It has happened more than once that Yakut residents who require high-tech medical care (HTMC) have to independently seek salvation in other cities. One precedent, in particular, was described “Torboznoe radio”: a Lenka woman who did not receive adequate treatment in her hometown was helped by Novosibirsk doctors.
Today we will talk about patients with liver pathology. In October of this year, the head of the department of drug treatment of the National Medical Research Center of Oncology named after. Blokhina Valery Breder told “Gazeta.ru”that liver cancer in Russia is most common in three regions – Chukotka, Yakutia and Buryatia. “The peoples inhabiting these areas have evolutionarily turned out to be very sensitive to viral hepatitis. Hepatitis B has spread especially there. They are actually more likely to get cancer,” – he explained. By words Head physician of the Yakut Oncology Center Tatiana Nikolaevaliver cancer ranks third in prevalence in the republic.
Cancer is preceded by cirrhosis. In Yakutia, registered at a dispensary with a diagnosis of “decompensated cirrhosis of the liver with previous bleeding” consist around 500 people, 30 percent of them need an organ transplant.
In 2013, the newspaper “Yakutia” wrote that our surgeons were the first on this side of the Urals to master the transplantation of a liver fragment from a related donor – an operation of the highest category of complexity. It was noted that Republican Hospital N1 – National Center for Medicine of RS(Y) is equipped with the same medical equipment that is used in well-known Moscow clinics, and has been engaged in organ transplantation for more than ten years. In August 2016 in Yakutsk Was held Cadaver liver transplantation.
However, since then there has been no particular progress in this direction, as far as one can judge. You come to this conclusion when you learn the stories of Yakut people suffering from serious liver pathologies, who sometimes have to literally fight for their salvation. There are not so many quotas allocated for transplantation in Moscow clinics; you may not even have to wait for your turn for a transplant. And if it’s your turn, you need to arrive at the hospital immediately, which, you see, is problematic. One Yakut resident lived in Moscow for a year and a half in rented apartments, but waited his turn, they say in the “liverworts” chat group.
This chat group is a real “online hospital” where patients exchange information, what to do if there is an emergency, who to contact if their condition worsens, etc. The chat group is the salvation of the sick. They read with interest the information of those who have already undergone a complex operation, and cordially congratulate them on the beginning of a new life. Here, patients learn about other clinics where they can help them, independently contact doctors at clinics in other regions and get the opportunity to save their lives and the lives of their loved ones if they did not get help at home.
Here is one of the real stories told by a resident of Yakutsk (copies of medical documents are available). A woman who is a little over fifty years old, a working pensioner, has been registered as a patient with viral hepatitis for more than 20 years, in 2019 she was given a terrible diagnosis of “cirrhosis of the liver.” She was supposed to undergo a liver transplant in Moscow; her close relative was ready to become a donor, but, unfortunately, she was refused due to medical conditions.
The patient says that if she had waited in line for surgery at a Moscow clinic, she would hardly have lived to see it. And then she turned to the Novosibirsk Regional Hospital, whose specialists in February 2023 transplanted her on a paid basis, for 1.8 mln rubles, cadaver liver. Low bow to Novosibirsk doctors, she says.
After completing the rehabilitation period and returning home, the Yakut woman turned to the regional Ministry of Health with a request to pay the costs of the operation. And she was refused, while the officials referred to the fact that the referral of the patient by the Yakut Republican Clinical Hospital (YARCH) to the Novosibirsk Regional Hospital did not have the signature of the chief transplantologist of the republic Albert Vasilieva. And he, according to the patient, refused to sign, since she intended (forcedly, we note) to receive in Novosibirsk paid medical service (forced intention, we note).
Upon arrival, Vasiliev, to whom the patient again turned after the refusal of the Ministry of Health, imposed such a visa on an extract from the protocol of the medical commission of the infectious diseases department of the Yaroslavl Regional Clinical Hospital dated January 30, 2023 (the conclusion indicated a recommendation due to the futility of conservative therapy, taking into account the stage of the disease, the presence of life-threatening complications , to carry out liver transplantation from a cadaver donor for emergency indications at the State Budgetary Healthcare Institution NSO “GNOK KB” in Novosibirsk; it was also indicated that the patient needs to be accompanied): “The patient was not referred according to the quota of the Ministry of Health of the Republic of Sakha (Yakutia). VHI only pays for travel as a disabled person.”
The majority of our population, let us remind you, are poor people. To pay for the operation, the patient I told about, she and her relatives had to take out loans, which would take several years to repay.
“An organ transplant is not a cosmetic surgery on a whim. Such an attitude towards a patient is a slap in the face, because the patient has been paying taxes for decades, including compulsory health insurance. Paradox in Yakut style, modern medicine service,” – they are indignant in the chat group of patients.
Participants in the spontaneous “online hospital” are asking a fair question: why don’t the republican authorities develop a special program with funding from the state budget, under which VTMP would be provided in Yakutsk by doctors from central medical clinics as part of business trips? Would local doctors gain experience from them? Why have the good initiatives in this direction, mentioned at the beginning of this article, stalled?
Olga SERGEEVA.
Photo from the website of the Ministry of Health of the Republic of Sakha (Yakutia).
2023-11-14 11:39:46
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