Idle medical services for cancer prevention

The National Cancer Center in cooperation with some commercial banks and media has been carrying out the annual campaign against cancer nationwide since 2010. Obviously, the key aim of the campaign is to raise public awareness about cancer and to encourage its prevention, detection, and treatment. As cancer is the most common cause of death among Mongolians, the annual campaign must raise awareness about the importance of preventing cancer.

Through the eight-year campaign, the number of illness and death caused by cancer should be reduced and public awareness of cancer should be raised, but the annual campaign doesn’t seem to be carried out in the most effective manner. The campaign is carried out in provinces, but it doesn’t reach the local people who need cancer screening tests and those affected by cancer don’t receive support offered through the campaign.

There are more than 3,200 medical organizations with roughly 50,000 employees, including public and private hospitals, clinics, and other medical centers operating to provide medical care across the country, but receiving medical services, especially cancer treatment services or cancer prevention health services, can be very hard for regular people without good connections or sizable disposable income.

According to an annual medical report, 5,000 to 7,500 people are diagnosed with cancer every year.

As of 2017, the greatest number of cancer among Mongolians is liver cancer, which makes up 38 percent of total cancer patients; 14.6 percent of people affected by cancer had stomach cancer; 7.2 percent had lung cancer or tracheal cancer; 5.9 percent cervical cancer; 5.7 percent esophageal cancer; 4.1 percent breast cancer; and colon cancer is at four percent.

As dirty needles were the most common means of transmission of hepatitis B and C virus infection because hospitals before the 1990s would reuse needles after attempting to sterilize them, a large number of people above the age of 40 make up those infected with hepatitis B and C, which is why liver cancer amongst middle aged people is a leading cause of cancer-related deaths.

Alcoholism and unhealthy eating habits of Mongolians affect people, especially those infected with hepatitis B and C, to become effected with liver cancer or colon cancer. Smoking and air pollution might cause most lung and tracheal cancers.

Problem is that as many Mongolians lack of knowledge about cancer, or deadliest diseases by some standards, and they don’t take enough precautions against cancer. They ignore symptoms and a lot of people, especially people in rural communities and herders, don’t go to hospitals to see doctors until the final stages of cancer.

As no one wants to die from a treatable disease, everybody wants to see a doctor to get preventive health care, but most can’t access the treatment they need due to state hospital bureaucracy, or they cannot afford the prescribed medication, screening tests, and most simple don’t have the time to get preventing care amidst the difficulties associated with medical care provision.

If you want to see a doctor at a public hospital for cancer care, you will need at least two or three weeks, because first you need to make an appointment to see a doctor specializing in particular diseases at a public hospital after seeing a doctor at your local clinic. Unfortunately, the appointment will be at least two weeks after your initial visit to a general physician. Although public hospitals were equipped in recent years with a laboratory and proper equipment for diagnosing patients, the public has not received enough medical services from public hospitals due to heavy workloads and bureaucracy.

When you see the specialized physician after a long-awaited appointment, the physician asks you to take many unrelated and expensive tests at private hospitals or purchase costly medication, which is why many people avoid hospitals. That is how Mongolian healthcare system works.

During the annual campaign, organizers claim that as preventing cancer is the best solution for reducing the impacts of cancer on society, they will be hosting the campaign every year. In reality, when it comes to cancer prevention, public hospitals do not encourage people to get tested for cancer prevention. When you ask a doctor at your local public hospital to get an approval for taking a blood test for cancer marker to detect cancer activity in your body, the doctor will ask you why you would want to be tested if you’re in good health. To give you the approval, the doctor reviews your medical history, and if you have no history of diseases or cases which could cause risk of a cancer, the doctor will never give you the approval. Even when you have a history of diseases that might lead to cancer, the doctor will ask you a number of questions so as not to issue an approval to go to the National Cancer Center for a test for cancer prevention.

If you tell the doctor that you are trying to take preventive action, the doctor will suggest you to take the cancer marker test for 50,000 MNT ahead of everyone else, which is supposed to be covered by health insurance.

Cancer prevention screenings are supposed to be free to the public, but unfortunately, most people are not aware of cancer marker tests and public hospitals don’t give people the opportunity to use their health insurance entitlements.

A person earning a median salary in Mongolia pays a health insurance fee of nearly 20,000 MNT from their monthly salary and their employer also pay a monthly fee of nearly 20,000 MNT for that person, which means that around 480,000 MNT goes to the Nation’s Health Insurance Fund for that person.

Though a working individual pays the cost of eight to nine cancer marker tests a year, they cannot use that money at all for themselves, or for cancer prevention.

Some lawmakers put forward a proposal to create a healthcare system to make it mandatory for all employers of public and private sectors to help provide free cancer prevention tests to their employees above the age of 40, but whether this proposal will be put to action is uncertain.

The current inefficient and restricted cancer prevention efforts will not decrease the prevalence of cancer and diminish its threat to the nation. The state must carry out a comprehensive reform in the health sector so as to make it efficient and customer orientated rather than the current heavily bureaucratic and ineffective system we have in place.

...If you want to see a doctor at a public hospital for cancer care, you will need at least two or three

weeks...