Thursday, April 10, 2014

Life at stake

None to care

Shah Jahan Begum, her son and husband (back to the camera) at AIIMS on Monday. Picture by Yasir Iqbal
The armed uprising led by the Mizo National Front in the 1960s, triggered by a famine linked to the 50-year cyclic flowering of bamboo, has long been gone. Mizoram has been labelled an island of peace — even earning a financial bonus from the Centre for the feat — and prospered.
But a new threat is now gnawing at the vitals of the hill state — cancer.
People gripped by this deadly disease, it appears, are still waiting for the right government to address their plight.
Political parties fighting the April 11 election to the state’s single Lok Sabha seat and the Hrangturzo Assembly seat appear to have no thoughts to spare for the welfare of Mizoram’s cancer patients, say local community leaders.
H.P. Vanlalengmawia, a 42-year-old pastor who established the Mizoram Cancer Care Foundation, an organisation of cancer patients and survivors, laments that the Mizoram government has not provided enough to manage the state’s huge population of cancer patients.
“Cancer is one of the most important issues politicians and political parties need to address,” said Vanlalengmawia, aka Maenga.
Mizoram has a population of 1.1 million, but 189 cancer patients for every 100,000 people. Aizawl district has the country’s highest incidence of cancer — 273 per 100,000 men and 227 per 100,000 women, more than twice Delhi’s incidence figures of 125 for men and 120 for women.
A population-based registry run by the Indian Council of Medical Research shows that stomach cancer is the most common among men in Mizoram, making up 23 per cent of cancer cases, followed by cancers of the oesophagus and the lungs. Cancers of the lungs, cervix, and breast are the most common among women in Mizoram.
“An average of three persons in Mizoram gets cancer every day,” said Jeremy L. Pautu, director of the Mizoram State Cancer Institute. Four districts in Mizoram — Aizawl, Kolasib, Mamit, and Serchhip — are among India’s top 10 districts in the incidence of cancer among men and women.
It was the government’s lack of a support system that prompted Maenga, himself a cancer survivor, to form the foundation three years ago.
Outside the main gate of the Mizoram State Cancer Institute (MSCI) at Zemabawk on the eastern outskirts of Aizawl, the foundation set up a 14-bed inn for cancer patients who come from outside Aizawl, relying mainly on donations from generous people. With a room rent of just Rs 5 per night, the inn provides free meals to the inmates. Owing to the growing demand, the foundation is planning to build another inn nearby.
“We have laid a concrete foundation with donations. We have more than once sought funds from both the MPs (of the Lok Sabha and the Rajya Sabha) to complete the building but to no avail. They have given us verbal assurances which are yet to materialise,” Vanlalengmawia said.
Robert Romawia Royte, the nominee of the United Democratic Front (UDF), an electoral alliance of eight Opposition parties, had visited the inn as the chief managing director of Northeast Consultancy Services before his nomination.
“Besides donating some money, he promised us every possible assistance. We have high hopes from him,” Vanlalengmawia said, adding that they also hope that the current MP, C.L. Ruala, would do something in his next term if he gets re-elected.
However, none of the candidates has made any commitment towards the welfare of cancer patients.
At present, 735 people have enrolled in the foundation. “We need more awareness campaigns to enrol more members.”
Given the high incidence of cancer in the state, the membership would be in thousands if all patients are enlisted.
For many years before local facilities sprang up, doctors in Mizoram had to refer patients to distant cities, mainly to the Christian Medical College, Vellore, and the Tata Memorial Centre, Mumbai. This was also another big factor behind the formation of the Mizoram Cancer Care Foundation.
At the initiative of the foundation, the Mizoram government has upgraded the Regional Cancer Centre at Zemabawk (which was earlier equipped with only daycare facilities) into a full-fledged hospital, Mizoram State Cancer Institute. But the hospital is still under-staffed and in need of adequate equipment. Around three-fourths of the 1,200-odd patients diagnosed with cancer each year receive treatment here.
Mazami Ralte, vice-president of the Mizoram Cancer Care Foundation, who also is a survivor of breast cancer, feels that the government does not give enough care to cancer patients.
“Despite the fact that Mizoram was dubbed the cancer capital of India many years ago, the state government set up the cancer hospital only last year. Even this hospital is far from being equipped with adequate facilities,” she said.
“As many cancer patients are from economically backward families, the state government should subsidise expensive treatment like chemotherapy as they do in big hospitals like Tata Memorial Hospital,” she said.
Chief minister Lal Thanhawla and his wife Lal Riliani are ardent campaigners against tobacco, which is said to be one of the causes of the high prevalence of cancer in Mizoram.
The chief minister, in most of his public speeches, has said it’s a shame for a Christian state to have such a high incidence of cancer. However, such remarks do not always go down well with the cancer patients.
“Such remarks make it look like the patients self-inflicted the disease through heavy consumption of tobacco. The fact is, more than two-thirds of cancer patients, including me, do not consume tobacco,” Vanlalengmawia says.
A plan to upgrade the state cancer hospital into a tertiary care cancer centre is likely to improve diagnostic and treatment facilities in Mizoram. The Centre has already approved Rs 45 crore for the plan, said a state health official.
“This will significantly improve facilities for patients,” says Eric Zomawia, a doctor who’s been documenting cancer in Mizoram for over a decade and heads the state’s efforts to prevent cancer, cardiovascular disease and diabetes. “The cancer centre will have more beds and machines like the linear accelerator (used in radiotherapy).”
Mizoram votes on April 11