Help a poor cancer patient with radiation therapy by Charutar Arogya Mandal

1) Problem
Anand and Kheda districts of Gujarat are tobacco producing areas, and as a result, tobacco is not only produced in large quantities, but is also consumed through various means in large quantities. This, together with the fact that cancer is a disease that can be cured if diagnosed early, had prompted Charutar Arogya Mandal to initiate its cancer education, awareness and early detection programmes in over 900 villages in 1999 in collaboration with the Tribhuvandas Foundation, an NGO working in maternal and infant care. The Mandal, through the project period of 10 years, has trained village health workers of Tribhuvandas Foundation in educating the community regarding cancer and benefits of early detection. These workers have also been trained in diagnosing early symptoms of cancer so that they can send those they suspect to Shree Krishna Hospital for further examination. Through its continuing extension activities in over 150 villages of Anand, Kheda and Panchmahal districts under the TATA Trusts sponsored Programme for NCDs, their efforts have continued and have been intensified. When the Project was first launched in 1999, the increasing number of cancer cases being detected led to the realisation that there had to be diagnostic and treatment facilities within the hospital that matched the best in the field. At the time, there was no facility available for treatment of cancer except in Ahmedabad.

Needy and economically less privileged families who are barely able to make the two ends meet with their meagre incomes first draw down their own savings and liquidate assets to meet treatment costs. Borrowings and financial aid from various communities, groups and friends, family and the state would be the next resort. Despite this, many people have to discontinue treatment, unable to bear the financial burden. This puts them through the grappling experience of having to helplessly watch a loved one painfully inch towards death. This is where donors and donor organizations could step in to save a precious life and prevent the family from falling into a abyss of debt which could last for over a generation in some cases.

2) Solution In the backdrop as explained above, the Mandal established the M.S. Patel Cancer Centre, a state-of-the-art facility with Radiation & Medical Oncology services in the year 2004. The Centre which was funded by Sir Dorabji Tata Trust was started with facilities for radiation and medical oncology, two Linear Accelerator, CT Simulation, 3-D Treatment Planning System, Image Guided Brachytherapy for Radiation and a full fledged Day Care Facility for the Chemotherapy. Since its inauguration by Shri Ratan Tata, the Centre has, over the last 16 years, earned the goodwill not only of the local community but also remote areas of the State.

As a result of increasing workload at the Centre over these years, and in view of the complexities of the cases received, it was necessary to add to the facilities for the radiation oncology. This was achieved with the installation of a new Linear Accelerator received with fund support from the Tata Trusts and having distinct features such as Image Guided Radiation Therapy (IGRT), and Intensity Modulated Radiation Therapy (IMRT). Considering the growing requirement for Bone Marrow Transplant procedures for blood cancers and other blood disorders such as thalassemia, the Bone Marrow Transplant facility was added in 2015 to the Cancer Centre, completing the array of Oncology services at the Hospital. Taking into account the increased inflow of patients, one more advanced Linear Accelerator was added in 2017. To enhance diagnostic capabilities, a 3 Tesla MRI machine was installed in May 2018, which enables early detection of tumours, stones and growths. The old Brachytherapy machine was replaced by a new one of Varian make in August 2020.

3) Impact The Centre, with its modern facilities and a compassionate team of clinical and para-clinical staff as well as social workers, is proving to be one of the best options available for the treatment of cancer across the state. The M.S. Patel Cancer Centre is registered on the National Cancer Grid, which is a distinction and a recognition of the extensive work being done at the Centre. Last year, the Centre of the hospital had 36097 admissions out of which around 3200 patients required Chemotherapy cycles and 4000 patients were put on Radiation therapy and 545 onco surgery of which 2200 are new patients.

Though the Centre is functional in the Anand and Kheda districts of Gujarat, it has registered patients not only from various districts of Gujarat but also from other states which include MP, Rajasthan and UP. The Centre has been receiving patients from all strata of society, out of which there are many who would not have pursued the expensive treatment of cancer, had the Mandal and the donors not supported them financially. The Centre, with the most modern technology and a range of experienced and compassionate experts and cancer caregivers has evolved as a shelter to numerous needy victims of the disease.

Patients on Radiation :

Year 2016-17 : 1290 Year 2017-18: 1442 Year 2018-19: 1696 Year 2019-20: 2102 Year 2020-21: 1617 (April'20 to Nov'20)

Charutar Arogya Mandal could treat more such patients and provide more concessions, if there was a source of fund available to fund such concessions. For the poor and needy patients who took treatment at the Cancer Centre during 2019-20 as detailed above, the total deficit towards providing concessional treatment came to Rs 2.72 cr.

To help us partly meet the deficit incurred this year due to concessional treatment at the Cancer Centre of the Hospital.

A Ray of Hope

Charutar Arogya Mandal has been managing the 30-bed Sonaba Hospital and Sadaba Prasuti Gruh for over 9 years now. Under the aegis of the Sonaba Hospital Trust, a function was organised on 27th December 2019 to dedicate a Mobile Health Clinic Van. It was donated by Dr Jayantibhai G Patel, in memory of Late Smt. Ramaben Patel for the SPARSH programme which reaches out with health-care solutions, related to non-communicable diseases, to 150 villages of Anand and Kheda districts through various initiatives such as camps, awareness programmes and interactions with students. The Van which is equipped with a fundus camera, Vibrotherm, ECG machine, facilities to check Hb1Ac, medicine dispensing etc. is expected to cover 50 villages
around Sevaliya.This would enable early diagnosis and examination of diabetic patients through village camps.

Radiation sessions in progress

Program Update

For over 2 years now, in 450 of its beds located in the “Ashirward wards”,
treatment has been made free. Admitted patients have to bear only the cost
of pharmacy and consumables. While undergoing surgery, these patients spend
only half to one third of the amount charged by other private Hospitals.
Our own as well as government schemes are being implemented to provide
succour to needy patients in terms of concession in treatment costs, which
annually amounts to over Rs 26 crores which is supported by generous
contributions from donors. It is only through the constant support and
generosity of donors that we have been able to do the kind of work that
benefits the community at large. We look forward to your continued support.

Story from the field

29 year old Mukeeta belongs Anand. Her husband Yasifbhai is a daily wage worker. Her in-laws stay with them. Though short of economic resources, they are happily married and have three children in their married life of nine years. In winter of 2018 for the last few days Mukeeta had cough and sore throat. She tried home remedies but the coughing continued. Suddenly one day while changing, she noticed a lump omn her left breast. She panicked and her mind wavered with fears of the unforeseen. She spoke to her neighbour friend who advised her to consult a doctor. The lump seemed to enlarge day by day. The skin colour & treatment texture had changed. Examination by the doctor and subsequent biopsy tests revealed that she had breast cancer. The world crashed around her. The oncologist councelled them that regarding the need for surgery, followed by radiation therapy & chemotherapy. She Examined that the estimated cost would br Rs.2 lakhs. Yasifbhai expressed to the doctor his unability to afford the treatment cost. The case was discussed within the Mandal team. Considering their family background, it was decided to treat her at subsidized rates with donor support. She was operated in April 2018. After follow ups radiation therapy & chemotherapy were started in December 2018. She has successfully completed her radiation therapy & chemotherapy. Now she has returned to her routine life with no fear whatsoever. The family is grateful for the support received from the Hospital as well as the donors.

What is the expected total number of beneficiaries in this program for FY18-19?	237
What is the number of beneficiaries/ benefits provided in this program, Year-To-Date	184
Village/City/State where project is located	Karamsad/Anand/Gujarat
Total Budget for the project for FY18-19	22500000
Total Expenses for the project YTD	17419500

Program Update

1. The Foundation Day of the Charutar Argoya Mandal was celebrated on 27th July, 2018 with narratives from patients, doctors, staff and facilitators. Employees who have completed 25 years of service were felicitated. In his address, Shri Sandeep Desai, CEO while thanking donors for their generous support to the Mandal, mentioned that less privileged patients were provided a relief to the extent of 25 percent of the Hospital income, through the various health-care schemes implemented at the Hospital.
2. The Foundation Day of the Manibhai Shivabhai Patel Cancer Centre was celebrated on 27th August, 2018. It was attended by cancer patients who shared their success stories and participated in the cultural events. Dr Rushi Panchal summarized the achievements of the Centre over the years and the expertise it offers to patients especially on consistent focussed radiation therapy, and brachytheraphy which makes the Centre unique. Ms Margaretwambu Macharia from Kenya, whose aunt has been flown in from Kenya for treatment appreciated the treatment being provided and the compassionate service by the Cancer Centre team. She also added that the Hospital is a great example of providing affordable quality healthcare to rural people.

Story from the field

Jigneshbhai lives in Vadodara with his monther, wife Hiralben, teenage son Jaymin and daughter Shitiksha. He gets up early in the morning and has to leave home in time to pick up the school children on a door-to-door basis and safely take them to school in the Van which he drives. Hiralben is very supportive as she gets up at 5 o'clock and prepares breakfast. After Jigneshbhai leaves, she gets Shitiksha ready for school. She also has to take care of her old mother-in-law. Jigneshbhai enjoys the company of his friends who are in a similar profession. Because of the monotonous nature of their work, many of them sit and smoke when they meet. That's how Jigneshbhai began smoking. His wife was not very happy to see him smoke and kept advising him to stop. But the addiction was strong so he could not resist the urge. In May 2018, Jigneshbhai had extreme throat pain & had difficulty in swallowing. He felt uneasy & could not focus on his driving. So he took few days leave, took rest at home but the pain continued. They came to Shree Krishna Hospital, Karamsad for medication. The doctor suggested Biopsy. Biopsy reports revealed that he had Cancer of Right PFS & AEF, and his right lung was affected. The Oncologist advised that he must undergo a treatment regime of chemotherapy and regular Radiotherapy. He is presently admitted at Shree Krishna Hospital, Karamsad for treatment and under nasogastric feeding. Since he is the only earning member in the family and earns a very nominal income, further treatment is beyond their means. With tears Hiralben checked with the doctor whether they could get some help. Considering their socioeconomic profile, the Mandal decided to take the responsibility to support Jigneshbhai for his Cancer treatment at subsidized rates with the support from generous donors like you. He is undergoing Radiotherapy cycles and responding well to the treatment. Both Jigneshbhai and his wife Hiralben are thankful to all donors who have contributing towards his treatment.

What is the number of beneficiaries/ benefits provided in this program, Year-To-Date	517
Village/City/State where project is located	Karamad/Anand/
Gujarat
Total Budget for the project for FY18-19	600 lakhs
Total Expenses for the project YTD	414 lakhs

Around 2000 residents of Anand, Vidyanagar and Karamsad participated in the third healthy heart Walkathon organized by Charutar Arogya Mandal on the occasion of Bhanubhai and Madhuben Patel Cardiac Centre’s Foundation Day at the Shree Krishna Hospital in October. The purpose behind the walkathon was to create awareness about the importance of adopting a healthy lifestyle. An exclusive library, The Knowledge Centre was built for the students of the Pramukh Swami Medical College and other educational institutions managed by the Mandal. World Diabetes Day was celebrated at Shree Krishna Hospital on 14 November 2017 with the theme 'Woman and Diabetes', on the occasion of which, female employees of the Mandal were addressed on care, treatment and preventive measures for Diabetes. Six students of the MBBS 2012 batch of the Pramukhswami Medical College got together and donated a wheelchair to the Cancer Centre from their savings, after performing at the annual cultural event of their college on a Cancer related theme, where they used a wheel chair as a prop. When they had clinical postings in the Palliative Care and ICU, they felt this would be the best way to make a difference.