Marine Galstyan was sick with cancer.
"These days the cancer rate has very high
indices," says director of the health center
Bazikyan. "The reasons are smoking, and improper
diet. But the most important in this case is constant
stress."
According to statistics, more than 75,000 residents
of Armenia have been diagnosed with cancer in
the past 15 years.
"The figures are extremely alarming for
such a small country like ours," says doctor-analyst
Poghos Poghosyan, who has been dealing with the
problems of this field for several decades. "It
seemed that morbidity tendencies should have decreased,
however, just the opposite is taking place."
Bazikyan says that every year more than 5,000
new cancer cases are registered in the republic.
And, unlike Soviet times, when medical examination
was compulsory and medical services were free
of charge, these days the problem is complicated
because most cancer patients go to a doctor only
after the disease has progressed beyond help.
"Patients apply to doctors very late, mainly
at the third or fourth stage," Bazikyan says.
"In that case effectiveness of treatment
is extremely low. In spite of that, however, we
have patients who (went in remission) and lived
five or more years."
According to law, treatment of cancer and care
for cancer patients must be carried out free of
charge in the republic. Immediately after making
diagnosis and confirming the disease, cancer patients
are automatically passed under wardship of the
state.
Representative of Healthcare Agency on the Government
of RA Karlen Antonyan assures that only last year
the state budget allotted more than 300 million
drams (about $515,000) for providing medical treatment
for cancer patients.
 |
Dr.Gagik
Bazikyan blames strees as a cause of cancer. |
"Moreover, according to the law, patients
also have a right to get medicines for free and
undertake chemotherapy and physiotherapy free
of charge," says Antonyan. "These days
the government is consistent in this issue and
unlike previous years the situation is much better."
Bazikyan doesn't deny that unlike the past few
years, today's financial situation in this field
is better. He says, however, that government still
does not effectively pay doctors and provide patients
with latest medicines.
"At average the government pays 70,000 drams
(about $120) for one course of treatment of each
patient sick with cancer and, of course, it is
not enough at all for covering all expenses,"
says Bazikyan. "However, we hope that in
the nearest future the decision on increasing
an amount of allotting money will be adopted and
that decision will also have influence on improving
the level of health services."
Marine Galstyan, who still tries to be cheerful
and receive people with a smile and treat everyone
well despite her hard state, says that a great
part of her problems is connected with inefficient
treatment in hospital and the indifference of
medical personnel.
"Maybe according to the law we must be treated
free of charge, however, today nothing is free
for us, only with small exceptions," she
says. "Everything has its firm prices including
injections and care."
Galstyan says examinations for systemic conditions
related to her cancer cost at least $15. Laser
therapy costs $50. She says once she was only
able to pay $30 and received several burns during
the treatment.
"There is nothing like that in our hospital,"
assures Sergey Seinyan, deputy director of Fanarjyan
Oncological Research Center where most cancer
patients are treated. "Today a doctor's salary
is 12,000-14,000 drams (about $20-24), which isn't
a worthy price for specialists at all. However,
there are no delays and the salaries are paid
always on time. And patients who have malignant
swelling are treated free of charge."
But patients and relatives say there is a great
difference between the reality of medial officials
and of patients.
"For three years I haven't seen the power
of state-guaranteed order," says Amalia Hambardzumyan.
"We were paying for using elevators and rooms,
we paid to personnel starting from nurses to those
who keep syringes, as there is no other way. If
you want to get medical treatment you have to
do that."
Hambardzumyan says that many patients are told
to leave if they can't pay.
Antonyan says that even though the state finances
care for cancer patients, the habit of unofficial
payments is ingrained in the medical profession
and its clients.
"Salaries are paid on time," Antonyan
assures. "Problems with supply of medicines
are resolved as well. However, unfortunately doctors
still tell patients that they don't get salaries
and have other problems for taking money from
them. These days we have a real problem of struggling
against that evil. It's not clear how we going
to do that.
Patients are concerned how current conditions
might impact their health care.
"I don't know what doctors think when they
express such a cynical treatment towards serious
patients like us," says one of the patients,
who was afraid to give his name. "Aren't
they ashamed?"
Another patient says that before one regular
examination one new young nurse whispered,"You
have a right not to pay. Why do you do that?"
 |
Cancer
hospital windows look out onto a graveyard. |
"Sometimes, when I take my mother to hospital
for getting necessary treatments, I hardly can
restrain my anger and not go mad," says Anahit,
elder daughter of Marine Galstyan. "Patients
who are pale, weak and light, who need not only
medicines but serious care and kind words as well,
have to sit from dawn to dusk in cold corridors
and listen to doctor's laughter and mirth greeting
from behind closed doors waiting when they will
deign to receive them. And as a result, if you
have no possibilities to pay individually, you
can leave the place without getting any attention
from them. Patients stay silent as they know that
their life and health totally depends on them,
and only God knows where did conscience and amiability
disappear."
Seinyan says accusations that doctors are taking
"under the table" money is just a false
impression.
"As a token of gratitude patients sometimes
give presents to doctors," he says. "What
do they want, that even such things not exist?"
Psychologist Narine Tovmasyan assures that cancer
patients also need psychological assistance.
"Of course, the inhumane conduct of some
doctors has a negative influence on patients,"
she says. "All those factors have a negative
influence on patients' health and process of their
treatment."
Marine Galstyan, for whom cold and inhospitable
hallways have become too familiar and a wig is
necessary to cover the effects of chemotherapy,
says that three years after learning she had breast
cancer, there are days when she wants to die.
"I ask myself 'Why?', they are doctors,
aren't they?. But instead of encouraging, helping
and invigorating, they depress and humble you
and everything fades away," says Marine.
"During three years I managed to pay and
get treatment only for one year in total and,
as a result I found myself in worse health condition.
The saddest thing is the hurt that I have in my
heart and soul."
|