BREAST CANCER AWARENESS, BUT DIAGNOSIS AND TREATMENT OPTIONS

UNCLAS SECTION 01 OF 02 SURABAYA 000094 SENSITIVE SIPDIS DEPT FOR EAP/MTS AND EAP/PD JAKARTA FOR ECON AND USAID E.O. 12958: N/A TAGS: EAID ECON KWMN KPAO PGOV SOCI ID SUBJECT: BREAST CANCER AWARENESS, BUT DIAGNOSIS AND TREATMENT OPTIONS ARE LIMITED REF: SURABAYA 73 (DECENTRALIZATION BRINGS LOCAL SOLUTIONS TO HEALTH SERVICES) SURABAYA 00000094 001.2 OF 002 This Message is Sensitive But Unclassified. Please Protect Accordingly. ¶1. (U) SUMMARY: Breast cancer diagnostic facilities are difficult to access in Indonesia, especially outside provincial capitals. Once a case of cancer is diagnosed, treatment is too expensive for all but the wealthiest individuals. In honor of Breast Cancer Awareness month, ConGen Surabaya is working with a local survior group to shine a light on the issue. According to local oncologists, while cervical cancer kills more women in Surabaya each year, the incidence of breast cancer is increasing rapidly as awareness grows. END SUMMARY Detection and Diagnosis -------------- ¶2. (U) Proper breast cancer diagnostic facilities are not available to many Indonesians, who visit their local clinic (Puskesmas) for health services (reftel). According to Doctor Wiwei Ristanto of the Surabaya Oncology Hospital, mammogram tests are typically not available outside of the public hospital located in each provincial capital. This is particularly problematic in wide-spread provinces such as Nusa Tenggara Timur (NTT) where inhabitants of remote islands may never have the means necessary to travel to the capital city for an examination. Another barrier to women having regular mammograms is that they cost approximately $40, a prohibitively large amount for the vast majority of Indonesians without access to health insurance. ¶3. (U) Public provincial hospitals are able to perform the biopsies necessary to properly diagnose the presence of cancer. Because none have the capacity to analyze the biopsy, they must send the samples to one of three diagnosis labs in hospitals in Jakarta, Surabaya, or Denpasar for examination and diagnosis. The biopsy results are typically available in three days. Prohibitive Costs of Treatment -------------- ¶4. (U) Once the cancer is detected and diagnosed, the patient faces prohibitive problems when seeking treatment. Doctor Wiwei explained that hormone therapy is the only type of treatment available at the Puskesmas. Hormone therapy is not only the most expensive treatment, it is only an option for patients with a type of cancer that will respond to the therapy. For pre-menopausal women, hormone therapy costs approximately $15 per month for a five-year treatment regime. However, if the patient is post-menopausal, then the hormone therapy's cost jumps to $200 per month for a five-year period. Chemotherapy is available at provincial hospitals, but costs as much as $180 per session. Surgery is also available at provincial hospitals, but costs up to $2,000 to perform. Radiation therapy is only available at hospitals in Jakarta, Surabaya, and Bandung, all on the island of Java, and has a total cost of up to $300. ¶5. (U) Poverty is a major impediment to cancer diagnosis and treatment in Indonesia. Public health insurance is limited to government employees, and private insurance is too expensive for all but the wealthiest Indonesians to afford. As a result, the vast majority of the population must pay for medical treatment themselves. With nearly 54% of the population living on less than $2 a day, the costs associated with cancer treatments, and even detection, are prohibitive. As a result, Indonesia's fledgling cancer detection and treatment facilities are out of reach of the majority of the population. Partnering With Survivors to Raise Awareness -------------- ¶6. (U) ConGen Surabaya partnered with the non-profit organization Reach to Recovery Surabaya (RRS) to promote breast cancer awareness activities throughout the month of October. RRS is a group of breast cancer survivors and oncologists who promote early detection and awareness, as well as provide support for women with breast cancer. This month's activities include two prominent billboards promoting October as breast cancer awareness month, appearances on six radio talk shows, a public workshop at the Oncology Hospital in Surabaya, and a public "Breast Talk" event at a major local shopping mall. On October 13th, the Consulate hosted a "Pink Ribbon Luncheon, " attended by the Mayor and Vice-Mayor's wives, members of RRS, and prominent women in the community, to raise public awareness SURABAYA 00000094 002.2 OF 002 about breast cancer. These events garnered significant media attention. MCCLELLANDCR