César Miranda, UICC member and Manager of Education and Prevention at Sociedad Anticancerosa de Venezuela, speaks about the current challenges facing a global pandemic in the context of political instability and a weak health system.
Having a comprehensive understanding of the cancer burden in a country is of utter importance to national cancer control planning. In Venezuela, there has been no official data on cancer mortality and incidence since 2014 and 2015 respectively, and the financial resources invested in cancer control are extremely scarce.
Early this year in January, Sociedad Anticancerosa de Venezuela (Venezuelan Anti-Cancer Society) published a prognostic report on mortality and cancer incidence in Venezuela in collaboration with other institutions. The statistics, in spite of being a prognosis, were highly alarming (28,304 cancer-related deaths and 64,088 new cancer cases in 2019). This month, the organisation is launching a summary of the report in order to make the information more accessible to the public and with the aim of raising awareness among government authorities of the urgent need to address the serious gaps in cancer control in Venezuela.
César Miranda is Manager of Education and Prevention at Sociedad Anticancerosa de Venezuela and has worked with the organisation for the past five years. He speaks here with UICC about the significant challenges facing organisations working in the cancer space amid a global pandemic when already confronting fragile health services and political unrest.
COVID-19 has hit Venezuela very hard. Back in March, the government did not show a lot of interest in the virus – that is why I believe most people thought we would not be affected.
Today, cases are increasing by thousands daily (for a current total of approximately 93,000 cases), However, the mortality rate has been low (810 deaths) and 87,941 patients are currently reported as recovered (official figures published by the Venezuelan government). Generally, the lack of testing is the biggest issue for us, so cases are underreported, which makes controlling the spread of the virus even more challenging.
The public health focus has completely shifted to COVID-19, away from cancer and other diseases, as has happened in the rest of the world. An example of the lack of public health data in Venezuela is the fact that there are no official reports on how many cancer patients have contracted the virus. The government has released official communications around COVID-19, but there has been no specific information for cancer patients.
As a consequence, during the first peaks of the pandemic, hospitals restricted access to patients because they were not prepared to maintain their services in such an extraordinary setting. At the same time, patients were afraid to leave their homes, not having any clear guidance on how to proceed.
Cancer prevention and early detection in particular have suffered severely and the access to medicines and the availability of specialised equipment, which was already very limited prior to the pandemic, has only gotten worse now.
We need to improve our health system and the necessary work must be done hand-in-hand with the government. Unfortunately, this is not the case. The State does not take responsibility for cancer patients in Venezuela. Therefore, for us and other cancer organisations, the continuation of prevention, screening and treatment has been our main concern throughout this pandemic – cancer does not stop just because COVID-19 has taken the centre stage.
Our organisation has suffered a 60 to 70% reduction in income this year and we have not received any support from the government. Our main income sources – the prevention clinic and workshops at schools and in communities – had to be closed and cancelled for a period of six to seven months. Nevertheless, we have been fortunate enough to have built a solid financial foundation since the establishment of the organisation 72 years ago. Thanks to this, we continue being operational.
With COVID-19, we knew that it was no longer possible to be physically close to our patients and the public. Nevertheless, we had to reach them to avoid losing contact, and like many other organisations, we decided to digitalise our services as much as possible.
Frankly, despite all the challenges, the digital transformation of our work has been a great success, above all our online campaigns. One big advantage of virtual activities is that we seem to be reaching a much broader audience than before, as well as targeting specific groups with specific communications. Furthermore, the collaboration with other cancer organisations has increased considerably.
While developing and implementing virtual activities has been extremely intense due to the limited infrastructure in Venezuela, it has most definitely helped cancer patients in the country, and we are committed to continuing our efforts beyond the pandemic.
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