Peru’s decentralised model of cancer care has been both a blessing and a curse. On one hand, it has bought healthcare closer to those living in poorer, isolated and indigenous communities. On the other, the best expertise tends to head to – and stay in – Lima.
During Covid, screenings and treatments dropped dramatically – the bar was already low. Good news then that the government has announced increased funding for cancer patients spanning the gamut from diagnosis to treatment. Naturally, the effectiveness of this new round of public expenditure will be measured by outcomes and it will take time for the data to reflect earlier rates of diagnosis and treatment leading to better survival rates.
An oncologist and specialist in radiotherapy based in Peru explained, “In terms of daily clinical experience managing patients, there can be little doubt that private healthcare centres specialising in cancer care are much better resourced and financed and attract the best clinicians due to higher salaries and better working conditions. There are also much longer waiting times in the public healthcare system which for cancer patients can be a death sentence.”
“…private healthcare centres specialising in cancer care are much better resourced and financed and attract the best clinicians due to higher salaries and better working conditions.”
An oncologist and specialist in radiotherapy, Peru
The pandemic put many of Peru’s cancer specialists between a rock and a hard place as cancer care and coverage became increasingly limited, especially outside of the major metropolitan areas. Radiotherapy care was reduced by 60% at the peak of the pandemic. “We had to maintain care, chemotherapy care was limited and the operating room was closed during Covid. This taught us to always be prepared and to start using tools that were in place but not necessarily considered, such as telemedicine and teleconsultation. The pandemic taught us to optimise times and improve service flows,” adds the oncologist.
Better familiarity in areas such as telemedicine and teleconsultation matters because investment in better technology will be particularly important if diagnosis rates are to improve. The head of mastology at one of Peru’s largest hospitals explained, “We have mammography specialists in most areas of the country which is the most important tool. But radiography specialists, also critically important, tend to be concentrated in the capital. Indeed, there is only one centre in Chiclayo, but it is the only one for the entire north of the country.”
“We have mammography specialists in most areas of the country…But radiography specialists, also critically important, tend to be concentrated in the capital.”
Head of mastology at one of Peru’s largest hospitals
At the level of Essalud, (which is semi-private), radiotherapy is in Lima and has to be outsourced, the resonators are only in Lima, as well as the treatments. This is concerning because the lack of technological investment in rural areas of the country remains a major challenge. In addition, Peru now faces a potential recession due to persistent political instability, which will result in further reducing investment in health. That’s not to mention proposals for a national health insurance which remain stagnant.
“I think that until before the pandemic, many of the telemedicine tools were not used on a regular basis, so my hope is that this situation will now change for the better. Many times, telemedicine tools were seen as something remote but with the pandemic we have realised that they are of great help and allow us to have a greater reach for our patients. We can now use telemedicine for diagnosis,” adds the mastology head.
Investment will have to be targeted towards cancer diagnostic platforms that optimise diagnostic and waiting times, shorten distances between specialist clinics and bring in a broader range of expertise. If those are prioritised, Peru’s cancer care should improve.