RETRACTED: Humanitarian mental health: Establishing an integrated psychosocial care pathway in a Kyrgyzstan Cancer Screening Project

Abstract

Background: In 2022 Medecins Sans Frontieres (MSF), established, ab initio, a cancer screening project in Kyrgyzstan, outside the capital Bishkek. In line with the MSF strategic vision of increasing the salience of mental health care into all its projects, we developed a psychosocial care programme integral to the project from the outset. In this paper we describe the strategy, execution, and delivery of a psychosocial care pathway to support patients along the cancer pathway. Methods: We conducted semi-structured interviews of 40 patients with end stage cancers at the Kyrgz Republic National Oncological Institute, in their native language to establish the degree of pyschosoial need to assist in predicting demand for psychosocial support and staffing requirment within the Chui project. Results: Patients were unfamiliar with concepts of psychosocial professional support relying instead on family and friends, but once explained, it was appreciated. Family and friends faced a considerable psychological burden, as did staff who reported feeling burnt out and requested a staff support group. Conclusion: Establishing a cancer screening project posed many unexpected challenges. Psychosocial support is novel and culturally alien in Central Asia, but was rapidly accepted following initial resistance by staff and patients. Ethical challenges included differential drug costs between MSF and non MSF patients, providing a superior service to patients in the MSF project whlilest trating them alongside patients with similar degrees of need, and working alongside a paternalistic state healthcare system where patients are frequently given little or no information about their condition.