Society / Issue September 18, 2008 ¹69
16 Boris Afanasyev: Everyone met one’s engagements fully
Society
Within this relatively short period the specialists from the first Russian specialized clinic have brought to life hundreds of patients with leukemia. That’s the achieved result, the yesterday that one can be proud of. However, there are thousands of seriously and sometimes hopelessly ill children in Russia. Their number is not decreasing, and this poses the tasks and plans for the institute’s employees.
These are hard tasks, and yet children with hopeless perspectives got a chance for survival now.
Shortly before the year’s anniversary, the director of the institute, Boris Afanasyev, answered the questions by Novaya Gazeta.
A: This kind of clinic has been in need for long. As far back as ’70-80s of the last century it became clear that many diseases could not be treated without transplantation of the marrow.
Eight years ago we organized a transplantation department at St Petersburg state medical institute, jointly with our German colleagues. However, that department did not meet all the international standards. The main problem was that it was only possible to carry 7-8 transplantations at a time. After transplantation done, the patient has to stay in the clinic for 1-2 months. So the number of patients who we could help in such a small clinic was only 40-50 people a year.
So after starting that department we still had to deal with growing queues of patients. Everyday we saw tears, suffering and scandals… The problem was not solved then. We wanted to have bigger and modern hospital for patients with leukemia. The problem was that this kind of departments and clinics is very expensive.
In 2002 the idea of making in St Petersburg the Institute of the child hematology and transplantology was supported by the charity fund of Mikhail Gorbachev. The money for construction was allotted by the National reserve Bank headed then by Alexander Lebedev. That was a rare example of ideal combination of efforts: by the state (represented by our university), charity fund and private capital. Everyone met their engagements fully. Then the health care ministry joined the process and acquired expensive equipment (deliveries are still going on). Allotted were also salaries for doctors and nurses. Maybe for the first time in my life I feel that the state has done its best.
Q: How has the institute worked during the first year?
A: During this first year it’s not everything that worked and was opened, and yet the number of transplantations has increased significantly. About 100 such operations were made in 2008. Most of them were most complicated ones – unrelated and haploidentical transplantations. Besides, increased is the number of patients we accept for applying chemotherapy and for preparation for transplantation.
Q: You said you could not be happy when 8 years ago you started a Russian-German clinic. And what about today?
A: Today the situation has significantly improved. While before we were hardly able to do 50 transplantations a year, now the figure has increased two times. And when at the end of the year we reach the full capacity (all the equipment will arrive, an all the personnel will be hired, and all the departments will start working) then I am sure we will be able to do 300 transplantations a year, and after the middle of 2009 the figure will be 500 a year. Plus several thousands of chemotherapies. And a unique department for dealing with genetic diseases will also be started. That will solve to a significant degree the problem of our North-West and will positively affect the whole situation in Russia.
With this institute open a big number of the Russian patients suffering from leukemia and many genetic diseases, where transplantation is needed, do not have to go to abroad. Everything can be done here with less spending.
Q: It’s no secret that many patients are convinced that treatment is more effective and of higher quality in abroad.
A: We equal our foreign colleagues. Our patients are placed in good conditions meeting all the modern international standards. The quality of examination and treatment in the institute will be just equal to any other country.
Besides, many leading western specialists are our consultants. We work in accordance with protocol created by us jointly and this is why the foreign colleagues are involved in our everyday practical working. When we deal with a complicated case where there are several potential ways of finding the solution and when we need to choose the most optimal one, then we can involve the doctors from abroad using the modern means of communication, including tele-medicine.
Yes, people in Russia know about the quality of treatment in abroad. But that costs colossal money – about 200 thousand euro, out of which 60% in the US and 50% in the European countries is spent on the staff salaries, not on medicines and not on donor, just salaries.
In St Petersburg we do the same for much cheaper and without quality loss. Unfortunately or luckily, with us it’s only 10% that goes for salaries. And we have our own infrastructure. The parents of the ill children are accommodated for free. If you consider that in the West you also need to pay for translator’s services and for accommodation, then the declared 200 thousand of euro or dollars turn into an amount half as large again.
I am convinced that the ill Russian citizens must not pay for anything, just because very few of them are able to pay for such kind of treatment.
Novaya Gazeta information
In Russia about 20,000 people a year are diagnosed the diseases where marrow transplantations may be the only effective remedy. Every year about 5,000 cases of blood diseases are registered with children. And the whole number of those in the age under 18 years old, put on constant observation in clinics on the count of the hematological pathologies, is about 30,000.
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