Despite Putin's promises to direct almost trillion to the fight against oncology, even simple painkillers are not enough in the province

More than 960 billion rubles are planned to be spent on the federal project to combat oncological diseases. President Vladimir Putin spoke about the imminent launch of a special program in the message to the Federal Assembly last year and reminded the current one in February. The head of state has devoted a lot of performances to the topic of cancer treatment. In 2017, the president during a direct line listened to the story of 24-year-old Daria Starikova from the city of Apatita (Murmansk Region), who, due to the closure of the hospital, was diagnosed too late. The patient was transported by the Ministry of Emergencies by the EMERCOM to Moscow at the Herzen Research Institute, the treatment allowed the young mother to live another year.

There will not be enough for all sore sides of the Ministry of Emergencies. The car registraist of the Ministry of Health now has 3.7 million people. According to the VTsIOM survey, 75% of residents of the country came across oncological diseases with oncological diseases or in loved ones. More than half of them consider the treatment inaccessible. People continue to suffer from the absence of painkillers. Last year, about a thousand such complaints were received on the hotline of Roszdravnadzor - every day, seven days a week and holidays, three messages about unbearable pain, which has nothing to stop.

Medicine in the terminal stage

Problems with painkillers for oncological patients arose in the Krasnoarmeysky district of the Saratov region. According to patients of patients, interruptions began in March. There is not a single pharmacy in the area that has the right to work with narcotic analgesics.

The Red Army Polyclinic is a three -story building on the very edge of the city. Further - a wasteland, fragments of reinforced concrete structures are whitewashed in burdocks. As old -timers say, a new building was built here, four floors were raised. But in healthcare, optimization began, and the almost finished building was dismantled into bricks.

“Surgeon, orthopedist, lor, neurologist, dermatologist, you see, there is no oncologist,” -

A resident of Krasnoarmeysk Elena Pykksha leads a hand on a schedule on a blue shield. The girl’s father Alexander Sergeyev has been sick for the second year, the disease in the fourth stage. Alexander Ilyich comes to the district therapist for prescriptions for drugs prescribed in the regional oncology center.

The therapist takes on the second floor. On the battered doors of the cabinets, yellow signs with duplicate inscriptions with Braille font are distinguished - it was not for nothing that Krasnoarmeisk participated in the project to ensure an accessible environment for the disabled. Below are the sheets with names of patients recorded today. In the list - at least 30 people, 12 minutes of admission for each. The line stretched throughout the corridor.

The room is stuffy. Outside the window is plus thirty, but wooden frames are tightly closed and covered with paper stripes from the winter. I ask where the cooler is here. Elena snorts with laughter and shakes her head negatively.

- You can sign up for the therapist by phone. On which day they will be appointed - it is like luck, they can be for tomorrow, or they can - in a week. Sign up, for example, at 10.30. You approach the office, ask who is the last. It turns out that those who are appointed at 8.00 have not passed. It happens that you will get stuck up to three hours. If there are not enough chairs, then you are standing, ”Alexander Ilyich shrugs his hands.

“It is likely that after waiting for many hours, you will leave here with nothing,” says Elena. - Interruptions with drugs began in March. The recipe may not be prescribed at all, because there are no drugs in the pharmacy. Or prescribe, but while the medicine comes, the prescription will be expired, and you need to follow the new one.

Diagnostics at your own expense

Sergeyev talks about the details of treatment in detail. But actually he wants to talk about something else. “Did you see a dog booth in the yard? Power!" - The owner proudly demonstrates a carved house with a decorative second floor, balcony and even television antenna.

All on the courtyard - from the fence to the bath - Alexander Ilyich made it with his own hands. “My wife and I were given the house from the poultry farm, I worked there as a welder and a plumber. Four walls, naked box. I spent gas, cooked heating. The children went, he was building up each room. I have three girls and a reception boy. Moreover, the boy lived from the village while he studied - where there are four, there is not the fifth of the fifth. ”

The poultry farm closed in the 1990s, "there were eleven birds-almost nothing left, even the roof failed." The same thing happened with the rest of the district center. “There were 5-6 thousand bulls in the pidecomas forces - not a single koshara now. The pigkomplex was 50 thousand heads, technology - science fiction, there is a pig, before allowing it, they washed with shampoo. There is nothing left either. Well, the weaving factory is the same, ”Alexander Ilyich waves his hand.

The welder went to earn money to the north, built a plant for the destruction of chemical weapons in the mountain, after leaving the “harmful” pension for ten years he worked in Moscow, then a butcher in the Red Army cafe.

A few years ago, Alexander Ilyich fell ill with his back. “Mom will make one injection to him, the other seems to be easier. We could not even think that it was so serious, ”Elena recalls. “And then I couldn’t drive the car: it began to double in my eyes,” the father adds. Relatives, fearing a stroke, urgently paid for the reception of a neurologist in a commercial clinic. The doctor advised to be immediately examined in Saratov.

“There is nothing but an x ​​-ray in Krasnoarmeysk,” Alexander Ilyich shrugs. An ultrasound in Saratov cost 800 rubles. MRI - 3 thousand (in a free line I would have to wait at least a month). Analysis for prostatic specific antigen - 1100 rubles. It can be made according to the compulsory medical insurance policy, but, as explained in the district clinic, reagents are very expensive, so the analysis is carried out when a “wholesale” group of patients is recruited. Consultation of an oncologist in a commercial clinic - 2 thousand rubles. Osteoscintigraphy (a study showing the spread of metastasis in bone tissue) is 7 thousand. Osteoscintigraphy prescribed a consultation in the regional oncology dispensary, but, as it turned out, this type of diagnosis is not included in the compulsory medical insurance.

In the first 7 months of illness, the family spent about 200 thousand rubles. For Krasnoarmeysk - a giant amount. Sergeyev’s pension - 15 thousand. Wife and children took loans. The youngest daughter of Alexander Ilyich, on student exchange, left for Germany and found a job there. Thanks to her help, it is possible to buy expensive drugs.

You weren't here here

For appointments, Elena turned to the chief freelance specialist in urology of the regional Ministry of Health. “He advises for free, people go in crowds. I arrived at 6.30 and was already the twentieth. ” The doctor recommended that Alexander Ilyich is a firmagon, a modern Danish production preparation that restrains the growth of the tumor.

The first shock dose of the company cost 27 thousand rubles. Subsequent injections in supporting dosage cost from 8 thousand rubles. They need to be done every three months for 3-5 years. The company is not sold in Saratov pharmacies, Elena went to Moscow for him.

The current substance of the drug Degarelix, by order of the Government of the Russian Federation since 2018, is included in the list of vital and most important drugs (GNLP). Commenting on the expansion of the list, the deputy chairman Olga Golodets said that new drugs should “provide a fundamentally different high -quality level of the healthcare system”. “But we must ensure that these drugs are available,” said Prime Minister Dmitry Medvedev.

- In the oncology dispensary, they told me that the Saratov region did not work with Degarselix. I wrote to the Saratov State Duma deputy Olga Batalina. She asked: how is it, because the president promised the program for the treatment of cancer, where is it? My letter was sent back to Saratov, to the oncode dispensary, ”says Elena.

Once every six months, the patient should undergo an oncoconilium, evaluating the results and clarifying the tactics of treatment. You need to sign up in advance on a certain day and hour. But, as in the case of a local therapist, in reality the patient expects a many -hour queue. “It’s difficult to be there. Who cries, who swears is difficult to see, ”says Elena. - We went through a consultation in the winter. We waited in line, went to the doctor. And he tells us: your registration is not in Saratov, but in the region, which means that you had to go to the corps that is in Engels! I’m calling to Engels, they reply that there is an hour left before the end of the reception, sign up the next day. That is, I must once again carry a sick person 100 kilometers in one direction and the same in the other, and we have a very “funny” road, sometimes KAMAZs are lying on the sidelines! ”

Oncoconilium appointed Sergeyev the antitumor drug Zodex in combination with bicalutomide necessary to suppress side effects.

Only for Facebook users?

The municipal pharmacy in the district center was closed several years ago. Preferential recipes were made in one of the commercial pharmacies. In early spring, free drugs became rare, and then the pharmacy was completely closed.

“Bikalutomide should be taken every day, but it is impossible to get it according to a preferential recipe, only by commercial - from 1,500 rubles per package,” says the patient’s wife Taisiya Petrovna. - Zolenronic acid ( a drug that promotes the restoration of bone tissue. - N.A. ) according to free recipes for three months. She also dripped her to his neighbor, he recently died, his wife gave us the rest. We buy painkillers at our own expense. In a month you need two packages of a tramadol of 270 rubles and two more pentallins of 200 rubles.

Supporting therapy - drugs for the heart, blood vessels, stomach, liver, etc. - costs 10-15 thousand rubles a month.

The patient does not even hope to get these medicines for free: in the district clinic they are prescribed not on the prescription form, but on a piece of paper as a recommendation.

There is no free nurse who could help oncological patients at home in Krasnoarmeysk either. Private traders take 300 rubles for installing a dropper.

As Alexander Ilyich admits, the actions of the tramadol are no longer enough. “I suffer a lot. It hurts constantly, ”he says briefly.

Tremadol is considered a potent drug. Alexander Ilyich is afraid to switch to more powerful narcotic analgesics, because, unlike the tramadol of morphine, you can’t buy for any money. Now in Krasnoarmeysk there is not a single pharmacy that has the right to issue medical drugs.

Elena tried to talk about the medicinal problem with the leadership of the district hospital, "but it did not work out: the head doctor was on vacation, then at the meeting." She left a message on the hotline of the regional Ministry of Health. They didn’t even call back from there. I contacted the district prosecutor's office. They demanded that the oncological patient write a complaint in person.

Elena wrote about the situation on Facebook. The message caused a scandal, journalists became interested in the situation.

A few hours after the New Armyska visited Krasnoarmeysk, representatives of the district hospital brought Sergeyev free medicines -

Tramadol, bicalutomide and zolandic acid.

Denis Balanov, the head physician of the district hospital, does not see anything exceptional in what happened: “The local private pharmacy that worked on preferential security was closed, apparently, due to economic reasons, we have nothing to do with them,” says Denis Vitalievich. - The Krasnoarmeysky district was reinforced for two pharmacies in Saratov. There, not only painkillers for cancer patients will be issued, but also all preferential medicines. Reloing is a long procedure. But now everyone in need will be able to receive drugs from their doctor, who prescribes a prescription. We will deliver medicines from Saratov by our transport. And two months later, when we pass the licensing, we will open the pharmacy at the clinic. ”

According to Balanov, there are 14 oncological patients with the fourth stage of the disease in the area. The pain syndrome is diagnosed in seven of them. Narcotic painkillers are not prescribed to anyone.

Saratov region