LEUKAEMIA IS NOT A DEATH SENTENCE

Of late there have been more and more appeals on the social networks to raise money for expensive treatments for children suffering from leukaemia. More often than not, this treatment has to be undertaken abroad. Why can't our own health service provide children suffering from cancer with this treatment?

But don't give up yet

Three-year-old Lyaman was a lively, active child like other children of her age. But in September 2007 she fell ill. Her mother, Dursun xanim [mode of address] tells us what happened: "We tried every single hospital in Baku. They were unable to say exactly what was wrong with her, and owing to the unsuitable treatment she lost the feeling in her arm and leg. Finally, we went to the republican children's hospital, where they diagnosed a terrible illness, acute leukaemia." Naturally this diagnosis came as a terrible blow to the mother who had brought the child up on her own. As she had no other alternative, the mother sold all the valuables and gold she had and paid for a blood transfusion and costly medical preparations. The girl's mother says that leukaemia is a very lengthy illness. And the medicaments needed for chemotherapy are very expensive. Laman also has quite an unhealthy sister who has serious problems with her eyesight. In spite of all the difficulties and problems Dursun xanim did not give up and managed to get her daughter completely cured. Now Laman is well again. But how many children in our country who are diagnosed with leukaemia, manage to get out of this quagmire successfully.
Throughout the world cancer treatment is being carried out under the slogan "Cancer is not a death sentence". Cancer treatments in Azerbaijan, especially the treatment of leukaemia, still leave much to be desired. Why are our fellow-countrymen resorting to treatment abroad? In an interview with Regionplus an expert in treating cancer patients, Mehriban Bagirova, who has been treating children suffering from leukaemia for three years now and does herself have seven years experience in leukaemia, has noted that the main problem is the absence of the right methods of establishing a diagnosis in the laboratory and the impossibility of carrying out bone marrow transplant operations.
Although the "cancer of the blood" or "leukaemia" diagnosis always "knocks one down with a feather", it can be this type of cancer stimulated by certain factors, first and foremost by stress. Most of the children who get leukaemia have been subjected to a great deal of stress, which takes a terrible toll on their feeble organisms. Viruses and poor immunity can also give rise to the pathological division of cells. 
Leukaemia is a genetic disease, but not a hereditary one. So, if one child in the family suffers from it, this does not mean that there is a high risk for the remaining members of the family. For the overwhelming majority of the sick children's kith and kin the fact that the medicines needed are so expensive is usually the main problem. Owing to the seriousness of this problem a state programme of measures has been adopted in Azerbaijan to provide patients suffering from cancer with anti-cancer drugs. This means that any treatment involving chemotherapy and expensive drugs would be provided absolutely free of charge.
Mehriban xanim believes that the measures relating to leukaemia patients should also include preventive measures and information for the population about the leukaemia and its main symptoms, so that it can be detected at an early stage, which would naturally influence leukaemia treatment and its outcome.
According to the statistics 31 out of 262 children suffering from leukaemia have died of the disease while the rest are undergoing treatment. This figure may not be so high, but this is 15 per cent of the overall number of children, not to mention the irreplaceable loss and the terrible blow to the parents. On average, according to the statistics, 13 people out of every 100,000 are suffering from leukaemia.

There is some progress 

One of the main problems in treating and monitoring sick children is the lack of a register of records for them. Moreover, a system of monitoring patients and keeping records of them would, for example, in the case of tuberculosis, allow the spread of the illness to be monitored and allow the course of treatment and its outcome, as well as death statistics, to be recorded. 

Parents go abroad for treatment because they are worried about their children's health, but healthcare abroad is very expensive. This is why there are constant appeals for funds on the social networks, to which some townspeople respond. So, a bone marrow transplant, which is the only treatment for myeloblastic leukaemia, costs 170,000-200,000 euros in neighbouring Turkey and 300,000-350,000 euros in Germany. Chemotherapy treatment for myeloblastic leukaemia, which is also carried out abroad, also costs several thousand euros.
In Azerbaijan the treatment of this disease is further complicated by the lack of complex reagents and the costly equipment needed to establish the correct diagnosis of leukaemia, in particular, phenotypic equipment, which helps to detect the stage that the disease has reached and how far the symptoms have developed at the current time. At the present time the Institute of Physiology and Blood Transfusions is being upgraded, expensive equipment is being brought in and the staff and doctors have undergone a three-month course of training to use the equipment in the Belarusian capital Minsk. Besides this, our doctors recently carried out a bone marrow transplant at the Central Clinical Hospital. It will be some time before we know how successful this operation has been, since the patient has to undergo a difficult period of convalescence.

In an interview with Regionplus the head doctor at the Institute of Physiology and Blood Transfusions, candidate of medical sciences Isgandar Bagirli noted with regret that they could not stop people from wanting to go abroad for treatment, although there is partly because of a distrust in the ability of our doctors. "Although it is a mistake to think that there are no good doctors in Azerbaijan, Dr Bagirli notes, " and what is more the treatment here would be much cheaper." Mehriban xanim confirms this: "On average the treatment for leukaemia takes three years. Every month approximately 400-500 manats are needed for medicines. All in all, a course of treatment costs less here than the same treatment abroad."
The situation is particularly difficult for sick children in the provinces. Taking the above-mentioned statistics into account, it can be calculated that there not that many children in the provinces, so the setting up of physiology and blood transfusion departments is deemed unnecessary. Thus, children suffering from leukaemia in the provinces have to come to Baku for treatment. When this happens, the parents have to shoulder the excessive burden of not only the treatment, but also the need to pay for permanent accommodation in Baku. Leukaemia is a disease that demands exacting standards of care, because the child's organism is particularly weakened by the chemotherapy and complex procedures, so that he or she requires a sterile environment in order to avoid infections. The treatment that the patient receives at an out-patients' clinic for the first 43-45 days requires constant monitoring, which is rather difficult for people living in the provinces. Like clinics abroad, lodgings are usually built next to the hospitals, providing accommodation for the patient's relatives. In Ukraine, for example, the patient's relatives live in the lodgings at the state's expense. If this practice were introduced in Azerbaijan, the diagnosis of leukaemia would cease to be a sentence against which there is no appeal, for children from the provinces as well. 
Alternative therapies like working with psychologists, art-therapy and entertaining activities also play an important part in the treatment of leukaemia. But unfortunately the clinics do not even have a children's room or a team of child psychologists or pedagogues. Mehriban xanim has told us that she was not permitted to take clowns into the hospital, because outsiders might well bring infections into the premises.
It is impossible to get rid of cancer altogether. It is impossible to prevent it, but we can be on the look-out for it and not close our eyes to those threatening symptoms. We have the power to tell people about it, to treat it and try to save yet another little, but precious life.