Bankruptcy is the cure for Cancer

'Cancer Cures Smoking' - this was the advert which caught my eyes over three decades ago on a family trip to Guwahati, as it is now called. Little did I understand the importance or the appeal of such a campaign and my only connect to it was a close relation of mine accompanying me, who was a chain smoker. The creativity of the advert was not good enough though to make my relative quit smoking, which he finally did after many years following lung infection.

As a ten year old boy then, cancer was very much alien to me, nor was I aware about its dreadfulness and the trauma it causes not only to the infected but also to the affected families. However, the trauma had befallen us a few years later when another close relation was diagnosed with cancer. As a teenager, I could estimate the anxiety that had gripped my family members then. Thanks to a timely intervention by the famous oncologist Dr Abani Chanda that the relative survived, despite being frail.

About 26 years later the trauma has returned again to our extended family and this time with a much grievous impact. The patient was diagnosed late and had to be shuttled between doctors and nursing homes, either because of lack of adequate facilities or with the expectation of improving the chances of her survival. Each movement was accompanied by a frustration of the delay in getting the treatment started and the rising cost in medical bill. When the choice is between spending more money and the hope (even if it is faint) of increasing the longevity of a loved person, the relatives are literally left with no option.

This is probably a typical story of any cancer patient in India. Every movement from one doctor to another involves a series of medical tests costing thousands of rupees. Although each test is carried out in clinical laboratories recognised by the government or any statutory or regulatory body, every doctor or a nursing home or a private hospital would demand a fresh set of the same examinations costing not only the patients and their families even more money but also draining out huge resources. My mother worked in a government laboratory for over three decades and I am fully aware about the cost of some of the tests that patients, suffering from life threatening diseases have to under go.

I wonder how the successive clinical tests are linked to the diagnosis or the treatment of the patients, especially when all of them are carried out in recognised pathological laboratories, or if there is a quid pro quo like in any other business. If there are failings then the concerned laboratory can be held accountable and brought to book. Often there are instances when two different medical practitioners have asked for similar tests to be carried out from the same laboratory and it beggars belief that these are guided by reasons beyond the remit of medical science. I have many friends who have taken up the noble profession of saving peoples’ lives. If they find time to read this blog and have an argument different from mine then I am ready to stand corrected.

While researching for this blog, I found that some private medical institutes, which took off in the major metropolis in India over the past decade, including some set up by non-resident Indians and foreigners, have been beneficiaries of discounted land prices and other infrastructural facilities with the promise of serving the poor. I wonder if there is any mechanism of auditing how many poor people they serve each year.

My fellow student at the School of Oriental and African Studies, Sheena Sumaria has done a wonderful piece of research on the “financialisation of health care and pensions” in developing countries for the Bretton Woods Project.

The report argues “that the privatisation reforms have failed to adequately address the social risks of old age, poverty and poor health. Far from increasing efficiency, the reforms have proved costly and have drained public resources through lavish tax incentives and significant administrative and regulatory expenses.”

The report also underlines that despite the failure of the privatisation reforms to benefit the majority, “the national governments – pressed by local elites, multilateral agencies and global corporate and financial interests – have contributed significant public resources towards enacting the reforms”.

Lack of accountability of private medical institutes and failure of the government to provide adequate services in state-run hospitals are actually leading to the pauperisation of those who suffer from life threatening diseases like cancer, so much so that, as a recent story done for the Anandabazar Patrika by Parijat Bandyopadhyay demonstrates, the families living in the lower end of the economic strata are not even willing to treat their loved ones, virtually pushing them to the throes of death.

I owe the idea behind this post to my colleague Alastair Lawson-Tancred.

The Anti-Smoking advertisement entitled "Cancer Cures Smoking" was created for the Cancer Patients Aid Association by O&M's Pushpinder Singh and Sagar Mahabaleshwarkar with the Creative Director - Mr. Piyush Pandey at the helm in 2003. It was awarded the Gold Lion in the category 'Outdoor Public Health' at the Cannes Lions International Advertising Festival held in Cannes, France in June 2003.