Many Papua New Guineans don’t know about the cost of cancer treatment until one member gets sick.
The diagnosis alone is problematic. In rural districts and outstations, many community health workers are not equipped with the awareness which would trigger a referral to a major hospital.
But that is just one problem.
Take for example, a place like Baindoang in the Nawaeb District of Morobe province. It is only accessible by plane. A young mum with the early stages of cervical or breast cancer will not be able to get the proper diagnosis until the disease is in its late stages.
If the community decides to send her to Lae, they will have to raise at least K2000 for airfares and treatment in Lae City. It is big money for a village community. There is no certainty of the time it will take for them to remain in the city. I’ve come across wives separated from their husbands and children for weeks and months.
Many give up and die lonely deaths surrounded by strangers who become family.
Many are left with no means of talking with their families either because of the lack of mobile network coverage or no means of buying a plane ticket back home.
There are unclaimed bodies at the Angau hospital morgue. Some came from remote outstations.
For urban families, access to health care is relatively better. But still not good enough. One person sent me a message on Facebook telling me how his sister died while waiting for the test results of tissue samples that had been sent to Port Moresby.
When the tests are positive for cancer and the radiotherapy option is suggested, the families will have to start rising upwards of K150,000 if the treatment venue is in the Philippines or Australia. It takes a lot of families and whole communities to raise that money.
If your family has a good number of siblings, aunts and uncles who are in formal employment, the burden is relatively easier. If not, a public appeal is put out. Old school friends, colleagues or sports club team mates come to help raise funds.
The money is used for airfares, passports, accommodation, food and treatment.
Today, I learned that a CT scan used for cancer detection costs an average of K4000 at private hospitals for one session. How many families can pay K4000 without even remotely thinking of the cost burden?
In Papua New Guinea, palliative care – the process of making a cancer sufferer comfortable in his or her last days through medication – is almost nonexistent in the public health system.
Traditionally, that part of care is done by the family. But with the breakdown of family structures, care is heavily reliant on the family’s financial resources.
Also today, I learned that a pack of four vials of morphine costs K100. For a cancer patient the family needs to spend K100 a day to ensure some level of comfort for their loved one. That’s K700 a week, K1400 a fortnight and K2800 a month.
I’ve been told more than once by health authorities not to ‘sensationalize’ the cancer treatment problem because it affects a relatively small number of people compare to HIV, TB, typhoid and malaria.
My point has always been that cancer is not only a health burden, it is an economic and financial burden that affects much more than just the patient.
We need to look honestly at the realities that exist.