My friend Nadira’s husband, Akmal (names have been changed to maintain privacy), was diagnosed with prostate cancer last year. They have been devastated, particularly because a few months ago Akmal lost his mother to cancer. For several years, Nadira took care of her mother-in-law who had undergone a double mastectomy and was bedridden following the chemotherapy and surgery.
This time, my friend was not sure she was up to the battle. But she had no other option but to fight along with her husband. After lengthy but inefficient treatment in Tashkent, they decided to follow the advice of one of the doctors and look for better service abroad. India was their choice. Now, after serious treatment there, Akmal is back in Tashkent and recovering.
“We had to use all our savings and even borrowed several thousand dollars from our relatives”, says Nadira.
Both Nadira and her husband are employed by international organizations which provide them with relatively good salaries. Akmal is 38, a young age for prostate cancer. Their two children are still in school, so they hope to be able to pay off their debt. “The most important thing is to be healthy”, Nadira says.
In Uzbekistan, cancer is often a death sentence. I hear stories about people being diagnosed with different kinds of it – and at an early age too. In most cases, doctors send their patients away to die in the false quiet and peace of their home surrounded by loving and heartbroken family.
The Uzbek authorities openly surrendered to leukemia in the early days of independence by adopting an unofficial decree that prohibits bone marrow transplantation. In a 2009 report, Fergana news agency cited a healthcare ministry official confirming this practice. At the time, the number of children with cancer was around 4,000 and on the rise. In total, 85,000 people were diagnosed and being treated for cancer. The report also said the average age of patients was getting younger.
Cancer is by no means the only diagnosis that forces people to look for medical treatment abroad. My uncle in Tashkent has been coping with a heart condition for many years. A few years ago, he had to undergo a bypass surgery. The doctors were honest about his bleak prospects in Uzbekistan and recommended for him to seek treatment elsewhere. His son explored possibilities in Russia, Germany and India. After considering treatments, prices, flight options and other details, they opted for India. The surgery was successful and my uncle quickly recovered in Tashkent. He says the high-quality service he received in New Delhl was worth every penny spent.
But not everyone has thousands of dollars for medical treatment abroad. Many patients from provinces cannot afford to go even to the capital Tashkent, although in Uzbek society, in case of a serious disease, one can rely on financial and psychological help from extended family and neighbors. Most people have to be content with local services which are far behind not only international standards, but also the services of the Soviet past.
Anyone living in Uzbekistan can produce a list of relatives and acquaintances with various medical conditions, including those they lost to diseases.
The low professional level of medical staff and lack of adequate medicine, equipment and technology are hardly the only problems.
The major issue in the healthcare system of Uzbekistan is that in the 22 years since the country’s independence, the authorities have not envisioned building a system and practice of health insurance.
Medical services are still supposed to be free of charge in public (state-funded) hospitals and clinics. However, one cannot get anything for free. The payments to doctors and nurses are made openly. Often, the medical staff have their unofficial rates for various services. For example, you will have to pay UZS 5,000-15,000 for a single intravenous infusion (IV) in Tashkent the minimal salary in Uzbekistan is about UZS 96,000). If checked into a hospital, one has to bring literally everything – from medicine, syringes and IVs to bed sheets, blankets and food. Some even bring their TV sets and fans or ACs for hot summer days.