Belarus Struggles to Contain Cancer
In mid-June 2016 Belarus hosted a regional forum on oncology for the second time since 2004. It brought together leading regional cancer specialists from 25 countries.
According to the World Health Organisation (WHO) 14 million people annually get diagnosed with cancer. In Belarus this number reached 50,000 new patients in 2015. Belarus has achieved considerable progress in cancer screenings and diagnoses at the regional level.
However, it consistently falls behind in cancer morbidity rates when compared to Western Europe, including immediate neighbours like Lithuania, and Latvia.
Currently more than 270,000 Belarusians have registered as oncological patients. In addition to the usual risk factors associated with cancer, such as ageing, smoking, and diet, Belarusians have now been living for 30 years with the radiation fall out from the Chernobyl disaster. This accounts for the saddest peak in cancer data – thyroid gland cancer increased disproportionately among children living in the affected areas.
The number of people diagnosed with cancer in Belarus has doubled since 1990: from 26,000 cases to 50,000 in 2016 according to the Chief Oncologist of Belarus, Aleh Sukonko. This number will continue to rise and reach 70,000 people by 2020. And the overall number of cancer patients diagnosed and registered with the healthcare system has steadily increased from 2002 and reached 271, 000 in 2015.
16% of patients go to see a doctor when the disease has already advanced to stage four, that is most advanced stage, at which cancer is almost always terminal, says Dr. Sukonko. Only 5% among them will recover.
To put it into perspective, according to Dr. Sukonko the morbidity rate in Belarus for cervix cancer is as high as 36%, compared with 21% in Germany. Screenings could help maximise early detection of the disease, and bring the morbidity rates down. Cancer screening involves testing apparently healthy people of a certain age, typically 50-70 years old.
Belarus has introduced regular cancer screenings aimed at prevention and early detection, but progress has stalled. Cervix cancer screenings among women are an example. Annual screenings are recommended for all women during their regular doctor's visit.Yet the ratio of stage four cancer cases diagnosed during such screenings remains stable at 10% among Belarusian women. In neighbouring Poland, where similar screening procedures are in place, the ratio is less than 4%, according to naviny.by.
What causes cancer in Belarus?
The most common risk factors for cancer include ageing, smoking, sun and/or radiation exposure, alcohol, poor diet, lack of physical activity, and being overweight. In Belarus quite a few of these factors come into play, such as radiation exposure after Chernobyl, overall population ageing, and poor self care with widespread smoking and high alcohol consumption.
Smoking is the leading cause of cancer in Belarus, with around 30% of all cases attributed to it, according to the chief oncologist Dr. Sukonko. Poor diet is the next most common cause, with 25% of cancer cases. The numbers are expected to increase because of the longer life expectancy among Belarusians.
Thyroid cancer is usually rare among children, with less than one new case per million diagnosed each year. However, after the Chernobyl accident a striking increase in the disease was reported in children and teenagers in the most contaminated areas of Belarus and Ukraine. Scientists have estimated up to 5,000 cases of thyroid cancer among residents who were children at the time of the accident, according to the WHO.
Gender plays a role too. Belarusian men most often suffer from prostate (17% of all cases) and lung (15%) cancer. Women face diagnoses of breast (18%) and cervix (10%) cancer. And 10% of all cases among both men and women turn out to be colorectal cancer. Most of these forms of cancer are curable if diagnosed at stages one or two.
How people deal with it
Cancer takes it toll: every seventh Belarusian dies from cancer. It is the second most common cause of death in Belarus after heart disease. The government, recognising the cost to human life as well as the problems of population decline, has pledged to invest in combating cancer. According to Belstat, around 30% of the healthcare budget will go to fight cancer.
While this may mean potential improvement to the national cancer statistics, large gaps in patient care remain. Below is the account of a cancer survivor Ulia Liashkevich, who also lost her mother to cancer in 2007:
My mother was diagnosed with stage four. Little could be done in terms of treatment. But a dying person is not yet dead. They (the doctors) told me I should take her home, that her death will look bad for their statistics, they threatened that they would perform an autopsy on her body. I did manage to make her last weeks painless, but only thanks to my connections and her friends.
Whenever the government does not provide a certain much-needed service, people have to self-organise. Cancer support groups have sprung around the country. Many have an online presence, such as http://oncopatient.by/ and http://news.tut.by/tag/1814-onkomarker.html. Both were created by cancer survivors aiming to provide resources for fellow citizens fighting the disease.
As one Belarusian neurosurgeons, who preferred to remain unnamed, put it:
Say, I have a patient with a malignant tumour in his head, and he has come to see me with his wife. I do not know whom to console, him or his crying wife. And most importantly, I feel like it is not up to me altogether. I am a surgeon after all, not a psychologist.
Much fear stems from lack of information. Most people feel overwhelmed and lost when diagnosed with cancer. Many turn to God, some look for answers in science. But for now cancer patients in Belarus, it seems, need to rely on their immediate family and friends in dealing with the non-medical aspects of this disease.
Opposition Critisized, New Money, Boosting Exports – State Press Digest
In the beginning of July state newspapers discuss the parliamentary election campaign, the re-denomination of the Belarusian currency and measures by the government to overcome economic difficulties.
Official ideologists criticise the opposition for its inability to hold a proper election campaign. Aliaksandr Lukashenka demonstrates desire to revive relations with the US. Belarus lops four zeros off its currency and introduces coins.
The government helps small and medium enterprises boost exports and removes restriction on travelling to the EU by car. This and more in the new edition of the state press digest.
Belarusian opposition is unable to lead an electoral campaign. Belarus Segodnia publishes a video of a round table hosted by the official news agency, BELTA, featuring high-rank Belarusian ideologists. They argued that changes in electoral legislation provide more opportunities for political parties and civil associations, but claimed that the parties showed week activity during the formation of regional and district level electoral commissions. The participants criticised opposition activists for making provocative claims in the media stating that authorities did not allow them access to commissions.
Deputy Chairman of Minsk City Executive Committee Ihar Karpienka stated that “any political force should meet people and seek support from them. A part of our civil society thinks that a trip to Brussels or Washington and a speech is enough to get people's support. But when electoral campaign starts, these politicians try to blame the government for their failure."
U.S. Chargé d'Affaires Scott Rauland ends his mission in Minsk. “I am pleased to meet you, but I am not pleased to see you leaving”, Lukashenka said to the diplomat. In the past two years political contacts between Minsk and Washington witnessed steady growth, writes Belarus Segodnia. Representatives of the US State Department, Congress, and the Ministry of Defence visited Belarus. In September 2015 Lukashenka met Barack Obama at the UN Summit on Sustainable Development in New York.
During the meeting Lukashenka promised that “We will solve any problems, if the United States only wishes it. We have very close cooperation with Russia, China, India, but we have no commitments with them that could harm development of relations with the US. Without normalisation of relations with the United States, we can not have a full-fledged foreign policy”. The diplomat replied that Washington is ready to cooperate further and values Belarusian independence above all.
Belarus has new money, introduces coins. On 1 July Belarus held the third re-denomination of the rouble in its sovereign history, writes Narodnaja Hazieta. This re-denomination was notable for the fact that the largest-yet amount of zeros was lopped off, allowing the value of the ruble to approach that of world currencies. 1 US dollar is now worth 2 rubles; previously it was worth 20,000. Moreover, Belarus introduced coins for the first time in history.
The process of designing new banknotes started back in 2008 and they were printed in 2009. However, because of the world economic crisis, authorities postponed re-denomination until 2016. Belarusians will be using both types of money until 2017, and they will be able to change old money in banks until 2021. Starting on 1 January 2022 the old banknotes will become invalid.
Unemployment in Belarus decreases. The economy is experiencing revival and Belarusian companies currently provide around 35,000 jobs, reports Zviazda. Whereas last year the Ministry of Labour and Social Protection registered 1,7 unemployed people per every vacancy, this year the rate has decreased to 1.5. The Ministry expects unemployment rates to fall to 2% by the end of 2016. (It must be noted that Belarus is using an unusual methodology to monitor unemployment)
In January-May 204,000 people were underemployed, while in the same period of 2015 the figure was 12% higher. According to an estimation of staff overage in 3,000 state companies, 4.3% of employees are at risk of being laid off at the moment. At the same time, in January-March 16,000 new jobs were created in Belarus, 9,000 of which appeared in newly created companies mostly in the service sector and the IT sphere.
The government plans to boost exports of Belarusian SME. The socio-economic development programme for 2016-2020 provides for the establishment of specialised agencies that will promote exports of small and medium-sized enterprises, informs Respublika. One such structure – the Chamber of Exporters – has recently started operating. Its creation followed the cooperation agreement between the Foreign Ministry and the Republican Confederation of Entrepreneurship.
One of the long term programmes of the Chamber will be the 'Belarus offers' trade fair, which has already started working in Moscow. The Confederation received a 60,000m2 space there on preferential terms until 2025. The fair will serve as a venue for deals, as well as a platform for development of dealer and supply chains. It aims to promote the Belarusian SME exports and will involve around 1,000 firms.
The government removes the ban on travel to the EU by car. Effective 1 September Belarus abolished the restriction on export of fuel to the EU for private cars, writes Belarus Segodnia. The government introduced this restriction in 2011 in order to reduce queues at border checkpoints and stop the massive fuel drain. One car could go to the EU only once in eight days, otherwise the driver had to pay a fuel duty.
Belarusian oil monopoly Belnaftachim welcomed the decision and expects a growth in fuel sales in the border regions. According to deputy prime-minister Uladzimir Siamaška, the government removed this limit because the Mazyr and Naftan refineries now have the capacities to produce more fuel. He added that the government will not raise fuel prises for consumers.
'I see' project checks rural children's eyesight. The Belarusian Children's Fund and the company Velcom have implement a charity project called "I see!" with the support of Mahilioŭ Regional Executive Committee, reports Holas Radzimy. The project is aimed at diagnosis and provision of eye care for children in rural areas. Unlike their peers in the city, children from rural areas have few opportunities to regularly visit ophthalmologists.
The organisers of the project purchased modern mobile diagnostic equipment, paid for the work of specialists, and covered travel costs and other expenses. In spring 2016 a total of 4880 children were examined in 8 districts of the Mahilioŭ region, and 29% turned out to have eye problems. In September the organisers will begin the second stage of the project and check another 10,000 children in the Mahilioŭ region.
The State Press Digest is based on review of state-controlled publications in Belarus. Freedom of the press in Belarus remains restricted and state media convey primarily the point of view of the Belarusian authorities. This review attempts to give the English-speaking audience a better understanding of how Belarusian state media shape public opinion in the country.