They come here in pain, hopeless, helpless, living for the sake of existing, suffering from a disease called cancer, and almost always pining for a peaceful place called Death. For death perhaps is the only salvation for terminally-ill patients to escape the misery. Yet, not all is so miserable for a cancer patient if he dies with his hands held warmly by a close relative or a caring attendant. And not always there is death, if the disease was detected before it took full possession of one’s body. Rightly so, Rahatkada called continuing care unit observes the motto Andheri Raat Mein Roshni Ki Kiran, (a ray of light I the darkness of night).
A place called home for advanced cancer patients coming from low income groups or those abandoned by their own people for fear of being too much involved with the ‘curse’ Rahatkada is the first and only of its kind in Pakistan. It is not a hospital, though it houses patients. It is not a medical centre, though it is manned by trained nurses and highly qualified doctors. It is a hospice though a 25-bed building in the heart of P.E.C.H.S. residential area which looks just the same as any other building around it. And perhaps much too small area wise to execute a task so great and magnanimous. Yet crisp and compact, tidy and peaceful. Perhaps for this reason pragmatically located in a fully residential area where homeliness prevails.
Dr Saira Khan, a pathologist by profession, has been for the last 20 years dealing incessantly and untiringly with cancer patients. Especially with those who have not enough resources to get proper treatment, or those without a family and a home to look after them.
In 1982, when Dr Khan, along with a handful of colleague-doctors and patrons, founded the Medical Aid Foundation (MAF), it was the first early detection cancer centre in Karachi. Although it was not until 1988 that MAF was registered with the Directorate of Social Welfare, Sindh. Within three years, three early detection centers for cancer were set up in Karachi. One in Neelam Colony, a slum in the vicinity of the posh Clifton area, the second was set up in Mehmoodabad # 6 and the third in Naseerabad, Federal B Area. As president of MAF, Dr khan saw to it that there should be proper education for every citizen, rich or poor young or old, on the prevention of cancer, awareness of the symptoms of this disease and early detection.
But the need for taking care of and looking after terminally ill cancer patients whose chances of survival are virtually nil gave birth to what is now Rahatkada, a hospice one of its kind in the country. Here human dignity is held above all virtues as the prime motive to serve. And, as Dr Khan says, “If one cannot live in peace, one can at least die in peace and dignity”. And she talks about people infested with maggots in their flesh and limbs, dying without as much a word of sympathy or a gesture of affection from anyone close by. Most are left in isolation to rot away their lives, or whatever is left of their lives.
“we do not claim to cure fully our patients, especially those in advanced stages of the disease, but at least we do try to give them relief and comfort from the excruciating pain they are in, in whatever ways we can medically, psychologically and other wise,” say Dr Saira Khan, who had started her career first with the PIA and was later attached to the Jinnah Hospital, where she is a daily visitor, although not working in the hospital on regular basis.
There are these patients occupying hospital beds, they have nowhere to go. They can’t just be sent elsewhere for want of proper attention. And they can’t be kept for long time in the hospitals as there is always a dearth of beds to accommodate new patients, who keep coming in anyway. For this very purpose Rahatkada was decide to be brought into existence by the MAF, where patients who are located to be whiling away their lives in agony elsewhere be brought in and looked after.
In September 1991, when Rahatkada was founded, Dr Saira Khan and her colleagues at MAF faced much difficulties in finding a place immediately to house Rahatkada. As Dr Saira Khan says, “People used to close the gates of their houses on our face and tell us to find a place elsewhere, as nobody was willing to rent their house for cancer patients. They used to say that nobody will ever want to live in or come even close to their house. Ultimately we did find this one on a rent of Rs 15,000 a month but we are satisfied with it, and presently we have facilities in here to look after 25 patients at a time. This is the best we could do for a start.
The average monthly expense of Rahatkada, according to Dr Khan, is around Rs 80,000 and the hospice has to depend largely on funds and donations from various organizations as also from individual philanthropists and patrons.
Rahatkada has a small but a neat kitchen of its own where food for 25 patients with their attendants, one for each patients, and the doctors on duty as well as the other staff and janitors, is cooked. Also, food is welcome from outside, provided it is uncooked so that it may be prepared hygienically and under strict medical supervision.
The food is good and for cancer patients whose appetite is generally completely lost, it is surprising that they even sometimes take as second helping, which goes on to show that with love, care and attention, not to speak of the quality of food, the cancer patients learn to live as much and as long as they can, a life oblivious of personal agonies.
Chemotherapy and radio therapy, used in treating cancer patients to relieve them of their trauma, are in themselves highly painful. Chemotherapy is usually followed by loss of hair and other metabolic disorders, and of course intense weakness.
These methods of treatment are rather expensive and the facilities are available only in select hospitals and medical centers.
Rahatkada has plans teo import a mammography machine which is essential for detecting breast cancer. Pap smear tests are however done for detecting cervical cancers and they are not that expensive. These two forms of cancer are quite common the world over and there are more females likely to be contracting cancer than males, especially in Third World countries where they are arriving to find relief in Rahatkada. Salma, 25, is suffering from breast cancer which has turned terminal. She has two children, one of them is four years old and the other one-and –a half. Her husband jilted her when he came to know of the dreadful disease and now Salma is, as they say, counting her last days with only her mother by her side.
Tamama, 48, comes from Hasanzai from the northern areas with her husband to Rahatkada, suffering from cancer of gums and lips. Dr Saira Khan talks to her in fluent Pushto and asks her if she used to chew tobacco. She replies in the negative. She is right, this writer confirms it from her husband.
Nazia, 13, has contracted limb cancer. A cancer specialist had advised that she get her limbs amputated but her parents and other family members protested vehemently. They thought she would not be able to get married. Now the disease has eaten up nearly half her body.
Muhammadi Khatoon, 54, has breast cancer. At the Aga Khan Hospital she was diagnosed terminally ill. At Rahatkada, she is praying for a peaceful end and the staff of the hospice are trying it to be so.
Najma Bibi, 50, comes from Orangi Block 14, her husband is jobless. She is more worried about his job than about her own physical misery. She contacted cervical cancer a long time ago. She too is a terminal patient and is a refugee from Bangladesh. Dr Saira talks to her in fluent Bengali and promises her that she would secure a job for her she would secure a job for her husband.
Mrs. Bachan from Balochistan, who is 57, is now facing a grim situation. Oral cancer has eaten away half her face and an eye.
These are but a few patients at Rahatkada who are counting listlessly paralyzed hours. “We have got them here so that at least maggots ma not feasts on them,” Says Dr Khan, “at least they will die in peace and dignity, with a loving and caring attendant by their side. No drug, no medicine and no surgery may be able to help them although their pain can be minimized. But sympathy would give them a sense of belonging as long as they are in Rahatkada.
Dr Khan and her colleagues have plans to open more such centers in Karachi. It would need a lot of money of course, but she is undeterred and she is hopeful. She is determined to assist the pilgrims of grief to their destination of relief.
‘O gold is great but greater far is heavenly sympathy…..’ |
