‘You are having malignancy” or ‘it is cancer’ ~ these words uttered by a medical practitioner when we visit them for some anomalies in our body and undergo tests to unravel the nature of the disease are enough to send shivers down the spine of even those of us who are otherwise known to be mentally strong, have undergone many challenges in life and are usually hard nuts to crack. It happened to me last year. While delivering a class lecture, I started experiencing moments of disassociation or blackouts lasting for a few seconds.

After two months of medication, since the occurrences did not disappear, the doctor advised an MRI. The report showed a well formed tumor in the right part of my brain which showed all signs of malignancy. The doctor advised immediate surgery. It was a bolt from the blue. Strangely, I did not experience any fear of death, perhaps because of the fact that I had to undergo many tests, seek a second opinion, and do myriad other preparations for the impending surgery. However, what distressed me most was the fear of being incapacitated; being in a vegetative state if the surgery went wrong, which is a possibility despite spectacular advancements in medical technology. By God’s grace, the surgery went well and the doctor advised radiation and chemotherapy to contain the possibility of metastasis. I started visiting a well known medical facility in Kolkata for further treatment. On the very first day, the huge crowd at the registration desk, the chaos, the anxiety writ large on the faces of patients and their family members struck me hard.

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On subsequent days, as I waited for my turn to meet the oncologist and thereafter receive my doses of radiation and later chemotherapy, I often picked up conversations with other patients to get an insight into the nature of their ordeal. Empathy with fellow sufferers does help to assuage slightly one’s own distress. I came to know that many of them were coming from distant suburban areas. Despite considerable advancement in treatment procedure, the impact of the procedure for most patients can be physically very exhausting as side effects are often quite severe. In such conditions, travelling long hours takes a tremendous toll on the health and energy of patients.

They said they had no other option since most districts don’t have hospitals that offer proper treatment for the affliction. The huge rush of patients not only from other parts of West Bengal but from other parts of the country as well as neighbouring countries like Bangladesh, Nepal and so on is predictably putting a tremendous pressure on the infrastructure of the reputed facility. Patients have to wait longer for their turn, toilets are unclean, canteens run out of food and the suffering of patients and their family members knows no bounds. Various researches indicate that there has been a significant increase in the number of cancer patients world wide as well as in India in recent years. While lifestyle issues like smoking, alcohol consumption, consumption of processed food, aerated drinks, exposure to hazardous materials as the food we consume has higher levels of insecticides and pesticides, have been identified as contributing factors. An inexplicable genetic mutation, which has happened in my case, also is responsible for increasing incidents of malignancy.

Environmental factors are also making the scenario bleak. Escalating greenhouse gas emissions and consequent depletion of the ozone layer, as per various studies, is playing a major role in the development of malignant melanoma. People of all ages, little children, young and old, are getting hit by this fatal disease. Government facilities are extremely overcrowded and even private facilities which are quite costly and beyond the reach of common people are having a huge rush of patients, indicating how the affliction is affecting people from all walks of life. A massive boost in infrastructure, new hospitals with stateof-the-art equipment, preferably on a public-private partnership model, is the need of the hour. Most high-tech machines like the MRI machine and those used in radiation therapy are still not manufactured in India.

Parts are imported and the machines are just assembled in India, thereby causing inordinate delay in getting various crucial procedures done which can prove fatal for many patients. There goes the story of Vikshit Bharat and Atmanirbhar Bharat. In the 2022-23 financial year, India spent only a meagre 2.6 per cent of the country’s GDP on healthcare, compared to Canada, France, Japan and many other developed countries that spent more than 10 per cent of their GDP on healthcare. One can’t help being intrigued by the fact that India’s leaders keep bragging incessantly about India being the fifth largest economy of the world and the fastest growing one and yet the public healthcare system presents a sorry picture. Many oncologists of repute are leaving for greener pastures abroad as working conditions and their perks are unsatisfactory here.

Another major area of concern is the shoddy manner in which various insurance authorities, both private and public, treat the hapless patients. I have often heard patients complaining that hospital authorities refuse to entertain government health schemes, the portal not being accessible is the common refrain. As a single person depending on mostly illiterate hired help, and at a time when a grueling treatment schedule consisting of surgery, followed by radiation and chemotherapy, ravaged my physical and mental strength, I faced a humongous challenge doing the paperwork needed for submitting reimbursement claims. Needless to say, the Insurance Regulatory and Development Authority needs to be more proactive in making insurance companies more patientfriendly.

As the treatment of cancer saps the energy of the patients and makes them non-functional for a long period of time, the spread of this non-communicable disease can severely damage the country’s manpower. While I am fortunate to work in an organized sector where I have received necessary support from my authorities, those working in non-organized sectors often lose their jobs as they become incapable of work, making themselves and their families totally helpless. The government also needs to focus more on spreading awareness about cancer and extend the net of welfare measures for those in desperate need of it. Some NGOs however are doing commendable work in helping those afflicted by the disease. Finally, the psychological impact of this fatal disease is catastrophic.

The pain, an emaciated body, the jaded look and fear of death, are enough to throw one in the deep pit of depression, as the patient tends to lose the ennui to look ahead. Support from friends, family and co-workers can be of great help as it was in my case. But ultimately, the struggle is our own. I tried to tell myself that only a warrior gets scars. Remembering the words of Seneca might help, “Sometimes, just living is an act of great courage.”

(The writer is Associate Professor, Department of Political Science, Women’s Christian College, Kolkata)