Cancer is a diseased growth in the body. It is a devastating malignant growth that often leads to death. The word cancer has acquired evil connotations, so when something despicable and loathsome despicable and loathsome occurs, we equate it with cancer. The disease itself is the scourge of humanity. It takes a heavy toll of life. But that is not the dreadfully grievous part of the story. Before it reduces a human being to the withered estate ready for the grave, it imposes such a heavy degree of physical agony, disfigures the human body so tortuously, that the victim has only one desire left; an early release from pain into enduring peace and tranquility.
To combat this obstinate foe, the Medical Aid Foundation, an organization founded by like minded and concerned people, has been waging battle on several fronts. It has established Early Detection Centres in Mehmoodabad, Federal B Area and Neelam Colony. These provide comprehensive medical cover at nominal cost, for example, a mammography costs Rs 400, as compared to Rs 1000 to Rs 1400 in private institutions and chest x ray Rs 35, which is almost one-fourth the cost of similar x ray done elsewhere. Since these are non-profit making centres, the patients are charged merely the cost price, however, for poor patients all diagnostic tests and x rays are free and so are the treatment and medicines at Rahatkada.
Unfortunately, because of lack of knowledge, and other reason, like fear of the disease and accompanying taboos, most people admit to something seriously wrong with them only when the pain becomes unbearable. The fact that the victim may be the sole bread earner in the family compounds the problem. He or she may go on suffering silently for ages before they realize that professional help has got to be sought. Dr Saira khan, the moving spirit behind the Medical Aid Foundation, was sorry that many of the patients exhaust all manner of quack treatment before they come to professionals. “We are the last resort,” she says with regret because by then cancer has the patient in its vise”
Then also there are taboos that go with cancer. People do not want their relatives or their mohalle walas to know. “Our daughters will not get married.” Societal opinions and sanctions weigh heavily with families of the afflicted. Doctors of the Medical Aid Foundation are asked to park vehicles for away from the homes of caner victims when they go to treat them, for such vehicles can be identified as belonging to the Cancer Division of Medical Aid Foundation.
To supplement detection efforts, which are at this stage pitiably small, the Medical Aid Foundation has prepared poster in English for display, and leaflets in English, Urdu, Sindhi and Gujarati for distribution. In such literature, Medical Aid Foundation tries to create awareness that cancer can be successfully treated. It spells out the broad symptoms that might be the result of nascent or latent cancerous growth. Leaflets describe how women can themselves do the initial checking to see if they are developing breast cancer.
One of the main causes of cancer of the lungs is smoking. As part of its awareness campaign, leaflets and posters have been prepared. These describe the hazards of smoking, not only to the smokers themselves but also to the ‘passive’ smokers, like family members, little children, visitors etc. smoking, such literature proclaims, is not only unnecessary and purposeless, it also causes diseases like bronchitis and cancer of the lungs. Smokers are invited to obtain anti smoking tablets from the Foundation’s medical centres.
Another threat is Paan and Chhalia. These attack the throat and the mouth. They have got to be avoided, at all costs. The posters are large and colorful. This campaign could become more effective if organizations that want to participate, contact the Cancer Division of Medical Aid Foundation, and distribute leaflets and display these posters in the premises of their organizations. Better still, as part of public service, business houses could join hands with Medical Aid Foundation and commission artists and photographers to projects the hazards of smoking. Lung cancer is the greatest cancer threat in Pakistan.
Perhaps an ad on the lines of Bholay’s suicide that PTV used to run a few years ago could be prepared. But that one was so hilarious, the message got lost in the fun. So this one’s got to be less flippant.
By the time the disease has taken hold, many a victim finds himself neglected and ignored by his near and dear ones. The disease is so frightening that most people do not like to acknowledge that they or anyone else in their family is suffering from it. In fact the unwritten taboo is so strong and pervasive, that many cancer patients have been abandoned by their kith and kin after Rahatkada took over.
But not all is dark and hopeless on the cancer front. There is a silver lining. And that lines in the early detection of the symptoms of the disease. The earlier the detection, the greater are the chances that it may be cured. Cancer, in the earlier stages, is not inevitable terminal.
Proper care and treatment at the appropriate early time can lead to cure. Thousands of people are alive today because their cancer was detected in the nascent stage. Unfortunately, however, early diagnostic arrangement do not generally exist in the country. Hence the Foundation’s early detection centres. Research has shown that 80 percent of cancer may be prevented by proper diet, prevention of smoking and a healthy environment.
Rahatkada was established in September 91, at Hali Road, a quiet and peaceful part of PECHS, Karachi, and its present premises. In case of advanced stages of the disease, usually terminal, free treatment is provided here. This is a twenty-five bed hospice run without a single penny being charged to the patient.
Dr Saira khan has committed herself to easing the pain of this particular type of sufferers since 1971. She saw cancer patients come to public hospitals, and saw the terminally ill patients go unattended. Those in early stages and those suffering from other diseases received attention. They could at least be saved. “Given the limited resources available to hospitals, what can one expect them to do? Those that could not be saved would eat up the resources that could be used to save the lives of those not so hopelessly ill. “It is customary to apportion blame but it is not one or the other organization that should be targeted,” she says. “It is society at large which has not developed institutional arrangements to look after this specific category of affliction.” While she is obviously grateful to those who have stood by her and Medical Aid Foundation, in the final analysis it is society which is ultimately responsible for the welfare of individuals. “We are passing the hat round the year. Cancer is an expensive disease to treat; money is required for the medicines, for the radio therapy, for the X-rays, for the upkeep of the premises and the vehicles. Yes, the doctors work voluntarily, but the support staff has to be paid.”
Treatment and attendance at Rahatkada is totally free of cost. It is the first extensive nursing facility for cancer patients in Pakistan. It is a continuing care unit for advanced and terminal cancer patients. It seeks to provide compassion and care in clean and hygienic surroundings through trained personal, helping people to die in peace and with dignity. A team of dedicated staff, working round the clock in three shifts looks after the patients. Each shift consists of a doctor, two male nurses, one female nurse, one or two ward boys, and one ayah, in addition to the necessary kitchen and janitorial staff.
There can be no doubt that it is providing a much needed service. There are a few community minded ladies and gentlemen, who have been contributing monetarily quite generously. But if the Medical Foundation is to expand its services, as expand it must, more people need to pitch in.
The expansion plan consists of a larger facility proposed to be built on a three thousand square yard plot that the Defence Housing Authority has allotted to the Foundation for a larger hospice. Although the plot is available, and the design of the building has been prepared without charge by Shahid khan of Ghandhara Consultants.
Instead of large hospitals, the Medical Aid Foundation has gone for small medical centres, in low income and Katchi Abadi areas. In Karachi alone, it is estimated that about 60 such medical centres are needed.
Dr Saira khan and her staff also visit many small towns and villages in Sindh, Where in addition to treating patients at the local hospitals and distributing food packets to the poor and needy, they identify cancer patients. Such suspected cases are given fare, if they can’t afford to travel, to come to Rahatkada, where tests are conducted. If the results are positive, these patients are admitted. During Ramazan the team was at Umerkot, a sleepy town in Tharparkar where they identified seven women and one man, who subsequently came to Karachi. Six of them are getting treatment at Rahatkada.
During the floods last year, the Medical Aid Foundation team provided medical relief to those affected by the swelling Indus. While these lines will be in print the Medical Aid Foundation team will be in Dadu, where they will hold camps in two nearby villages.
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