By Khursheed Wani
During the ongoing budget session of the Kashmir assembly, the health ministry presented alarming statistics on the prevalence of cancer. In last seven years, 26214 cancer cases were detected. The more alarming is the continual annual increase in the number of people attacked by the killer disease. Worse, the state government is still struggling to set-up appropriate infrastructure to manage the non-communicable disease with highest morbidity and mortality rate.
The Sher-e-Kashmir Institute of Medical Sciences (SKIMS) is the premier tertiary hospital where most of the cancer patients land. The Institute has always been plagued with controversies, the latest being the unceremonious exit of its director, which has triggered a legal battle and deflected the focus of the government from the patient care to the administrative matters. The vested interests have been playing politics inside the SKIMS for decades to sustain a messy situation inside the vast health facility. This has, in turn, led to the deteriorating standard of the patient care. This is despite the fact that the state government recently changed the board composition to help the hospital to improve decision-making.
The cancer treatment is a case in point. Many years ago, a Regional Cancer Center was established in the institute, which has now been converted into State Cancer Institute. The Institute caters to the patients from the entire Kashmir Valley, Ladakh region and several parts of Chenab Valley. Every day scores of patients arrive at the Institute for consultation, follow-up treatment or issues related to the disease. Many of them don’t return satisfied.
The prevalence of cancer disease in Kashmir is not new. The oldest records have shown 30 cases of skin cancer in the Valley as back as in 1866 when overuse of Kangri in winters used to damage the skin cells beyond the scope of treatment. This type of cancer has been eradicated, of course by the changing lifestyle, but this change has introduced new types of malignancies.
A senior oncologist at SKIMS tells you that the cancers prevalent in places like Delhi and Mumbai are fast attacking people in Kashmir. The geographical location and peculiar food habits have already been listed as main causes of several types of cancer including stomach and oesophagal cancer, colorectal and lung cancer. The oncologists have apprehensions that massive spread of breast cancer has the potential to outnumber male sufferers, who were previously dominating the male-female ratio.
Every year, February 4, is dedicated to cancer patients across the world. The 2008 declaration of the Union of International Control has pledged for working effectively to reduce the illness and deaths caused by it by 2020. The annual increase in the registered cases of cancer in Kashmir indicates that the international declaration has not been paid sufficient heed in our region.
This explains as to why the important PET-CT facility was not available at SKIMS until January 7, 2018. Hundreds of patients were travelling outside the state for the crucial scanning. The radiation oncology department at Sri Maharaja Hari Singh Hospital remained dysfunctional for the past four years after September 2014 floods. Ironically, there is no coordination between the two premier referral hospitals. A lady told me that her father suffering from stomach cancer was subjected to painful endoscopy several times at SMHS. When he was shifted to SKIMS, the procedure was repeated only for the same results but during the process, the patient lost his vocal cords never to regain them till death, additional costs notwithstanding.
The accurate detection of the killer disease is a major problem and in several cases, this becomes the major cause for the proliferation of the disease. There are cases of misdiagnosis as well. The oncologists at SKIMS admit that they cater to a huge rush of patients and there was a chance that some patients were not handled the way they deserved. A senior oncologist said that the scale of cancer requires at least four SKIMS like facilities for a satisfactory response to patient care. This may be one of the causes that several patients take flights to Delhi and Mumbai for their treatment. Several patients, this writer spoke to complained that many of the Valley doctors, though sufficiently competent, have been sluggish in their procedures and economical in sharing sympathy with the patients.
The patients coming from weaker economic sections are the worst hit. The disease leaves them in shambles. Ironically, the social response to the disease is disproportionate and unorganized. The nonprofit organisations like Cancer Society of Kashmir (CSK) have mobilized resources and taken care of a number of patients but they are also struggling to coup up with the patient demands. There is a need to set-up a system, at the societal level, to cater to cancer patients and their families at the grass root level.
The cancer drugs are generally expensive. This has given rise to a drug mafia that deals with these drugs in certain pockets, in league with some unscrupulous medicos. The authorities must tighten the noose around these druggists and encourage the supply of cancer drugs at hospitals. The SKIMS drug store has many, if not all, drugs available.
The government has announced several schemes for the cancer patients but many of them lack the knowledge to avail them. On the cancer day, it is incumbent on the government to launch an awareness campaign to mitigate the sufferings of these patients.