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Cancer burden in Vietnam – P1: Liabilities

Sunday, December 13, 2015, 11:19 GMT+7

Huge debts incurred by the costly treatment of debilitating cancers have drained many patients physically, mentally and financially.

Many poor people have been forced to spend their life savings, sell off their homes and take high-interest loans in desperate attempts to take back their own or their dearest ones’ lives from the ticking clock of death.

As night falls on a typical day, every unused inch of Ho Chi Minh City Oncology Hospital is occupied by “out-patients” who lie down for a night’s rest after lingering around the hospital all day.

Patients’ moans of pain are heard in the distance.

At 11:00 pm, Vo Van Chi, 62, from the southernmost province of Ca Mau, was still awake, watching over his 60-year-old wife, Doan Ngoc Minh, who was lying asleep on the cold floor.

Minh is seeking treatment for a second-phase malignant tumor.

A tiny mole on her arm had gone unnoticed until last year when it began to bulge alarmingly, crack and change color.

Minh was given surgery shortly after her diagnosis of cancer.

She is waiting for a second operation now that the tumor has begun growing again.

Minh and her husband have sought treatment and shelter at the hospital for the past two months.

Chi revealed that he had lost his elder and younger brothers to lung cancer.

Costly treatment

Vo Thi Mot, from the Mekong Delta province of Long An, said she had undergone surgery to treat cure her of breast cancer.

Her husband, who had taken great pains to care for her and cover her treatment fees, was diagnosed with terminal-phase lung cancer two months ago.

The man is now too frail for surgery.

Mot is turning to every source available to cover his medication. She has just managed to scrape together a total of VND11 million (US$490).

Vietnam’s per capita income is about $2,200 in 2015, according to official figures.

Tuoi Tre (Youth) newspaper reporters have witnessed exhausted patients at top medical facilities for cancer in the southern region, including Ho Chi Minh City Oncology Hospital, Cho Ray Hospital and People’s Hospital 115, paying from a few up to dozens of millions of dong (VND1 million is equivalent to $45) for treatment.

For the past seven months, Truong Van Do, 70, from the Mekong Delta province of Dong Thap, has been bringing his wife, who is stricken with terminal large intestine cancer, to the oncology hospital.

Having undergone two surgeries already, his wife is currently on chemotherapy. Each treatment, taken every 21 days, costs her VND2.7 million ($120).     

The couple have sold off all their valuables, including their home.

Do’s wife has repeatedly considered giving up orthodox treatment and switching to much cheaper herbal medications, leaving her life at the mercy of God.

However, Do would not give up.

Elderly patients, D.N.T., N.T.H.H. C.H.V., and D.H.T. at the Oncology- Radiotherapy unit at Huu Nghi Hospital in Hanoi, are also struggling to pay their monthly treatment fees.

The patients are prescribed with specialized medication to treat their lung cancers which cost them more than VND20 million ($890) each month.

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Free porridge portions are handed out at Da Nang Cancer Hospital, located in the central city of Da Nang. Photo: Tuoi Tre

They are struggling to pay the fee even though medical insurance has covered half of their bill.

Many have lived off free porridge or rice meals offered by volunteers for months.

Lam Thi Giao was seen spoon-feeding her 65-year-old husband with porridge at Da Nang Cancer Hospital.

In 1998, her husband was diagnosed with nasopharyngeal cancer, which was cured after three years of treatment at Cho Ray Hospital in Ho Chi Minh City.

The couple toiled hard to pay off their debts.

They were then shocked to learn that the old man has now developed tongue cancer.

Again, they sought medical attention in Ho Chi Minh City and are now empty-handed though insurance has covered half of their medical bills and they have received assistance from their locality as a needy household.

Giao’s husband is currently receiving free treatment meant for poor patients at Da Nang Cancer Hospital.

Younger couples do not fare much better. They are also forced to quit their jobs and linger at hospitals 24/7 in the faint hope of having their loved ones’ lives extended.

Three years ago, Le Thanh Son, from the Mekong Delta city of Can Tho, decided to give up his job and trust their two kids with his wife’s relatives to tend to his wife in hospital.

His 38-year-old wife, Nguyen Thi Kim Anh, is currently going through renal haemodialysis due to complications from a terminal large intestinal cancer. More than a few couples have broken up as one spouse cannot bear staggering medical costs incurred or just succumbs to the pressure of constant treatment.

Quitting treatment

A recent survey conducted by Can Tho Oncology Hospital revealed a high death toll, at 66-83.3 percent, in groups of cancer patients who do not receive orthodox treatment or switch to alternative remedies.

Financial constraint is typically the culprit when families choose this course.

Another study carried out by the hospital indicated that among 359 people diagnosed with cancer, 36.8 percent do not adopt traditional treatment courses. Up to 18.2 percent of this group refuse treatment because of financial hurdles.

Dr. Huynh Thao Luat, the hospital’s deputy director, pointed out that patients who fail to return for treatment following diagnoses of cancer are generally deterred by the disturbing effects of chemotherapy, financial difficulty, and a lack of faith that their cancer will be cured.

According to Bach Quoc Khanh, deputy head of the National Institute of Hematology and Blood Transfusion, full treatment fees for a blood cancer patient at his institute are estimated at VND150-200 million ($6,676- 8,901), higher than those for other kinds of cancer.

In the case of complications, these fees will rise.

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