Rs 2000 crore Assam Cancer Care Foundation project a distant dream
Assam reportedly has around 55,000 cancer patients at any given point of time. To cater to these many people, there are just a few dedicated cancer hospitals in the state. Of these, the most renowned are the Bhubaneshwar Barooah Cancer Institute (BBCI), State Cancer Institute at Gauhati Medical College & Hospital (GMCH) and the North East Cancer Hospital, located on the city’s outskirts ahead of Khanapara.
The state Ministry of Health & Family Welfare website lists just 14 cancer hospitals, institutes and cancer care centres across Assam.
The bed capacity of BBCI is 210, GMCH Cancer Hospital is 200 and the North East Cancer Hospital just 80, in the backdrop of thousands of patients.
Dr Amal Chandra Kataki, Director of BBCI, comparing the statistics of patients over 31-day period, informed that prior to the lockdown the cancer institute recorded a monthly footfall of 5,961. During the lockdown period the footfall decreased by around 50% to 3,081. For new patients that underwent radiotherapy, the numbers reduced from 330 to 147, a reduction by 56%. Chemotherapy patients reduced from 2,500 to 1,461. The routine surgeries dropped by a massive 74%.
However, the Day Care Emergency services rose from 60 patients in a month’s time, prior to lockdown to 236 patients during lockdown. Further, as the emergency surgeries increased, the number of new admissions also rose from 983 to 1,058.
Given the above statistics, does the reduction in the number of admissions and treatments signify that there was a reduction in the number of cancer patients? No.
The reduced number was probably due to the fact that as the hospital caters to many outstation patients from within Assam as well as from the other northeastern states, the lockdown has prevented them from travelling to Guwahati, until the emergency remains.
Earlier Dr Kataki had said, “For a hospital that sees around 14,000 new patients every year, any slowdown of services for cancer diagnosis and treatment would carry a significant impact on the outcome of thousands of cancer patients.”
However, the untoward happened, and the COVID-19 pandemic that has engulfed the entire globe, also touched upon the B. Borooah Cancer Institute.
After 16-year old Dipika Nath, who was posthumously detected positive of coronavirus, was linked to the staff quarters of the hospital, the entire staff quarters have been declared as containment zone since 8th May. The hospital closed all services for the day and resumed emergency services from 9th May. From 11th May only, patients taking regular radiotherapy and chemotherapy were catered to.
"As BBCI's staff quarters have been declared as containment zone, we have very limited number of health workers. So we might not be able to take in OPD patients as of now," said Dr Amal Chandra Kataki.
The hospital currently has 78 in-house patients. Reportedly, all staff and patients are tested for coronavirus. With the staff quarters under containment, BBCI has only about 10 to 12 percent of its regular staff currently in service.
An attendant of a patient from Arunachal Pradesh, speaking to G Plus lamented, “My sister was tested with stomach cancer on 6th May. The hospital closed all operations on the 8th and she along with the rest of the patients has been tested for COVID-19. We have been informed that if she is tested positive, she will be sent to GMCH and if found negative will be asked to discharge. Where will we admit her then? Her cancer treatment has not yet started although the hospital is providing drips and other necessities.”
Tarun Sonowal, a designated Social Worker of BBCI informed, “We have to wait for the COVID-19 results. We cannot be liable for our patients contacting coronavirus, as they are already the vulnerable section. We will be treating all as required. However, they have to wait in queue before their number comes and right now we have very limited staff. So the required time might be longer.”
Given the situation, the most valid question to be asked is: Does the state have enough cancer hospitals? How will the closing of regular services to its full capacity by just one hospital, the BBCI, impact the cancer scenario of Assam?
The Assam Cancer Care Foundation
The Assam Cancer Care Foundation was set up in 2017 in joint partnership of the Assam government and the Tata trust. The Rs 2000 crore project was set to establish a first-of-its-kind three-tier cancer grid in the state. The cancer project proposed to have a total of 19 cancer facilities, set up at three levels across Assam.
The government proposed the establishment of two Level-I apex cancer hospitals within the premises of the Gauhati Medical College and Hospital and the Assam Medical College and Hospital, Dibrugarh with education and public health research facilities. These would have 500 bed capacity and all necessary facilities for diagnosis and treatment.
12 Level-II hospitals with 122 beds each with almost all required facilities for cancer treatment (except a few expensive ones) would be located at all other government medical hospitals in Barpeta, Silchar, Tezpur, Karimganj, Tinsukia, Jorhat, Dhubri, Nagoan, Kokrajhar, Nalbari, Diphu and Lakhimpur.
Another 5 Level-III cancer facilities were to be established at the district hospitals of Sivasagar, Goalpara, Golaghat, Darrang and Haflong. These were only to have diagnosis facilities and ‘Day Care’ services.
Health minister Himanta Biswa Sarma, on 21st May, 2018, said that the hospitals would be operational in the next two years. Of the Rs 2000 crores, 51 percent contribution will be from the state government and the rest 49 percent was to be funded by the Tata Trust. Although the project was to be completed by April 2020, the project can be labelled almost as a non-starter as of today.
As reported by media, construction has started at 10 sites since October 2019. However, further development had to be halted due to various hitches, amongst them the CAA protest and the COVID-19 pandemic. Palliative care service has started in three hospitals viz AMCH, JMCH (Jorhat) and GMCH. Allegedly, only three oncologists and four palliative care specialists have been appointed although a total of 200 cancer specialists are required across the project.
Further, renowned oncologist, Dr Tapan Saikia, who was appointed as the Director of the cancer project, has resigned allegedly due to loss of respect and dignity. There is lack of coordination between the Tata trust and the local stakeholders and the trust does not take the local experts into confidence.
Most of Dr Saikia’s advices were allegedly left unheard and experts of the state were apparently not given the necessary opportunity to work. Apart from him, several other top medical professionals associated with the project have also made their exit supposedly due to trust issues and various other reasons.
Although sources claim that the Assam Cancer Care Foundation is lacking pace due to the alleged lack of trust and support from the Tata Trust, the main concern lies in the completion of the project.
Given the current COVID-19 crisis, both the BBCI as well as the State Cancer Institute-GMCH are within limits of the novel viruses attack. So where do the cancer patients of the state and the nearby areas get treated? Had even a few of the proposed 19 facilities been completed, at least the cancer scenario of the state would have looked satisfactory in this global health crisis.
