Subproject implementation in the newspaper "Your health"

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The Subproject Management Consultant, Khrystyna Pak, told for the medical newspaper in Ukraine "Your health" about the state of the "Preventive oncology and the implementation of effective anti-tumour technologies in Lviv oblast" subproject implementation.
 
The "Preventive oncology and the implementation of effective anti-tumour technologies in Lviv oblast" subproject appeared to be the most successful of all those that are being implemented in the framework of the joint World Bank's and the Ministry of Health care of Ukraine "Serving People, Improving Health" Project. Almost all contract agreements in the Lviv oblast are signed; the first deliveries of the equipment have been already carried out. Thus, the region has become the leader among other regions of Ukraine in terms of utilizing the funds allocated for this project.
 
YH? What is the current stage of the "Preventive oncology and the implementation of effective anti-tumour technologies in Lviv oblast" subproject implementation?
 
- The subproject is aimed at implementing sophisticated screening technologies and early detection of cervical and breast cancer. There are about 800 000 women residing in the oblast. In order not to miss any of them, 6 screening centers have been established on the basis of medical institutions, two of which are in Lviv (municipal and regional) and four - in district centers (Chervonohrad Sambir, Drohobych, and Stryi). The main lines of expenditures associated with the subproject are the purchase of medical equipment, both diagnostic and therapeutic, training of the medical experts, establishment of the electronic registry of the female population in the oblast and holding extensive information campaign among women to promote regular visits to a gynecologist. Women will have an opportunity to undergo free examination by that specialist, along with carrying out cytological and mammology examination.
 
 
As for today, 80% of all the required agreements for the purchase of medical equipment have been already signed, specifically for a total of 7.9 mln. USD. (A total of 10,15 mln. USD has been allocated for the subproject). The main contracts are those signed with AMK Management Services GmbH & Co.Kg with regard to the procurement of digital colposcope sand binocular microscopes (159,78 thousand euros) and those signed with Diatech S.A. for the purchase of ultramodern magnetic resonance imaging scanner manufactured by General Electric to carry out the most accurate diagnosis of cancer (1.32 mln. USD). Contracts for the procurement of computed tomography scanner, single photon emission computed tomography, fluorography device, digital mammography devices, C-arch X-ray and ultrasound devices (4.66 mln. euros) have been signed with Siemens Healthcare GmbH. The LLP "TechMedKontract" signed a contract with us for the supply of surgical tables and lamps, and gynecological chairs (3.53 mln. UAH), while the LLP "Labvita" will supply equipment for laboratory diagnostic examination methods (1.57 mln. UAH).
 
Our oblasr was the first one where the delivery of equipment under the contracts has been carried out. At the end of 2016, 7 cytological laboratories in the Lviv oblast (Lviv State Oblast-level Cancer Treatment and Diagnostics Centre and its polyclinic department, the polyclinic department of the municipal clinical hospital No. 5, and four multi-district screening centres) received "Christmas gifts" in the form of 11 microscopes with integrated cameras manufactured by Carl Zeiss. Already this year, the colposcopes of the same manufacturing company and the gynecological chairs have been delivered to themulti-district screeening centres.
 
At the beginning of 2017, the experts from the Siemens Health Care GmbH (Germany) examined the premises of the Lviv State Oblast-level Cancer Treatment and Diagnostics Centre, which are designated for the installation of respective equipment. The representatives of the company were quite satisfied with the condition of the premises, since these are already operating diagnostic rooms. Thus, the Diatech S.A. company delivered the magnetic resonance imaging scanner manufactured by General Electric to the Lviv Cancer Treatment Centre in the first day of spring; so soon it will be installed and put into operation.
 
Signing of some contracts, such as those for the procurement of brushes for taking samples for cytology examinations are either still underway or require reannouncement of the bidding procedures, since the requirements for the bidders are extremely high, and sometimes even too high for Ukrainian enterprises, while for foreign companies they are financially unattractive due to small, in their opinion, contract amounts.
 
The project co-financing is mainly provided by the regional budget in the framework of the regional program for fighting cancer in the Lviv oblast in the period between 2017 and 2020, which was approved in December, 2016. During 1.5 years, equipment for surgery, Force Triad electric coagulator, mammography film, and chemotherapeutics.
 
YH? Large-scale training sessions are planned to be held in foreign clinics in the framework of the subproject. How many professionals have already taken advantage of this opportunity? How is the selection of doctors for training carried out?
 
- We try to capture the largest possible number of doctors from the regional screening centres and hospitals, to get the skills of the experts in various fields improved. Sometimes a host institution determines itself the number and the specialty of the physicians, which they are willing to host. Thus, more than 40 experts have already visited foreign clinics, while about 250 gynecologists, radiologists, mammologist, and laboratory technicians from Lviv participated in scientific conferences. The experts from the Lviv oblast have also attended highly specialized foreign clinics and centers, including the National Agency for Research on Cancer in Lyon (France), St. Raphael Clinic Scanmed (Poland), University Clinic in Heidelberg (Germany), where they got familiarized with the work of their colleagues. The team of radiologists have recently participated in the European Congress of Radiology "The Flower Gardens of Radiology" (Vienna, Austria). In early February the surgical oncologists, radiologists, and radiation therapists from Lviv, Drohobych, Stryi, Sambir, and Chervonohrad returned back from their week-long internship at the Center for diagnosis and treatment of breast cancer in the Gynecological Clinic at Heidelberg University Medical Hospital (Germany). Our experts have not only received theoretical knowledge, but also had an opportunity to gain practical skills directly during the treatment process, as they attended the pre- and postoperative consultations, surgerical procedures with radical mastectomy, lumpectomy, reconstructive surgery, and were able to observe the treatment session with the use of the only in the world ultra modern linear proton and carbon accelerator. Soon a study visit to Lodz is planned to be held for cytologists (Poland), as well as attendance of the V International Breast Symposium (Duesseldorf, Germany).
 
It should be noted that the training sessions for radiologists require more attention, because, unlike those for cytologists, which are widely used in clinical practice, mammography was only available in the oblast-level center. According to the majority of the physicians, these are going to be completely new equipment items and procedures, so such professionals might be trained several times.
 
YH? How do you plan to cover the entire female population of the Lviv oblast and, most important, to encourage each woman to undergo screening, which is so important?
 
- Audio and video spots have been already developed in the framework of agreemwnt signed with PE Agency 'Partner'; the promotional campaign is actively underway using the oblast media, which very unobstructively, in the form of an appeal of a man or a child encourages a woman to take care of her own health. The are regular measures implemented in the oblast, during which informational materials are distributed among women. A clinical route of a patient is approved by the Order of the Health care Department of LOSA; this is a handout for doctors which "prompts" as to how to act in each specific case.
 
Although it is expected that the number of detected cancer cases will rapidly increase, however, the diagnosis of diseases in the early stages will help to significantly reduced the mortality. We also hope that we can set an example for the whole Ukraine and to provide reasoning for the Ministry of Health care to implement a similar program in the country as a whole.
 
Julia MASYUKEVYCH, specifically for the "YH", Lviv