Patients with liver diseases and viral hepatitis cannot undergo a Fibroscan examination, because the only device in the country, located at the Clinic for Infectious Diseases of the Clinical Center of Montenegro (KCCG), has been out of service for months.
World Hepatitis Day was marked around the world on Monday, and patients and the civil sector are warning that it is unacceptable that patients are not provided with modern equipment, the price of which does not exceed 100.000 euros.
The KCCG confirmed to "Vijesti" on Monday that the device was out of order, without specifying when, and they do not have an exact date when the fibroscan will be back in operation.
"Fibroscan, a device owned by the Clinic for Infectious Diseases of the Croatian Medical University of Montenegro, was donated to our institution in 2016. We would like to point out that the examination with the aforementioned device is one of the auxiliary diagnostic procedures for assessing the stage of liver disease. The device is currently not in operation, which does not call into question the quality of healthcare services provided to citizens for the reason already mentioned above, due to the regular annual service that was not performed for technical reasons. Namely, the servicing of this device is performed by an authorized service technician outside the borders of Montenegro. Therefore, we cannot provide an exact date for the completion of the service and the device being put back into full function," the response from the institution headed by Dr. Aleksandar Radovic.
The KCCG believe that "the device has successfully met all the needs of citizens so far," and that at their suggestion, the purchase of a new device is planned, using funds from the Ministry of Health.
Serious failure of the healthcare system
The non-governmental organization Juventas assessed that it is a serious failure of the healthcare system that the only fibroscan device, crucial for assessing the stage of liver damage, is not available to all patients.
"The malfunction or limited functionality of the device affects the possibility of timely diagnosis and quality treatment of people living with hepatitis B and C, as well as other liver diseases. This situation potentially endangers the health of patients and increases the duration of the process of inclusion in the treatment of various liver diseases. Consequently, the costs of treatment in the later stages of the disease increase and it makes it difficult to implement national public health policies," says the program director at Juventas Marija Radovic.
She believes that it is completely unacceptable that modern equipment, especially when it comes to chronic and potentially fatal diseases, is not used in the interest of all citizens and that such an important medical device is allowed to malfunction for months.
President of the Montenegrin Foundation for HIV and Viral Hepatitis Boris Vuksanovic He told "Vijesti" yesterday that according to their knowledge, the servicing of the device has not yet been completed and that at this point it is not known when the service will be completed.
"Since fibroscan is a diagnostic method when hepatitis C is detected, we are waiting to receive therapy," said Vuksanović.
The fight against hepatitis is not a single event
According to World Health Organization estimates, about 1,3 million people die from viral hepatitis B and C annually - more than 3.500 people worldwide every day, and about 6.000 people are infected daily.
On the occasion of World Hepatitis Day, free and confidential testing for hepatitis B and C was organized yesterday at the Institute of Public Health and health centers, without an appointment.
Hepatitis B is predominantly transmitted sexually, but also through blood and other body fluids. On the other hand, hepatitis C is transmitted through blood, or objects and utensils contaminated with infected blood. There is a safe and effective vaccine for hepatitis B, which is part of the regular vaccination schedule in Montenegro, and is administered according to clinical and epidemiological indications in adults. There is no vaccine against hepatitis C, but there is a very effective therapy, especially if administered in the early stages of the disease.
Juventas told "Vijesti" that World Hepatitis Day should be an opportunity to raise awareness, announce specific measures, as well as provide free, accessible testing, counseling, and treatment.
"Instead, there is a lack of systemic support, public campaigns are rare, and sufferers still encounter a number of obstacles in diagnostics, treatment and exercising their rights. Patients in Montenegro still need a referral from a chosen doctor in order to exercise their right to be tested for hepatitis B and C, which does not support the need to make testing more accessible and easier for all those who assess that they were at some risk of the aforementioned infections," Radović emphasizes.
He reminds that Juventas has been making efforts for years to make community testing a continuous and clearly regulated practice, but even in that area the situation is such that these are only periodic activities.
"Community testing makes testing accessible to everyone, and in particular ensures greater coverage of citizens who are at risk of social exclusion and exposed to various health risks. The approach of the competent institutions is not systemic and does not offer significant solutions, especially when it comes to modernizing testing, and further distances all those who are at risk from being protected by adequate, timely health care. The fight against hepatitis must be a continuous and strategic process, not just a one-day PR event," concludes Radović.
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